Laparoscopic robotic-assisted gastrointestinal surgery: a Geneva experience

Abstract

The continuing development of robotic surgery supports its use in laparoscopic gastrointestinal surgery. Our study retrospectively reviewed the surgical outcome and patient's satisfaction of gastrointestinal laparoscopic robotic procedures. From January 2003 to September 2007, 94 patients (27 women, 67 men) with a mean age of 53 years (range 19-84 years) underwent laparoscopic surgery with a da Vinci robotic system. There were 40 colorectal cases (43%), 31 anti-reXux surgery cases (33%) and 14 obesity surgery cases (15%); the remaining cases consisted of gastric and gallbladder surgery, intra-abdominal tumour excisions, and hepatic cyst resections. The majority of the cases (88, 94%) were performed for benign disease.The mean operative time was 153 min (range 60-330 min). One patient needed a blood transfusion. The mean body mass index was 25 (range 16-47). No death occurred. Five cases (5.3%) were converted to conventional laparoscopic surgery (n = 3) or to laparotomy (n = 2). Morbidity consisted of one Nissen redo surgery to loosen a tight anti-reXux valve 6 days after robotic surgery, a robotic left ureter repair and pelvic haemorrhage following proctectomy requiring re-operation to control haemostasis and to remove pelvic haematoma. Mean follow-up time was 11 months (range 15 days to 34 months). One case of incisional trocar hernia needed re-operation. Overall patient's satisfaction was high: few scars were cheloïd, while functional surgical outcome was rated high by most of the patients. Our preliminary experience was encouraging, with minimal morbidity and very high acceptance by patients.

Robotic‐assisted colon and rectal surgery: a systematic review

“…In total 20 studies fulfilled the inclusion criteria and were included in this review. Fourteen studies were case series, one of which was also a comparative study with conventional laparoscopy . Three were case control studies , two comparative nonrandomized trials and one study was a retrospective analysis of prospectively collected data .…”

Robotic‐assisted bariatric surgery: a systematic review

“…Following careful screening, all 22 primary studies met the inclusion criteria. These included one randomized controlled trial7, three prospective cohort studies14–16, 18 case‐series17–34. Six of the included studies involved restrictive bariatric procedures, thirteen studies involved malabsorptive procedures and three involved both.…”

Robotic colonic resection

“…Multiple reports have also demonstrated that robotic left colectomy and sigmoid resection are technically feasible and safe . A list of retrospective studies comparing the efficacy of robotic with laparoscopic sigmoid or left colectomy is summarized in Table .…”