Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer

Pigazzi, Alessio; Luca, Fabrizio; Patriti, Alberto; Valvo, Manuela; Ceccarelli, Graziano; Casciola, Luciano; Biffi, R.; Garcia‐Aguilar, Julio; Baek, Jeong‐Heum

doi:10.1245/s10434-010-0909-3

Cited by 234 publications

(192 citation statements)

References 27 publications

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“…Pigazzi et al also showed a benefit in terms of shortening the learning curve in rectal surgery using a robotic platform. 71 They reported a reduction in operative time during the first 20 cases of robotic, with a rapid transfer of surgical skills from open to the robotic approach. This result was consistent with reports by other surgeons with limited experience in minimally invasive colorectal surgery.…”

Section: Applicability Of the XI -Overcoming The Learning Curvementioning

confidence: 99%

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Ngu¹,

Tsang²,

Koh³

2017

RSRR

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Abstract:The Xi is the latest da Vinci surgical system approved for use in colorectal surgery. With its novel overhead architecture, slimmer boom-mounted arms, extended instrument reach, guided targeting, and integrated auxiliary technology, the Xi manages to address several limitations of earlier models. The versatility of this new system allows it to be implemented in a wide range of colorectal procedures -from complex multiquadrant colectomies to challenging mesorectal dissections in the pelvis. While commonly criticized for its cost and prolonged operative time, robotic colorectal surgery holds the potential for enhanced ergonomics, superior precision, and a reduction in the learning curve involved in training an expert surgeon. This review appraises the existing literature on robotic colorectal surgery while elaborating how the improved capabilities of the Xi serve to usher in a new era of minimally invasive colorectal surgery.

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Section: Applicability Of the XI -Overcoming The Learning Curvementioning

confidence: 99%

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Ngu¹,

Tsang²,

Koh³

2017

RSRR

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show abstract

“…They also found that the robotic surgery group had significantly decreased length of hospital stay, increased number of harvested lymph nodes and extent of distal margin. Pigazzi et al (2010) reported a multicentre study on the role of robot-assisted tumourspecific rectal surgery (RTSRS) to verify, on a multicentre basis, the peri-operative and oncologic outcome of RTSRS. The study included 140 consecutive patients undergoing RTSR in three centres.…”

Section: Learning Curve In Robotic Rectal Surgerymentioning

confidence: 99%

Laparoscopic Surgery for Rectal Cancer: Approaches, Challenges and Outcome

Aly¹

2012

Contemporary Issues in Colorectal Surgical Practice

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“…206 Only a few papers have assessed the learning curve for RRR. Specifically, Pigazzi et al 207 reported how operative time decreased after 20 consecutive procedures, while D'Annibale et al 208 obtained a decrease in mean operative time from 312.5 minutes in the first 25 procedures to 238.2 minutes in the last ten (P=0.002).…”

mentioning

confidence: 99%

“…207,221 Moreover, new devices, such as fluorescence in situ, picture-in-picture technology, navigation surgery through virtual reality software, 222 and EndoWrist manipulation adapted to sealing devices could increase the advantages of robotic procedures, even for pure laparoscopy. For example, indocyanine green and fluorescence imaging are currently applied for ureter localization, node mapping, biliary anatomy, and bowel vitality appraisal.…”

mentioning

confidence: 99%

Gastrointestinal robotic surgery: challenges and developments

Becchini¹,

Annecchiarico²,

Marino³

et al. 2015

RSRR

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Abstract:The rapid diffusion of new technologies in surgery, together with high expectations of both patients and the mass media, has led to many gastrointestinal procedures being approached using robots. Robotic technology seems to resolve many of the drawbacks of laparoscopic advanced procedures, such as anastomotic reconstructions, accurate lymphadenectomy, and vascular sutures. In addition, a deeper tridimensional steady vision with excellent high definition, the EndoWrist technology offering seven degrees of freedom, tremor filtration, scaled motion, optimal working ergonomics, and avoidance of the 'fulcrum effect', are the main strengths of the da Vinci ® system. The use of near-infrared technology and the possibility of tutoring through a double-console will most likely add many more advantages of this technology over laparoscopy alone. However, none of the gastrointestinal robotic interventions has reached a level of evidence-based efficacy that enables it to be routinely applied. The main limitations of robotic gastrointestinal procedures are represented by the learning curve, the higher costs of robotic surgery compared to traditional and laparoscopic surgery, and the longer operation times, including setup and organizational troubles. Moreover, while the limits of robotics for benign diseases are mainly represented by technical issues, oncologic outcomes remain the foundation of any procedures to cure malignancies, and long-term follow-up is still lacking. On the other hand, a word of caution should be presented on the adoption of robotics in too many surgical units without the correct and formal technical background and third-party control to guarantee the best outcomes for patients at minimum risk. Therefore, the robotic treatment of gastrointestinal diseases requires a thorough analysis of the published evidence, in order to determine the correct indications and patient selection. This review aims to examine the evidence for the use of robotic surgery in both malignancies and benign disease arising from the gastrointestinal area. Future developments in robotics and ongoing areas of research are also analyzed.

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Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer

Abstract: RTSRS is a safe and feasible procedure that may facilitate mesorectal excision. Randomized clinical trials and longer follow-up are needed to evaluate a possible influence of RTSRS on patient survival.

Cited by 234 publications

References 27 publications

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Laparoscopic Surgery for Rectal Cancer: Approaches, Challenges and Outcome

Gastrointestinal robotic surgery: challenges and developments

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