Robotic-assisted aortic surgery with and without minilaparotomy for complicated occlusive disease and aneurysm

Lin, Judith C.; Kaul, Sanjeev; Bhandari, Akshay; Peterson, Edward L.; Peabody, James O.; Menon, Mani

doi:10.1016/j.jvs.2011.06.103

Cited by 24 publications

(14 citation statements)

References 20 publications

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“…Notably, similar to our series, nearly all patients began a solid diet on POD 2, and the mean hospital stay was 5 days. Similarly, low mortality and conversion rates have also been reported by Novotný et al 15 (0% mortality, 5% conversion), Jongkind et al 16 (3% mortality, 14% conversion), and Lin et al 17 (0% mortality, 4% conversion).…”

Section: Discussionsupporting

confidence: 70%

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

Colvard

Georg

Lejay

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

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Objective Internal iliac artery (IIA) preservation is associated with improved outcomes after both open and endovascular aortoiliac aneurysm repair. Total robotic laparoscopic repair of aortoiliac aneurysms has been reported in the past, but not in combination with sutureless anastomosis applied to the IIAs. The objective of this study was to demonstrate the feasibility of the total robotic laparoscopic technique including a method of deploying the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) using robotic instruments. Methods Between June 2015 and December 2016, four patients underwent total robotic laparoscopic repair of isolated common iliac artery (CIA) aneurysms. Two patients had unilateral aneurysms and two had bilateral aneurysms. Unilateral CIA aneurysms were treated with a graft from the proximal CIA to the proximal external iliac artery, and bilateral CIA aneurysms were treated with a bifurcated graft between the distal aorta and both proximal external iliac arteries. The nitinol reinforced section of the GHVG was then inserted and deployed into the corresponding IIA, and the nonreinforced segment was sewn in an end-to-side fashion to the iliac graft. Results The median age of patients was 55.5 years (range, 48-64 years); median body mass index was 24.9 kg/m 2 (range, 23-26.4 kg/m 2 ). All four cases were technically successful. Operative times were 325 and 332 minutes for unilateral cases and 491 and 385 minutes for bilateral cases. For the entire series, median proximal clamping time was 143 minutes (range, 110-163 minutes), and the median time to deploy the GHVG was 15 minutes (range, 8-27 minutes). The median estimated blood loss was 1800 mL (range, 800-2100 mL). Intraoperative cell salvage was used in all cases. No intraoperative or postoperative complications occurred. No patient required blood transfusion. All patients tolerated a regular diet on postoperative day 2 and were discharged on postoperative day 4. Patients returned to work and full physical activity within 6 weeks (range, 2-6 weeks). At 6-month follow-up, computed tomography angiography demonstrated 100% patency of iliac artery grafts as well as of the GHVGs. Conclusions Total robotic laparoscopic CIA aneurysm repair is feasible in both unilateral and bilateral cases in carefully selected patients. The GHVG can be successfully deployed using robotic technique for IIA preservation during total robotic CIA aneurysm repair.

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Section: Discussionsupporting

confidence: 70%

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

Colvard

Georg

Lejay

et al. 2019

Journal of Vascular Surgery Cases, Innovations and Techniques

View full text Add to dashboard Cite

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“…52 The inferior mesenteric artery can also be ligated easily with conventional laparoscopy, whereas robotic technology facilitates clipping of lumbar side branches owing to the increased flexibility of the instruments, improved access to these arteries, and easier placement of the clips. 52 Thromboendarterectomy Generally, surgical thromboendarterectomy of the aorta and pelvic artery is rarely performed. This also applies to robotic surgery, because the presence of isolated stenotic lesions in this region is commonly an indication for percutaneous balloon angioplasty.…”

Section: Resultsmentioning

confidence: 99%

Robotic technology in cardiovascular medicine

et al. 2014

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Robotic technology has been used in cardiovascular medicine since the late 1990s. Interventional cardiology, electrophysiology, endovascular surgery, minimally invasive cardiac surgery, and laparoscopic vascular surgery are all fields of application. Robotic devices enable endoscopic reconstructive surgery in narrow spaces and fast, very precise placement of catheters and devices in catheter-based interventions. In all robotic systems, the operator manipulates the robotic arms from a control station or console. In the field of cardiac surgery, mitral valve repair, CABG surgery, atrial septal defect repair, and myxoma resection can be achieved using robotic technology. Furthermore, vascular surgeons can perform a variety of robotically assisted operations to treat aortic, visceral, and peripheral artery disease. In electrophysiology, ablation procedures for atrial fibrillation can be carried out with robotic support. In the past few years, robotically assisted percutaneous coronary intervention and abdominal aortic endovascular surgery techniques have been developed. The basic feasibility and safety of robotic approaches in cardiovascular medicine has been demonstrated, but learning curves and the high costs associated with this technology have limited its widespread use. Nonetheless, increased procedural speed, accuracy, and reduced exposure to radiation and contrast agent in robotically assisted catheter-based interventions, as well as reduced surgical trauma and shortened patient recovery times after robotic cardiovascular surgery are promising achievements in the field.

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“…Data extraction was performed on these 13 remaining papers. This included three retrospective analyses, [22][23][24] nine case reports and series, 19,20,[25][26][27][28][29][30][31][32] and one technical case report. 33 This search strategy is shown in Figure 1 and is based on the PRISMA flow diagram systematic reviews.…”

Section: Systematic Search Strategymentioning

confidence: 99%

“…Twenty-six cases adopted a fully transperitoneal approach using >3 abdominal trochars to achieve triangulation. 19,20,23,24,26,28,31,33 Sac fenestration is described by Touma et al in their paper with diagrams and pictures 33 and is a novel approach unique to their centre. They clipped off all aortic collaterals, followed by employing laparoscopic scissors to incise the sac and the thrombus was removed thereafter.…”

Section: Procedural Technique and 30-day Outcomesmentioning

confidence: 99%

Laparoscopic ligation of Type II endoleaks following endovascular aneurysm repair: A systematic review

et al. 2018

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Robotic-assisted aortic surgery with and without minilaparotomy for complicated occlusive disease and aneurysm

Cited by 24 publications

References 20 publications

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

Total robotic iliac aneurysm repair with preservation of the internal iliac artery using sutureless vascular anastomosis

Robotic technology in cardiovascular medicine

Laparoscopic ligation of Type II endoleaks following endovascular aneurysm repair: A systematic review

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