Robotic assisted surgery for gynaecological cancer

Lu, Donghao; Liu, Zhihong; Su, Gang; Liu, Dan; Zhou, Xiaoyan

doi:10.1002/14651858.cd008640.pub2

Cited by 14 publications

(6 citation statements)

References 55 publications

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“…Under these experimental conditions, and with the aid of a high density recording system, any observed stimulus – dependent change in interhemispheric coherence cannot be ascribed to the influence of a common reference, each hemisphere having its own independent reference electrode [46,47]. Another problem for a high-density EEG is about spurious coherence due to volume conduction effects: however, since we were mainly interested in comparing coherence between contrasting surgical approaches, rather than assessing contribution of different cortical areas, concerns about volume conduction are of secondary relevance [33]. …”

Section: Methodsmentioning

confidence: 99%

“…To date, the choice between laparoscopy and robotic surgery has been made on the basis of the surgeon’s experience only: there is no evidence in literature that robotic procedures are better than laparoscopy or open surgery and no randomized trial regarding this issue has been reported yet. Today, robotic procedures are extensively used in a wide number of surgical applications, ranging from the management of gynecologic malignancies [31-33] to resection of urinary [34-36] and digestive tract tumors [37,38]. …”

Section: Introductionmentioning

confidence: 99%

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How does a surgeon’s brain buzz? An EEG coherence study on the interaction between humans and robot

et al. 2013

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IntroductionIn humans, both primary and non-primary motor areas are involved in the control of voluntary movements. However, the dynamics of functional coupling among different motor areas have not been fully clarified yet. There is to date no research looking to the functional dynamics in the brain of surgeons working in laparoscopy compared with those trained and working in robotic surgery.Experimental proceduresWe enrolled 16 right-handed trained surgeons and assessed changes in intra- and inter-hemispheric EEG coherence with a 32-channels device during the same motor task with either a robotic or a laparoscopic approach. Estimates of auto and coherence spectra were calculated by a fast Fourier transform algorithm implemented on Matlab 5.3.ResultsWe found increase of coherence in surgeons performing laparoscopy, especially in theta and lower alpha activity, in all experimental conditions (M1 vs. SMA, S1 vs. SMA, S1 vs. pre-SMA and M1 vs. S1; p < 0.001). Conversely, an increase in inter-hemispheric coherence in upper alpha and beta band was found in surgeons using the robotic procedure (right vs. left M1, right vs. left S1, right pre-SMA vs. left M1, left pre-SMA vs. right M1; p < 0.001).DiscussionOur data provide a semi-quantitative evaluation of dynamics in functional coupling among different cortical areas in skilled surgeons performing laparoscopy or robotic surgery. These results suggest that motor and non-motor areas are differently activated and coordinated in surgeons performing the same task with different approaches. To the best of our knowledge, this is the first study that tried to assess semi-quantitative differences during the interaction between normal human brain and robotic devices.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How does a surgeon’s brain buzz? An EEG coherence study on the interaction between humans and robot

et al. 2013

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“…Very limited randomized trials of robotassisted laparoscopy versus conventional laparoscopy did not show an advantage for robot assistance [7][8][9]. Recent Cochrane reviews of robot-assisted surgery in both benign disease [10] and malignant disease [11] equally failed to find a benefit in terms of patient outcome. Randomized trials for cancer surgery are scarce and have not yet yielded public data, such as the only trial running for radical surgery in cervical cancer comparing robot-assisted laparoscopic radical hysterectomy with conventional laparoscopic radical hysterectomy [12].…”

Section: Methodsmentioning

confidence: 99%

Robotic Surgery for Gynaecologic Cancer: An Overview

Verheijen

Zweemer

2012

Curr Oncol Rep

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After decades of reluctance to change surgical approaches, new technologies have created new perspectives for surgery. Initially, the laparoscopic approach was considered to be only one useful for relatively simple procedures as the design of the instruments and the limited access hampered free movements to perform complicated surgery. Robotic systems overcame this problem and boosted the use of minimally invasive techniques also for radical gynaecological surgery. Robot-assisted laparoscopy can now routinely be used for the surgical treatment of early or downstaged cervical carcinoma, endometrial carcinoma and staging of early ovarian carcinoma. Robot-assisted laparoscopy has proven to be feasible, although the benefits for the patient are less clear than those for the surgeon. The main advantage of robot-assisted laparoscopy over conventional laparoscopy is probably not that it is safer or better, but that it allows more types of radical surgery to be performed and that it prevents the surgeon from developing complaints and muscular conditions that interfere with the ability to perform surgery. New applications have emerged with the introduction of new devices to be used in conjunction with the robotic system as well as with totally new robotic systems. Training in these new tools should be more systematic and structured to allow their safe introduction and use.

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“…los estudios han sido relativamente pequeños, no aleatorios y limitados a centros y cirujanos altamente especializados, Sin embargo, posteriormente se ha publicado 4 metaanálisis que demuestran la factibilidad, seguridad y eficacia de la técnica (43) . Se evaluaron 2 913 pacientes operadas mediante cirugía robótica, 2 196 por laparoscopia y 1 219 por cirugía abierta (44)(45)(46)(47) , estableciéndose resultados similares excepto por la menor pérdida sanguínea y menor frecuencia de conversión (a laparotomía) en las pacientes tratadas con cirugía robótica. La cirugía laparoscópica y la cirugía robótica tradicional mantienen sus ventajas en comparación a la laparotomía en cuanto a pérdida sanguínea, transfusión de glóbulos rojos, complicaciones post y perioperatorias, infección de herida operatoria, dolor postoperatorio, tiempo de recuperación y estancia hospitalaria (43) .…”

Section: Cirugía Robóticaunclassified

Laparoscopia en cáncer de endometrio

Zevallos¹

2018

Rev peru ginecol obstet.

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El estadiaje quirúrgico es esencial en el manejo de las pacientes con cáncer de endometrio aparentemente confinado al útero. La cirugía mínimamente invasiva (CMI) con su enfoque laparoscópico convencional o más recientemente mediante robótica asistida por laparoscopia se han convertido en el estándar de manejo gracias a sus ventajas en cuanto a pérdida sanguínea, estancia hospitalaria y calidad de vida en comparación a la laparotomía. La linfadenectomía pélvica y paraaórtica como parte del estadiaje quirúrgico es determinante del pronóstico y marca la pauta del tratamiento adyuvante; y aunque aún es controversial en cuanto a su valor terapéutico, es factible mediante CMI. La realización del ganglio centinela con menores compliaciones intraoperatorias y morbilidad postoperatoria puede ser considerada como una alternativa a la linfadenectomía, sobretodo teniendo en cuenta el valor agregado de permitir detectar enfermedad ganglionar metastásica de bajo volumen mediante inmunohistoquimica.

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Robotic assisted surgery for gynaecological cancer

Cited by 14 publications

References 55 publications

How does a surgeon’s brain buzz? An EEG coherence study on the interaction between humans and robot

How does a surgeon’s brain buzz? An EEG coherence study on the interaction between humans and robot

Robotic Surgery for Gynaecologic Cancer: An Overview

Laparoscopia en cáncer de endometrio

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