Robotic Assisted Surgery in Pediatric Gynecology: Promising Innovation in Mini Invasive Surgical Procedures

Nakib, Ghassan; Calcaterra, Valeria; Scorletti, Federico; Romano, Piero; Goruppi, Ilaria; Mencherini, Simonetta; Avolio, Luigi; Pelizzo, Gloria

doi:10.1016/j.jpag.2012.09.009

Cited by 26 publications

(28 citation statements)

References 14 publications

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“…Um robô industrial foi utilizado para colocar uma sonda durante a realização de uma biopsia no cérebro, usando a orientação de um tomógrafo computadorizado. Estudos recentes indicam que cerca de 50% das cirurgias passaram a usar robôs depois de apenas um ano da sua introdução nos hospitais (Nakib et al, 2013). O mesmo se observa no tratamento do câncer, o que reforça a necessidade de estudos a respeito da viabilidade econômica e da segurança dos pacientes (Baek et al, 2012).…”

Section: Robótica Na Saúdeunclassified

A Cirurgia Robótica nas Organizações Públicas de Saúde: O Caso do Instituto Nacional do Câncer (INCA)

Pitassi

Gonçalves

Barbosa

et al. 2016

Adm. Púb. e Gest. Social

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Resumo: O objetivo deste artigo é analisar o processo de implantação da cirurgia assistida por robótica no Sistema Único de Saúde (SUS) por meio de um estudo de caso realizado no Instituto Nacional de Câncer (INCA). Trata-se de um estudo teórico empírico com abordagem qualitativa, cujos dados foram coletados por meio de observação participante, documentos internos e entrevistas semiestruturadas. As evidências obtidas indicam a relevância do caso INCA para a incorporação definitiva da cirurgia robótica no SUS. Por um lado, relatos da área clínica não deixaram dúvidas dos benefícios da tecnologia para a qualidade de vida dos pacientes. Por outro, colheram-se indícios da falta de um consenso mais amplo sobre a relação custo-efetividade da robótica em hospitais públicos de países com o perfil social, econômico e demográfico brasileiro. Também há indícios de que o processo de adoção pelo SUS de tecnologias médicas de ponta não é uma decisão com critérios claramente definidos. Assim sendo, a inclusão dos procedimentos na tabela de remuneração revelou-se o grande desafio no processo de difusão da cirurgia robótica no SUS. Palavras-chave: gestão em saúde; inovação; difusão; tecnologia; cirurgia robótica. Abstract:The purpose of this article is to analyze the process of diffusion of surgery assisted by robotics in the Unified Health System (SUS) through a case study conducted at the National Cancer Institute of Brazil (INCA). This is a theoretical, empirical and qualitative study, whose data were collected through participant observation, internal documents and semi-structured interviews. The evidence collected indicates the relevance of INCA for the definitive incorporation of robotic surgery in SUS. Reports from the clinical area left no doubt of the benefits of robotic surgery to the quality of life of patients. However, indications were collected demonstrating the lack of consensus on the cost-effectiveness of robotic in public hospitals in countries with Brazilian social, economic and demographic profile. There are also indications that the process of adoption by SUS of state of the art medical technologies is not a decision with clearly defined criteria. Thus, the inclusion of procedures in the compensation table proved to be the major challenge in the diffusion process of robotic surgery into the SUS.

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Section: Robótica Na Saúdeunclassified

A Cirurgia Robótica nas Organizações Públicas de Saúde: O Caso do Instituto Nacional do Câncer (INCA)

Pitassi

Gonçalves

Barbosa

et al. 2016

Adm. Púb. e Gest. Social

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“…One paper from Italy reported on six pediatric robot-assisted surgeries for adnexal pathologies. They concluded that the initial results suggest the robotic approach is safe in the pediatric population however further studies are required to assess the safety and the limits of the approach [49].…”

Section: Pediatric Gynecologymentioning

confidence: 99%

Gynecological Surgery and the Robot

O’Sullivan¹,

O’Reilly²

2014

ENG

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As the only robotic device with FDA approval for gynecological surgery, the da Vinci ® Surgical System dominates robot-assisted surgery in the field. Benefits to the Surgeon include decreased risk of neck and back injury secondary to improved ergonomics. However, patients benefit greatly due to decreased length of stay, decreased blood loss and analgesic requirements. Unfortunately the initial economic impact of purchasing and maintaining a robot is great but must be balanced with the potential savings from reduced length of stay and earlier return to normal activity. This article looks at the indications for robot-assisted surgery in gynecology. Assessing the efficacy of this modality compared to both straight stick (Laparoscopy) and open procedures. We discuss the impact and implications for surgical training imposed by robotic surgery. Furthermore, we assess the safety of robotic surgery from both the surgeons prospective and as a surgical modality.

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“…17,20 Almost universally, authors commented that the dexterity of seven degree-of-freedom articulated instruments, along with intuitive master-slave control permitted more meticulous dissection during tumor extirpation. 17,20,22,23,27,28,31,[33][34][35][36]38,39 Tremor filtration and motion scaling capability were also noted to facilitate greater instrument control and precision. 20,28,34 When intracorporeal suturing was required, this was considered an easier and quicker task to perform.…”

Section: Technical Advantagesmentioning

confidence: 99%

“…22 Interestingly, by using the distal instrument shaft to mechanically elevate the abdominal wall directly over the operative site, Nakib et al felt lower pneumoperitoneum insufflation pressures may be used compared with conventional laparoscopy without affecting instrument tip dexterity, as more distal degrees of freedom are used for tissue handling. 35 High-definition stereoscopic optics was reported to contribute to enhanced recognition of the operative field and subsequent tissue manipulation. 17,20,22,23,27,28,31,[33][34][35][36]38,39 These remarks are supported by findings of a comprehensive bench-top experiment by Jourdan et al who established that stereoscopic vision improves task performance and accelerates the learning curve.…”

Section: Technical Advantagesmentioning

confidence: 99%

“…Lack of tactile feedback (haptics) was frequently cited as a primary technical concern. 17,19,23,28 Several authors commented that this was partially compensated by visual cues provided through the enhanced optics 17,35 and experiencerelated factors. 23 Both of the two major oncological complications were discussed as possibly contributed by diminished tactile feedback.…”

Section: Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

et al. 2013

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Robotic Assisted Surgery in Pediatric Gynecology: Promising Innovation in Mini Invasive Surgical Procedures

Cited by 26 publications

References 14 publications

A Cirurgia Robótica nas Organizações Públicas de Saúde: O Caso do Instituto Nacional do Câncer (INCA)

A Cirurgia Robótica nas Organizações Públicas de Saúde: O Caso do Instituto Nacional do Câncer (INCA)

Gynecological Surgery and the Robot

Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

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