Robotic Colorectal Surgery: A Systematic Review

Alasari, Sami; Min, Byung Soh

doi:10.5402/2012/293894

Cited by 83 publications

(59 citation statements)

References 48 publications

(79 reference statements)

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“…Another motivation was the ergonomic benefits that the robot is anticipated to offer to the surgeon. With the surgeon using natural hand movements 147 and sitting at the console, 148 the awkward and unnatural positions often required during laparoscopy are removed. This suggests motivation to undertake RAS would be greater among those surgeons who were familiar with Intuitive Surgical's marketing of the da Vinci robot and/or the published literature on the clinical and ergonomic benefits of RAS.…”

Section: Issues Of Implementationmentioning

confidence: 99%

“…147 The scrub practitioner and circulating practitioner need to acquire new skills and need to learn their part in draping and docking the robot, how to change instruments, and troubleshooting. 164,165 The first assistant will need to learn all of this, as well as have an understanding of basic laparoscopic surgery.…”

Section: A Realist Review Of Stakeholders' Theoriesmentioning

confidence: 99%

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A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/04. The contractual start date was in September 2013. The final report began editorial review in September 2016 and was accepted for publication in February 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department...

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Section: Issues Of Implementationmentioning

confidence: 99%

Section: A Realist Review Of Stakeholders' Theoriesmentioning

confidence: 99%

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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“…Technically, this system provides high-definition three-di mensional vision, filters physiological tremor, provides a human wrist-like motion and offers stable camera control with better ergonomics 2,3 . Low versus high ligation remains a controversial issue in the literature, and no consensus yet exists.…”

Section: Discussionmentioning

confidence: 99%

Robotic low ligation in rectal cancer: How we do it

Nk¹

2013

OA Robotic Surgery

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IntroductionHigh versus low ligation of the inferior mesenteric artery is a controversial issue in the literature. However, low ligation is revealed to be technically demanding, particularly in minimal invasive surgery. Here we provide technical tips to facilitate safe inferior mesenteric artery skeletonization and low ligation at the level of the superior rectal artery. MethodologyThe robotic approach to vascular ligation possesses many advantages over the laparoscopic approach; however, due to the lack of haptic feedback, technical skills are necessary to achieve low ligation and vascular skeletonization. Conclusion Ligation of the inferior mesenteric artery is easier than low ligation. However, if procedures are followed, then low ligation can be easy.

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“…No published data assesses the knowledge gained by the entire staff during a single operative procedure. The only modest measure of this phenomenon is the docking time for the Da Vinci robot, a metric that clearly improves with case experience (26).…”

Section: The Hospital Value Propositionmentioning

confidence: 96%

Value-based assessment of robotic pancreas and liver surgery

Patti

Ore

Barrows

et al. 2017

Hepatobiliary Surg. Nutr.

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Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies must incorporate (I) quality of life, survival, and return to independent function alongside data such as (II) intent-to-treat analysis of minimally-invasive surgery accounting for conversions to open, (III) surgeon and institution experience and operative time as surrogates for the learning curve; and (IV) amortization and maintenance costs as well as direct costs of disposables and instruments.

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Robotic Colorectal Surgery: A Systematic Review

Cited by 83 publications

References 48 publications

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Robotic low ligation in rectal cancer: How we do it

Value-based assessment of robotic pancreas and liver surgery

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