Robotic single-site surgery versus laparoendoscopic single-site surgery in early-stage endometrial cancer: a case-control study.

Sun, Haiyan; Gao, Jinghai; Jin, Zhijin; Wu, Yuxian; Zhou, Yang; Liu, Xiaojun

doi:10.5114/wiitm.2021.103955

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…This procedure can also be performed in any hospital. 35 Research has shown that LESS surgery results in higher prefrontal beta power during suturing, compared with other methods. 36 To assess the ergonomic stress on surgeons, various methods have been employed in the literature, including surface electromyography (sEMG) to measure muscle activity; 37 hand function models for analyzing tendon and joint forces, electromyographic (EMG) activity; 38 and assessments of posture, activity, tools, and handling, as well as eye tracking to evaluate cognitive variations in surgical scenarios.…”

Section: Discussionmentioning

confidence: 99%

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Technical, ergonomic and cognitive learning methodology in transumbilical single‐port laparoscopic hysterectomy

Yang

Sang

et al. 2023

Intl J Gynecology & Obste

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ObjectiveWe introduced learning curves on a detailed step protocol and ergonomic aspect to determine key surgical points in transumbilical single‐port laparoscopic hysterectomy (TSPLH) and to popularize both technical and cognitive methodology on laparoendoscopic single‐site surgery (LESS).Materials and MethodsA retrospective analysis of 87 TSPLH procedures was conducted by a single surgeon in three learning stages. Technical, ergonomic, and cognitive steps were introduced, and surgical outcomes were analyzed.ResultsKey production points in TSPLH include developing a clear retroperitoneal space, maintaining appropriate strength and direction with a vaginal manipulator, coagulating the uterine artery, and applying an improved vaginal stump suturing method. Technical factors included instrument domination, hand–eye coordination, and alternating hand functions. Ergonomic techniques focused on shoulder, elbow, arm, wrist, and finger movements, range of motion, muscle power, continuous forces, and flexibility. Improved cognitive factors such as confidence, decision‐making, and communication were also observed.ConclusionsThe study aimed to form methodological education on TSPLH and LESS and benefit more surgeons. The detailed production and key ergonomic points will help guide self‐learning and education.

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Section: Discussionmentioning

confidence: 99%

“…Conversely, laparoscopic hysterectomy offers several advantages over robotic‐assisted hysterectomy, including lower cost, shorter surgical time, fewer ports needed, and similar outcomes. This procedure can also be performed in any hospital 35 …”

Section: Discussionmentioning

confidence: 99%

Technical, ergonomic and cognitive learning methodology in transumbilical single‐port laparoscopic hysterectomy

Yang

Sang

et al. 2023

Intl J Gynecology & Obste

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“…With the introduction of the da Vinci robotic system, the combination of a robot system and a single port platform will overcome many of the challenges in single-port surgery, such as instrument crowding and the need for highly advanced laparoscopic skills ( 32 , 33 ). However, robotic surgery remains relatively expensive, single-port laparoscopic surgery may be a more relevant option for our patients, but it does pose a challenge to the surgeon’s surgical skills.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transumbilical laparoendoscopic single-site surgery versus multi-port laparoscopic surgery for endometrial cancer: a retrospective comparison study

You,

Wang,

Zheng

et al. 2023

Front. Oncol.

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BackgroundAlthough single-port laparoscopy surgery has been evaluated for several years, it has not been widely adopted by gynecologic oncologists. The objective was to compare the perioperative outcomes and survival of endometrial cancer (EC) patients undergoing transumbilical laparoendoscopic single-site surgery (TU-LESS) with multi-port laparoscopic surgery (MLS).Materials and methodsThis is a retrospective comparative monocentric study including patients treated between December 2017 and October 2021. The perioperative outcomes and survival of EC patients who had surgery via TU-LESS or MLS were compared, by propensity matching.ResultsA total of 156 patients were included (TU-LESS vs. MLS: 78 vs. 78). The conversion rate of TU-LESS and MLS was 5.13% and 2.56%, respectively (P=0.681). The operation time was comparable between the two groups [207.5min (180-251) vs. 197.5min (168.8-225), P=0.095]. There was no significant difference between the two groups in exhaustion time, perioperative complications, or postoperative complications. While, the TU-LESS group had a shorter out-of-bed activity time [36 hours (24-48) vs. 48 hours (48-72), P<0.001] and a lower visual analog pain scale 36 hours after surgery [1 (1-2) vs. 2 (1-2), P<0.001] than the MLS group. The length of hospital stay was similar in the two groups [5(4-6) vs. 5(4-5), P=0.599]. Following surgery, 38.5% of the TU-LESS patients and 41% of the MLS patients got adjuvant therapy (P=0.744). The median follow-up time for TU-LESS and MLS cohorts was 45 months (range: 20-66) and 43 months (range: 18-66), respectively. One TU-LESS patient and one MLS patient died following recurrence. The 4-year overall survival was similar in both groups (98.3% vs. 98.5%, P=0.875).ConclusionTU-LESS is a feasible and safe option with comparable perioperative outcomes and survival of MLS in endometrial cancer. With the growing acceptance of sentinel lymph node biopsy, TU-LESS of endometrial cancer may be a viable option for patients and surgeons.

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“…Sun H et al [59] demonstrated in 2021 that robotic singlesite surgery (RSSS) for early-stage endometrial cancer was feasible and safe. It also reduced significantly operating time, blood loss, and hospital stay compared to LESS[59]. The RSSS group had considerably longer pre-surgical time (8 min vs. 2 min, p < 0.05), lower blood loss (Me = 50 mL vs. 85 mL, p < 0.05), and much shorter vaginal cuff closure time (21 min vs. 30 min, p < 0.05) than the LESS group.…”

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confidence: 89%

“Less is More, is R-LESS More?”—The Use of Robotic Laparoendoscopic Single-Site Surgery in Gynaecology: A Scoping Review

Mereu¹,

Gaia²,

Afonina³

et al. 2023

Clin. Exp. Obstet. Gynecol.

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Background: Since the Da Vinci system was introduced in the gynaecological profession, for benign and most malignant procedures, it appeared that using 5 incisions for trocar insertion could jeopardize the system's mini-invasiveness. To protect this important characteristic, robotic laparoendoscopic single-site surgery was developed and authorized for gynaecological use in 2013. Using a single small incision for the entire treatment appears to be a promising attempt to improve cosmetic results while lowering wound infections, postoperative pain, and recovery time. After nearly ten years of use, several limitations of this technique became apparent, such as a limited set of non-articulating instruments and electrical possibilities compared to multiport surgery, smoke evacuation and visual impairment. By examining the most relevant research, the goal of this review was to emphasize the indications, risks, and benefits of R-LESS in gynaecological surgery. Methods: A scoping review was conducted on Pubmed, Scopus, Web of Science, and Embase. Publications in English or Italian in the previous 10 years on the use of single-site robotic surgery in gynaecology for benign disorders were included. Results: This review includes 37 of the 297 papers that were retrieved. Myomectomy, hysterectomy, pelvic floor surgery, and endometriosis were the most common indications for single-site surgery. Several studies have reported R-LESS usage in cancer patients. According to the data analysis, the R-LESS approach is comparable to robotic multi-port surgery as regards feasibility and safety, with faster operative and postoperative durations, reduced pain, and a superior cosmetic outcome. Conclusions: The single-port robotic technique is gaining popularity. Our findings provide preliminary evidence of the global experience of surgical teams. Standardizing operative durations and conducting comparative research on the R-LESS learning curve represent one of the most significant future difficulties, as do surgical outcomes, costs, and patient satisfaction in the long run.

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Robotic single-site surgery versus laparoendoscopic single-site surgery in early-stage endometrial cancer: a case-control study.

Cited by 7 publications

References 26 publications

Technical, ergonomic and cognitive learning methodology in transumbilical single‐port laparoscopic hysterectomy

Technical, ergonomic and cognitive learning methodology in transumbilical single‐port laparoscopic hysterectomy

Efficacy of transumbilical laparoendoscopic single-site surgery versus multi-port laparoscopic surgery for endometrial cancer: a retrospective comparison study

“Less is More, is R-LESS More?”—The Use of Robotic Laparoendoscopic Single-Site Surgery in Gynaecology: A Scoping Review

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