Robotic surgery and standard laparoscopy: A surgical hybrid technique for use in colorectal endometriosis

Abstract

To the best of our knowledge, this report is the first concerning the use of a hybrid technique for intestinal resection in severe endometriosis, and comparing our data with that in the literature, its methodological and clinical advantages are evident. Moreover, the complete removal of endometriotic implants seems to offer good results in terms of postoperative fertility, although the study data do not allow us to draw definitive conclusions on the management of fertility.

Robotic surgery for deep endometriosis: a paradigm shift

“…Just as occurred during surgical treatment of former oncologic conditions, the advantages given by the robotassisted technique are greatly enhanced in challenging and surgically demanding procedures such as nodule excision in rectovaginal septum, partial bladder resection or colorectal resection. It is noteworthy that in this series we haven't experienced any intraoperative complications, including inadvertent bowel perforation during dissection, ureteral or vascular lesions, in agreement also with previous studies (11,18) and all the procedures were finally considered successful.…”

“…However the advantages given by robotics alone can't replace the surgeon's experience in this field and this issue may reduce the external validity of our results to all those surgeons who need to manage patients with DIE. Moreover, our experience, which represents the largest series available to date, contributes to increase the body of evidence regarding this topic, which, however, is still limited to a few case reports and other initial experiences . We need to acknowledge that we are probably still taking the first steps in the history of robotic surgery for DIE but thanks to larger future experiences, progress will run much faster.…”

‘Money for nothing’. The role of robotic-assisted laparoscopy for the treatment of endometriosis

“…Another five publications were excluded from the current review. One study (Vitobello et al, 2013) was excluded because enrolled patients were most likely included in a larger, more recent study from the same group (Siesto et al, 2014). Two studies were excluded because the number of patients with (Tan et al, 2012;Williams and Leveillee, 2009).…”

A prospective, single-arm study on the use of the da Vinci® Table Motion with the Trumpf TS7000dV operating table

“…A docked da Vinci System Si or Xi prevents the OR team to reposition the patient by gravity, easily obtained in DMLS, since safe repositioning of the patient requires undocking and re-docking the robot, which is time-consuming [8][9][10][11]. Reducing the OR time during RAS is not only relevant for patient safety, but also carries economic advantages, especially in major multidisciplinary centres where use by several specialties and surgical units on a booking basis increases the financial sustainability of RAS.…”

“…Undocking the robot involves interrupting the operation to remove the instruments, and undock the manipulator arms from each of the cannulas before repositioning the patient; followed by re-docking the manipulator arms to each of the cannulas, reinserting the instruments before resuming the operation. The disruption of the surgical work flow is the major cause for prolonging the OR time [8][9][10][11].…”