Robotic surgery for deep endometriosis: a paradigm shift

Siesto, Gabriele; Iedà, N.; Rosati, Riccardo; Vitobello, Domenico

doi:10.1002/rcs.1518

Cited by 47 publications

(46 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This study demonstrates that robotic resection of DIE is a viable approach for comprehensive surgical management of DIE with comparable symptom resolution. Due to the mechanical and ergonomic advantages of robotic‐assisted surgery and newer data showing similar outcomes to laparoscopy, surgeons treating DIE have started to migrate toward a robotic platform …”

Section: Discussionmentioning

confidence: 99%

A review of deep infiltrative colorectal endometriosis treated robotically at a single institution

Graham

Chen

Skancke

et al. 2019

Robotics Computer Surgery

View full text Add to dashboard Cite

Purpose/background Using robotic surgery, we report successful resection of deep invasive pelvic endometriosis with a multidisciplinary team of colorectal and gynecologic surgeons. Methods/interventions Fifteen cases of robotic‐assisted endometrial resections for deep invasive endometriosis were performed by a multidisciplinary team between 2013 and 2016. Results/outcomes The average total operative time of robotic endometrial extirpation was 342 minutes, and the average blood loss was 283 cc. There were no intraoperative complications and no conversion to laparotomy. Postoperative complications, including one superficial wound infection, four patients with pelvic abscesses, a bowel leak, and one rectovaginal fistula, occurred in five of 15 patients, three of which required percutaneous drainage and one required reoperation. All patients who followed up after surgery showed 100% dysmenorrhea resolution at one month (13 of 15 patients). Conclusion/discussion Deep infiltrating endometriosis is a complex disease associated with significant morbidity and requires highly trained, multidisciplinary team approach for safe and efficient excision.

show abstract

Section: Discussionmentioning

confidence: 99%

A review of deep infiltrative colorectal endometriosis treated robotically at a single institution

Graham

Chen

Skancke

et al. 2019

Robotics Computer Surgery

View full text Add to dashboard Cite

show abstract

“…Deep infiltrating endometriosis is one of the most suitable indications for robotic surgery in benign gynecological disease treatment. Since the patients are still young and wish to have children, they require organ-preserving and tissue-protective surgery (13). Continuity is usually preserved during excision of the endometriosis from the rectum and the ureter.…”

Section: Application In Benign Gynecological Diseasesmentioning

confidence: 99%

“…However, more extensive interventions with partial resection of the bowel or bladder can also be performed with lower complication rates by this minimally invasive approach. Furthermore, the excellent view and the precise navigation of instruments permit preservation of the ovarian reserve, optimal restoration of anatomical conditions, and the prevention of postoperative adhesions (13). Recent investigations have shown that robotic surgery achieves these goals in the vast majority of cases, such as the fulfillment of a woman's wish for children, a significant reduction of pain, and the improvement of gastrointestinal symptoms.…”

Section: Application In Benign Gynecological Diseasesmentioning

confidence: 99%

Robotic surgery in gynecology

Alkatout

Mettler

Maass

et al. 2016

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

Review 224 Robotic surgery in gynecologyRobotic surgery is a dynamic development for minimally invasive procedures. The specialty of gynecology consistently offers new opportunities for innovative surgical techniques and the advancement of existing therapy approaches (Figure 1). Ever since the American FDA granted approval of the Da Vinci operation robot for gynecological operations in 2005, about three million robotic operations have been performed worldwide. 3500 Da Vinci systems are currently in use: 586 of these in Europe and 77 in Germany (4 th quarter of 2015). According to the figures of Intuitive Surgical, about 600,000 interventions were performed on a worldwide basis in the year 2014, of which 50% were performed in gynecology, approximately 30% in urology, and about 20% in general and chest surgeries. In 2011, the proportion of robotic hysterectomies performed for benign indications in the USA was as high as 27% (1). Currently, we have experience in robotic surgery for the majority of gynecological operations and fields of application. The known advantages of minimally invasive surgery, such as less blood loss, shorter durations of hospital stay, and lower patient morbidity compared to open procedures, have been observed here as well. Better exposure of the operating field by 3D technology and the extension of surgical instruments to 7 degrees of freedom permit the use of minimally invasive surgery, even for complex indications. Robot-assisted manipulation of the instruments permits tremor-free handling and reduces work fatigue for the surgeon, which is very advantageous for the surgeon as well as the patient in long and complex interventions. The possibility of working simultaneously on two parallel consoles shortens the learning curve, reduces complication rates, and facilitates the training of surgeons (2). The advancement of robotic surgery in terms of the Da Vinci Xi permits the variable use of optics in all four trocars (paraaortic lymphadenectomy, omentectomy, or interdisciplinary surgery in the upper abdomen can be performed without re-docking) and ensures markedly greater flexibility due to the optimized geometry of the so-called patient cart. Robotic surgery has been criticized for the fact that it requires the use of larger trocars compared to conventional laparoscopy, and is therefore associated with more numerous and larger cosmetic scars; this is avoided by the smaller trocars now used in robotic surgery (3). The development of the single-site systems signifies further new options for the gynecological surgeon (Figure 2). For instance, freedom of movement is now maximized by the introduction of one or more additional working trocars (4, 5). The low level of postoperative pain appears to be another advantage. It is accompanied by a lesser need for analgesics and even shorter hospital stays compared to traditional laparoscopic surgery. One explanation could be the fact that the abdominal wall need not be used as a counter bearing. The absence of irritation and the advantage of tissue protec...

show abstract

“…Robot-assisted approaches had reportedly been used for endometriosis surgery [47], Siesto in the largest series published regarding robot-assisted surgery for deep infiltrating endometriosis concluded robot-assisted surgery is a safe and attractive alternative to accomplish a comprehensive surgical treatment especially when bowel or bladder resections are required [48].…”

Section: General Gynecology: Endometriosis Surgerymentioning

confidence: 99%

Gynecological Surgery and the Robot

O’Sullivan¹,

O’Reilly²

2014

ENG

View full text Add to dashboard Cite

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.

show abstract

Robotic surgery for deep endometriosis: a paradigm shift

Abstract: This series of robotic procedures for DIE represents the largest currently available and it helps to promote robotics as a safe and attractive alternative to accomplish a comprehensive surgical treatment of DIE, especially when bowel or bladder resections are needed.

Cited by 47 publications

References 25 publications

A review of deep infiltrative colorectal endometriosis treated robotically at a single institution

A review of deep infiltrative colorectal endometriosis treated robotically at a single institution

Robotic surgery in gynecology

Gynecological Surgery and the Robot

Contact Info

Product

Resources

About