Robotic total pelvic exenteration

Lawande, Akhil; Kenawadekar, Rahul; Desai, Riddhi; Malireddy, Chaitanya; Nallapothula, Kathya; Puntambekar, Shailesh

doi:10.1007/s11701-013-0404-5

Cited by 13 publications

(4 citation statements)

References 6 publications

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“…Despite advancements in surgical technique, the morbidity remains significant with complications ranging from 27 to 86% [ 1 – 4 ]. Data detailing robotic TPE surgery is limited and while the procedure has been described [ 7 – 9 ], to our knowledge, we are the first to describe perioperative characteristics of robotic versus open total pelvic exenteration. Further, we are the first to describe combining minimally invasive rectus flap coverage in this setting [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite advancements in surgical techniques and perioperative care over time, TPE continues to be highly morbid with a wide range of complication rates (27–86%) [ 1 – 4 ]. The existing minimally invasive literature focuses primarily on anterior exenteration surgery while minimally invasive TPE (MITPE) data are lacking with no reports describing simultaneous laparoscopic rectus flap harvesting [ 5 – 9 ]. Herein, we report our initial experience with three cases of MITPE with laparoscopic rectus flap and compare perioperative characteristics to open TPE experience.…”

Section: Introductionmentioning

confidence: 99%

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Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

Winters

Mann

Louie

et al. 2015

Case Reports in Surgery

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Total pelvic exenteration is a highly morbid procedure performed for locally advanced pelvic malignancies. We describe our experience with three patients who underwent robotic total pelvic exenteration with laparoscopic rectus flap and compare perioperative characteristics to our open experience. Demographic, tumor, operative, and perioperative factors were examined with descriptive statistics reported. Mean operative times were similar between the two groups. When compared to open total pelvic exenteration cases (n = 9), median estimated blood loss, ICU stay, and hospital stay were all decreased. These data show robotic pelvic exenteration with laparoscopic rectus flap is technically feasible. The surgery was well tolerated with low blood loss and comparable operative times to the open surgery. Further study is needed to confirm the oncologic efficacy and the suggested improvement in surgical morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

Winters

Mann

Louie

et al. 2015

Case Reports in Surgery

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“…Two patients developed metastasis in the liver or para-aortic nodes. Lawande et al published, in 2014, a case of advanced cervical cancer involving the bladder and rectum with a rectovaginal fistula and impending vesicovaginal fistula [28]. The patient underwent a robotic-assisted TPE with colo-anal anastomosis and ureterosigmoidostomy.…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging

Van Trappen,

Walgraeve,

Roels

et al. 2024

JCM

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Background: Patients with persistent or recurrent cervical cancer, following primary treatment with concurrent chemoradiation, represent a subgroup eligible for pelvic exenteration. In light of the substantial morbidity associated with open pelvic exenterations, minimally invasive surgical techniques have been introduced. This systematic review aims to analyze and discuss the current literature on robotic-assisted pelvic exenterations in cervical cancer. In addition, novel aspects of compartment-based magnetic resonance imaging (MRI) are highlighted. Methods: This systematic review followed the PRISMA guidelines, and a comprehensive literature search on robotic-assisted pelvic exenterations in cervical cancer was conducted to assess, as main objectives, early and late postoperative complications as well as oncological outcomes. Inclusion and exclusion criteria were applied to select eligible studies. Results: Among the reported cases of robotic-assisted pelvic exenterations in cervical cancer, 79.4% are anterior pelvic exenterations. Intraoperative complications are minimal and early/late major complications averaged between 30–35%, which is lower compared to open pelvic exenterations. Oncological outcomes are similar between robotic and open pelvic exenterations. Sensitivity for locoregional invasion increases up to 93% for compartment-based MRI in colorectal cancer. A refined delineation of the seven pelvic compartments for cervical cancer is proposed here. Conclusions: Robotic-assisted pelvic exenterations have demonstrated feasibility and safety, with reduced rates of major complications compared to open surgery, while maintaining surgical efficiency and oncological outcomes. Compartment-based MRI holds promise for standardizing the selection and categorization of pelvic exenteration procedures.

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“…It was concluded that MIS exenteration was associated with reduced intra-operative blood loss and hospital length of stay while having no adverse effect on resectability [ 1 ]. Since robotic-assisted pelvic exenteration was first described in 2013, there are increasing numbers of case reports and series demonstrating its safety and feasibility [ 85 ]. The current evidence in the literature suggests an acceptable operative time, blood loss and a range of R0 rates [ 84 , 86 , 87 , 88 , 89 , 90 , 91 ].…”

Section: Contemporary Management Strategiesmentioning

confidence: 99%

Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative

Collaborative¹

2022

Cancers

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Pelvic exenteration is a complex operation performed for locally advanced and recurrent pelvic cancers. The goal of surgery is to achieve clear margins, therefore identifying adjacent or involved organs, bone, muscle, nerves and/or vascular structures that may need resection. While these extensive resections are potentially curative, they can be associated with substantial morbidity. Recently, there has been a move to centralize care to specialized units, as this facilitates better multidisciplinary care input. Advancements in pelvic oncology and surgical innovation have redefined the boundaries of pelvic exenterative surgery. Combined with improved neoadjuvant therapies, advances in diagnostics, and better reconstructive techniques have provided quicker recovery and better quality of life outcomes, with improved survival This article provides highlights of the current management of advanced pelvic cancers in terms of surgical strategy and potential future developments.

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Robotic total pelvic exenteration

Abstract: The total operative time was 240 min and the console time was 120 min. The estimated blood loss was 300 ml and the intensive care unit stay was 2 days. Post-operatively, the patient had good faecal and urinary continence and good quality of life.

Cited by 13 publications

References 6 publications

Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

Robotic-Assisted Pelvic Exenteration for Cervical Cancer: A Systematic Review and Novel Insights into Compartment-Based Imaging

Contemporary Management of Locally Advanced and Recurrent Rectal Cancer: Views from the PelvEx Collaborative

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