Single‐incision robotic colectomy (SIRC): Current status and future directions

Juo, Yen-Yi; Luka, Samuel; Obias, Vincent

doi:10.1002/jso.23935

Cited by 14 publications

(6 citation statements)

References 38 publications

(57 reference statements)

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“…There is only one study reporting the learning curve of SIRA which states a cutoff of 21 operations (17). This is comparable to conventional robotic multiport adrenalectomy (20) procedures. In this study, the difference in mean operative time between the first 7 cases and 7 cases after passing threshold was 21 minutes (17).…”

Section: Learning Curvementioning

confidence: 99%

“…Although several authors reported no significant difference in operative time in single incision surgeries, Juo et al (20) found increased rates of surgical site infections and incisional hernia when they compared outcomes of single incision robotic colectomy with laparoscopic colectomy.…”

Section: Rationale For Siramentioning

confidence: 99%

“…Considering limited number of studies on SIRA, data from other specialties and techniques may show pros and cons of single incision robotic surgery. According to the results of a study on single incision robotic colectomy (SIRC) by Juo et al (20) incisional hernia and conversion to open surgery was reported to be more common in patients with BMI >30, which lead the authors to change their selection criteria and operate only on patients with BMI <30.…”

Section: Patient Selectionmentioning

confidence: 99%

See 2 more Smart Citations

Single-incision robotic adrenalectomy (SIRA): the future of adrenal surgery?

2020

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In compliance with the trend toward less invasive techniques, single incision robotic surgeries have become more common and they have been increasingly used for several surgeries including adrenalectomy.Single incision robotic adrenalectomy (SIRA) aims to combine the merits of robotic surgery with previously defined single incision laparoscopic techniques. It has been shown to be safe and feasible, however, there are only few studies on this new technique. Due to scant data on SIRA in the current literature, it remains to be a current challenge in adrenal surgery. In this review, our goal is to present current literature on SIRA and discuss the data regarding perioperative outcomes, patient selection, learning curve, and its limitations.

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Section: Learning Curvementioning

confidence: 99%

Section: Rationale For Siramentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

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Single-incision robotic adrenalectomy (SIRA): the future of adrenal surgery?

2020

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“…Finally, robotic surgery can be combined with both SILS, and also with transanal surgery, as outlined below. 33…”

Section: Robotics and Ibdmentioning

confidence: 99%

Training for Minimally Invasive Surgery for IBD: A Current Need

Kotze

Holubar

Lipman

et al. 2021

Clin Colon Rectal Surg

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Surgery for inflammatory bowel diseases (IBD) management has passed through an important evolution over the last decades, with innovative strategies and new technologies, especially in minimally invasive surgery (MIS) approaches. MIS procedures for IBD include multiport laparoscopy, single-port surgery, robotics, and the use of transanal platforms. These approaches can be used in the surgical management of both Crohn's disease (CD) and ulcerative colitis (UC). There are significant peculiarities in the surgical field in CD and UC, and their perfect understanding are directly related to better outcomes in IBD patients, as a consequence of improvement in knowledge by IBD surgeons. Different strategies to train colorectal surgeons were developed worldwide, for better application of MIS, usually for malignant or non-IBD benign diseases. There is a significant lack of evidence in specific training strategies for MIS in the IBD field. In this review, the authors outline the importance of adequate surgical training in IBD MIS, by discussing the current evidence on different approaches and emphasizing the need for better training protocols included in multidisciplinary teams in IBD centers throughout the globe.

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“…The system has been used largely in the clinical setting for cholecystectomies 120,121 and hysterec-tomies. 122,123 A few case reports have been published so far describing right colectomy, [124][125][126] and one single case report describes the application of da Vinci in single-incision robotic total colectomy. 127 Finally, a new single-site robotic platform realized by Intuitive Surgical is currently under development.…”

Section: Robotics and Single Access Surgerymentioning

confidence: 99%

Future of Minimally Invasive Colorectal Surgery

Whealon

Vinci

Pigazzi

2016

Clinics in Colon and Rectal Surgery

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Minimally invasive surgery has been adapted to a wide variety of colorectal procedures. The first laparoscopic right colectomy was published by Jacobs et al in 1991 1 ; shortly after which Fowler performed the first laparoscopic left colectomy. Since these initial reports, several large studies found that the oncologic outcomes of laparoscopic colectomy were equivalent to open surgery and that patients undergoing laparoscopic colectomy tended to have improved shortterm outcomes such as decreased blood loss, shorter length of stay, faster return of bowel function, fewer wound complications, and improved postoperative pain. 2-9 Despite the growing body of evidence supporting the use of laparoscopic colectomy for colon cancer, the adoption of the technique was relatively slow with the utilization of laparoscopic colectomy only reaching 41.6% in 2010. [10][11][12] Despite its advantages over open surgery, there are some limitations to minimally invasive surgery. Loss of binocular vision, paradoxical motion of the instruments, amplified movements, parallel instrumentation, poor ergonomics, 13,14 increased motion needed to accomplish a given task, 15 and loss of proprioception are all common limitations. To overcome some of these shortfalls, the use of hand-assisted laparoscopy was introduced. 16,17 Although studies have shown similar oncologic outcomes, the short-term outcome benefits of laparoscopy were lost with the hand-assisted technique. 18,19 Furthermore, the incisional hernia rate for hand-assisted laparoscopic surgery has reported to be between 6 and 10.6%, 20,21 although this may be contingent on port site placement. 22 The da Vinci robotic system (Intuitive Surgical Inc., Sunnyvale, CA) was developed to overcome the limitations of traditional laparoscopic surgery. This system provided several potential advantages over traditional laparoscopic surgery including a stable camera platform, three-dimensional (3D) imaging, improved ergonomics, tremor elimination, ambidextrous capability, motion scaling, and instruments with multiple degrees of freedom. The first two robotic-assisted colectomies described in the literature were performed in 2001 by Weber et al. 23 Several studies have compared the outcomes of laparoscopic versus robotic colectomy 24-33 and overall, robotic-assisted right colectomy had similar perioperative and oncologic outcomes at the expense of longer operation times, and increased surgical costs. Some studies suggest there may be some advantage to robotic right colectomy with regards to decreased estimated blood loss 25,26,30,31 and faster return of bowel function. [30][31][32] Although no significant benefit of robotic surgery has been seen, some authors feel that a robotic right colectomy is a good procedure for surgeons to tackle the learning curve of robotic surgery before undertaking more complex operations such as a low anterior resection, 24 while others liken the use of robotic surgery for right colectomy to taking a Ferrari to the grocery store to do the weekly shopping. 34 Left colect...

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Single‐incision robotic colectomy (SIRC): Current status and future directions

Cited by 14 publications

References 38 publications

Single-incision robotic adrenalectomy (SIRA): the future of adrenal surgery?

Single-incision robotic adrenalectomy (SIRA): the future of adrenal surgery?

Training for Minimally Invasive Surgery for IBD: A Current Need

Future of Minimally Invasive Colorectal Surgery

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