Single- versus dual-console robot-assisted radical prostatectomy: impact on intraoperative and postoperative outcomes in a teaching institution

Morgan, Monica; Shakir, Nabeel; Garcia-Gil, Maurilio; Özayar, Asım; Gahan, Jeffrey; Friedlander, Justin I.; Roehrborn, Claus G.; Cadeddu, Jeffrey A.

doi:10.1007/s00345-014-1349-7

Cited by 36 publications

(18 citation statements)

References 10 publications

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“…They showed that these methods could have an impact on the learning curve, particularly when they were combined. In a model of robot‐assisted radical prostatectomy, Morgan et al showed that a dual‐console system may improve intra‐ and peri‐operative outcomes. Rundstedt et al used three‐dimensional printing technology to generate a patient‐specific silicone renal model and performed simulation with a standard laparoscopic trainer box before the corresponding patient's surgery.…”

Section: Discussionmentioning

confidence: 99%

Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

et al. 2017

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“…In addition, the trainer can provide virtual pointers to guide the trainee on the screen of the trainee's console. A recent study of urological surgery showed significant reductions in operating time, intraoperative complications, and postoperative complications when using a dual‐console system than a single‐console system . Although studies evaluating dual‐console robotic training systems are insufficient to date, they have the potential to change surgical training strategies in the near future.…”

Section: Learning Curvementioning

confidence: 99%

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Matsuyama

Kinugasa

Nakajima

et al. 2018

Annals of Gastroent Surgery

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Interest in minimally invasive surgery has increased in recent decades. Robotic‐assisted laparoscopic surgery (RALS) was introduced as the latest advance in minimally invasive surgery. RALS has the potential to provide better clinical outcomes in rectal cancer surgery, allowing for precise dissection in the narrow pelvic space. In addition, RALS represents an important advancement in surgical education with respect to use of the dual‐console robotic surgery system. Because the public health insurance systems in Japan have covered the cost of RALS for rectal cancer since April 2018, RALS has been attracting increasingly more attention. Although no overall robust evidence has yet shown that RALS is superior to laparoscopic or open surgery, the current evidence supports the notion that technically demanding subgroups (patients with obesity, male patients, and patients treated by extended procedures) may benefit from RALS. Technological innovation is a constantly evolving field. Several companies have been developing new robotic systems that incorporate new technology. This competition among companies in the development of such systems is anticipated to lead to further improvements in patient outcomes as well as drive down the cost of RALS, which is one main concern of this new technique.

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“…Experience of ∼100 procedures has been considered necessary for surgeons to master their skills in pelvic procedures, but complication rates decrease progressively even after 300 procedures [36] , [37] . During the training period, mentorship using a dual-console system may play a role in reducing perioperative complications [38] . Without considering the learning curve, robotic malfunction appears to be the strongest predictor of prolonged operative time, followed by blood loss, and surgery complexity [39] .…”

Section: Resultsmentioning

confidence: 99%

Complications in robotic urological surgeries and how to avoid them: A systematic review

Tourinho-Barbosa

Tobias-Machado

Castro-Alfaro

et al. 2018

Arab Journal of Urology

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ObjectivesTo review the main complications related to the robot-assisted laparoscopic (RAL) approach in urology and to suggest measures to avoid such issues.MethodsA systematic search for articles of the contemporary literature was performed in PubMed database for complications in RAL urological procedures focused on positioning, access, and operative technique considerations. Each complication topic is followed by recommendations about how to avoid it.ResultsIn all, 40 of 253 articles were included in this analysis. Several complications in RAL procedures can be avoided if the surgical team follows some key steps. Adequate patient positioning must avoid skin, peripheral nerve, and muscles injuries, and ocular and cognitive complications mainly related to steep Trendelenburg positioning in pelvic procedures. Port-site access and closure should not be neglected during minimally invasive procedures as these complications although rare can be troublesome. Technique-related complications depend on surgeon experience and the early learning curve should be monitored.ConclusionsAdequate patient selection, surgical positioning, mentorship training, and avoiding long-lasting procedures are essential to prevent RAL-related complications. The robotic surgical team must be careful and work together to avoid possible complications. This review offers several steps in surgical planning to reach this goal.

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Single- versus dual-console robot-assisted radical prostatectomy: impact on intraoperative and postoperative outcomes in a teaching institution

Abstract: When training resident surgeons to perform RALP, a dual-console system may improve intraoperative and perioperative outcomes. The dual-console may represent a safer, more efficient modality for robotic surgical education as compared to a single-console system.

Cited by 36 publications

References 10 publications

Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

Does training of fellows affect peri‐operative outcomes of robot‐assisted partial nephrectomy?

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Complications in robotic urological surgeries and how to avoid them: A systematic review

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