Systematic review of single‑port vs. multi‑port surgery for rectal cancer

Tei, Mitsuyoshi; Sueda, Toshinori; Matsumura, Tae; Furukawa, H; Koga, Chikato; Wakasugi, Masaki; Miyagaki, Hiromichi; Kawabata, Ryohei; Tsujie, Masanori; Hasegawa, Junichi

doi:10.3892/mco.2020.2186

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…22 Furthermore, SPS can provide more oncological outcomes in the patients with colon cancer. 23 On the other hand, there are some reports of the use of SPS for rectal surgery, 24 and a recent systematic review has reported that SPS can also be performed safely and provide good shortterm oncological outcomes. 25 However, the usefulness of SPS, including long-term oncological outcomes, is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Long‐term oncological outcome of reduced‐port laparoscopic surgery (single‐incision plus one port) as a technical option for rectal cancer

Ishii

Ochiai

Sako

et al. 2023

Asian J Endoscop Surgery

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BackgroundThe purpose of this study was to clarify the oncological safety of reduced‐port laparoscopic surgery (single‐incision plus one port) (RPS) for patients with rectal cancer.MethodsThe clinicopathological data of 63 selected patients with clinical Stage I‐III (T1‐3 and N0‐2) rectal cancer who underwent RPS of radical anterior resection between 2012 and 2017 were retrospectively analyzed. The median distance of tumor from anal verge was 11 cm. Ordinarily, a multiport platform with three channels was placed in the 3‐cm umbilical incision, and another 5‐ or 12‐mm port was placed in the right lower abdomen.ResultsThe median operative time, amount of intraoperative bleeding, number of harvested lymph nodes, and length of distal margin were 272 min, 10 mL, 22 nodes, and 4.0 cm, respectively, and there was one (2%) patient with involvement of the radial margin. There were eight patients (13%) who required additional ports, and one patient (2%) who converted to open surgery. Intra‐ and postoperative complications occurred in one (2%) and 12 patients (19%), respectively. The median length of postoperative hospital stay was 8 days. The median follow‐up period was 79 months, and incisional hernia was observed in 3 (5%) patients at the platform site not the port site, and cancer recurrence occurred in four patients (6%). The 5‐year relapse‐free and overall survival rates were 100% and 100% in the patients with pathological Stage I disease, 94% and 100% in the patients with pathological Stage II disease, and 83% and 89% in the patients with pathological Stage III disease, respectively.ConclusionRPS in the selected patients with rectal cancer, performed by an expert laparoscopic surgeon, may be technically safe and oncologically acceptable as well as multiport laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Long‐term oncological outcome of reduced‐port laparoscopic surgery (single‐incision plus one port) as a technical option for rectal cancer

Ishii

Ochiai

Sako

et al. 2023

Asian J Endoscop Surgery

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“…Compared with previous systematic reviews on SILS and CMLS in the treatment of CRC [13,14] , the greatest feature of this study is that the 8 included articles were all high-quality RCT studies, from different countries and regions of the East and West, with some representativeness, of which 5 were registered for clinical trials, so the results had high reliability. The limitations of this study are mainly the lack of long-term follow-up results in the included literature, including local tumor recurrence or distant metastasis rate, survival rate, etc., which cannot evaluate the long-term efficacy of SILS in the treatment of CRC.…”

Section: Discussionmentioning

confidence: 99%

“…After more than 10 years of development, SILS has been widely used in the treatment of CRC [11] . However, there is still a lack of high-quality evidence-based medical evidence for the safety and efficacy of SILS in the treatment of CRC compared with CMLS, and some previous meta-analyses included too many retrospective non-randomized studies [12][13][14] , resulting in poor reliability and stability of this result. Therefore, the main purpose of this study is to systematically evaluate the published high-quality RCT of SILS and CMLS in the treatment of CRC to objectively evaluate the safety and efficacy of SILS in CRC surgery.…”

Section: Introductionmentioning

confidence: 99%

Single-port versus conventional multi-port laparoscopic surgery in the treatment of colorectal cancer: A systematic review and meta-analysis

2022

FMSR

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Objective: To compare the clinical efficacy of single-port laparoscopic surgery (SILS) and conventional multi-port laparoscopic surgery (CMLS) in the treatment of colorectal cancer.Methods: A systematic literature search was performed in Pubmed, Embase, Cochrane library, Web of science and ClinicalTrials.gov. Randomized controlled trials (RCTs) studies comparing SILS and CMLS for colorectal cancer (CRC) were enrolled. Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. Meta-analysis was performed using Review Manager 5.4.1.Results: Eight RCTs with a total of 1143 patients were finally included. The results of meta-analysis showed that the incision length of SILS group was shorter than that of CMLS group in radical resection of CRC [P = 0.003, MD = -2.64, 95% CI (-4.39, -0.89)], the tumor size in pathological specimens of SILS group was smaller than that of CMLS group [P = 0.008, MD = 0.12, 95% CI (0.03, 0.22)]; while the operation time, intraoperative blood loss, conversion rate, postoperative first anus exhaust time, postoperative first day rest pain score, hospital stay, incidence of postoperative complications, incidence of reoperation, number of dissected lymph nodes, length of pathological specimens, distance from the distal resection margin of the tumor and distance from the proximal resection margin of the tumor was not statistically different between SILS and CMLS.Conclusion: SILS is feasible and safe in the treatment of colorectal cancer, and may be more advantageous in terms of cosmetic results. Long-term outcomes need to be confirmed by larger RCTs with complete follow-up data.

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“…At the same time, SPL is considered a more demanding approach, not suitable for every intervention as it largely depends on the available working space [ 19 ]. With the introduction of systems like da Vinci SP, single-port interventions still lag behind the operations performed using multi-port robotic systems [ 13 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Automatic patient positioning based on robot rotational workspace for extended reality

et al. 2023

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Purpose Understanding the properties and aspects of the robotic system is essential to a successful medical intervention, as different capabilities and limits characterize each. Robot positioning is a crucial step in the surgical setup that ensures proper reachability to the desired port locations and facilitates docking procedures. This very demanding task requires much experience to master, especially with multiple trocars, increasing the barrier of entry for surgeons in training. Methods Previously, we demonstrated an Augmented Reality-based system to visualize the rotational workspace of the robotic system and proved it helps the surgical staff to optimize patient positioning for single-port interventions. In this work, we implemented a new algorithm to allow for an automatic, real-time robotic arm positioning for multiple ports. Results Our system, based on the rotational workspace data of the robotic arm and the set of trocar locations, can calculate the optimal position of the robotic arm in milliseconds for the positional and in seconds for the rotational workspace in virtual and augmented reality setups. Conclusions Following the previous work, we extended our system to support multiple ports to cover a broader range of surgical procedures and introduced the automatic positioning component. Our solution can decrease the surgical setup time and eliminate the need to repositioning the robot mid-procedure and is suitable both for the preoperative planning step using VR and in the operating room—running on an AR headset.

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Systematic review of single‑port vs. multi‑port surgery for rectal cancer

Cited by 9 publications

References 23 publications

Long‐term oncological outcome of reduced‐port laparoscopic surgery (single‐incision plus one port) as a technical option for rectal cancer

Long‐term oncological outcome of reduced‐port laparoscopic surgery (single‐incision plus one port) as a technical option for rectal cancer

Single-port versus conventional multi-port laparoscopic surgery in the treatment of colorectal cancer: A systematic review and meta-analysis

Automatic patient positioning based on robot rotational workspace for extended reality

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