Telerobotic surgery for right and sigmoid colectomies: 30 consecutive cases

Rawlings, Arthur; Woodland, J.; Crawford, D. L.

doi:10.1007/s00464-005-0771-8

Cited by 91 publications

(70 citation statements)

References 13 publications

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“…As we gain more experience, we expect the operating time to fall even further and be similar to the open method. The advanced technology in the robotic surgical system shortens the time of actual operative procedure itself, because it mimics intuitively the open procedure as opposed to the laparoscopic procedure in which surgical maneuvering is counterintuitive [4,5] The estimated blood loss was significantly less in roboticassisted surgery compared with the open method (165.14 vs 406.04 ml). Magnified vision and improved dexterity helps in better vascular control than the open method.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

Somashekhar

Ashwin²,

Rajashekhar

et al. 2013

Indian J Surg

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Rectal cancer is one of the common cancers in India. Surgical management is the mainstay of initial treatment for majority of patients. Minimally invasive surgery has gained acceptance for the surgical treatment of rectal cancer because, compared with laparotomy, it is associated with fewer complications, shorter hospitalization, and faster recovery. The aim of this study is to evaluate the safety, feasibility, technique, and outcomes (postoperative, oncological, and functional) of robotic-assisted rectal surgery in comparison with open surgery in the Indian population. A prospective randomized study was undertaken from August 2011 to December 2012. Fifty patients who presented with rectal carcinoma were randomized to either robotic arm (RA) or open arm (OA) group. Both groups were matched for clinical stage and operation type. Technique and feasibility of roboticassisted surgery in terms of operating time, estimated blood loss, margins status, total number of lymph nodes retrieved, hospital stay, conversion to open procedure, complications, and functional outcomes were analyzed. The mean operative time was significantly longer in the RA than in the OA group (310 vs 246 min, P <0.001) but was significantly reduced in the latter part of the robotic-assisted patients compared with the initial patients. The mean estimated blood loss was significantly less in the RA compared with the OA group (165.14 vs 406.04 ml, P <0.001). None of the patients had margin positivity. The mean distal resection margin was significantly longer in the RA than in the OA group (3.6 vs 2.4 cm, P < 0.001). A total of 100 % of patients in the RA group had complete mesorectal excision while two patients in the OA group had incomplete mesorectal excision. The average number of retrieved lymph nodes was adequate for accurate staging. The number of lymph nodes removed by robotic method is slightly higher than the open method (16.88 vs 15.20) but with no statistical significance. Conversion rate was nil. The mean hospital stay was significantly shorter in the RA group (7.52 vs 13.24 days, P <0.001). Postoperative and functional outcomes were comparable between the two groups. Roboticassisted surgery is an emerging technique in our country. Robotic-assisted rectal cancer surgery is safe with low conversion rates and acceptable morbidity and is oncologically feasible.

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Section: Discussionmentioning

confidence: 99%

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

Somashekhar

Ashwin²,

Rajashekhar

et al. 2013

Indian J Surg

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“…The mean age of patients undergoing this procedure was 49 years (range 19-68 years). The mean hospital stay was 6 days (range 4-13 days), while the mean BMI was 27.3 (range [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. The mean operative time was 166 min (range 60-270 min).…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic robotic-assisted gastrointestinal surgery: a Geneva experience

et al. 2008

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The continuing development of robotic surgery supports its use in laparoscopic gastrointestinal surgery. Our study retrospectively reviewed the surgical outcome and patient's satisfaction of gastrointestinal laparoscopic robotic procedures. From January 2003 to September 2007, 94 patients (27 women, 67 men) with a mean age of 53 years (range 19-84 years) underwent laparoscopic surgery with a da Vinci robotic system. There were 40 colorectal cases (43%), 31 anti-reXux surgery cases (33%) and 14 obesity surgery cases (15%); the remaining cases consisted of gastric and gallbladder surgery, intra-abdominal tumour excisions, and hepatic cyst resections. The majority of the cases (88, 94%) were performed for benign disease.The mean operative time was 153 min (range 60-330 min). One patient needed a blood transfusion. The mean body mass index was 25 (range 16-47). No death occurred. Five cases (5.3%) were converted to conventional laparoscopic surgery (n = 3) or to laparotomy (n = 2). Morbidity consisted of one Nissen redo surgery to loosen a tight anti-reXux valve 6 days after robotic surgery, a robotic left ureter repair and pelvic haemorrhage following proctectomy requiring re-operation to control haemostasis and to remove pelvic haematoma. Mean follow-up time was 11 months (range 15 days to 34 months). One case of incisional trocar hernia needed re-operation. Overall patient's satisfaction was high: few scars were cheloïd, while functional surgical outcome was rated high by most of the patients. Our preliminary experience was encouraging, with minimal morbidity and very high acceptance by patients.

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“…Early experiences with different robotic-assisted colorectal procedures such as colectomies (Rawlings et al, 2006;D'Annibale et al, 2004), rectopexy (Munz et al, 2004) and anterior resections (D'Annibale et al, 2004 are described in recent literature including our previous early report of robotic-assisted TMEs (Pigazzi et al, 2006). These studies found no difference in specimen length, number of lymph nodes retrieved, estimated blood loss, recovery of bowel function or hospital stay between laparoscopic and robotic colorectal resections.…”

Section: Discussionmentioning

confidence: 99%