The current state and the future of robotic surgery in female pelvic medicine and reconstructive surgery

Sussman, Rachael D.; Peyronnet, B.; Brucker, Benjamin M.

doi:10.5152/tud.2019.19068

Cited by 7 publications

(3 citation statements)

References 68 publications

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“…Robotic assisted surgery has paved the way for increasingly precise adrenal-sparing surgery, allowing for increased dexterity, visualization in three dimensions, elimination of physiologic tremors, and ergonomic positioning [18]. PA is primarily indicated for those individuals with bilateral adrenal pathology, as well as those with unilateral pathology whose contralateral gland may be compromised [6].…”

Section: Discussionmentioning

confidence: 99%

Partial versus total adrenalectomy for pheochromocytoma: a population-based comparison of outcomes

et al. 2021

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PurposeThe literature assessing outcomes of partial adrenalectomy (PA) among patients with pheochromocytoma patients is largely limited to isolated, single-institution series. We aimed to perform a population-level comparison of outcomes between patients undergoing PA versus those undergoing total adrenalectomy (TA). Methods The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify adults with pheochromocytoma who underwent either PA or TA. Survival was assessed using multivariable Cox proportional hazards regression, Fine and Gray competing-risks regression, propensity score matching, Kaplan-Meier analysis, and cumulative incidence plots. Results 286 patients (PA: 101, TA: 185) were included in this study. As compared to those undergoing TA, patients undergoing PA had fewer tumors ≥ 8 cm in size (28.7% versus 42.7%, p = 0.048) and were more likely to have localized disease (61.4% versus 44.3%, p = 0.01). In multivariable analysis, patients undergoing PA demonstrated similar all-cause mortality (HR = 0.71, 95% CI 0.44-1.14, p = 0.16) and cancer-specific mortality (HR = 0.64, 95% CI 0.35-1.17, p = 0.15) compared to those who underwent TA. Following 1:1 propensity score matching, Kaplan-Meier analysis revealed no difference in overall survival between PA and TA groups (p = 0.26) nor was there a difference in the cumulative incidence of cancerspecific mortality (p = 0.29). Conclusions In this first population-level comparison of outcomes among patients with pheochromocytoma undergoing PA and those undergoing TA, we found no long-term differences in any survival metric between groups. PA circumvents the need for lifelong corticoid replacement therapy and remains a promising option for patients with bilateral or recurrent pheochromocytoma.

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Section: Discussionmentioning

confidence: 99%

Partial versus total adrenalectomy for pheochromocytoma: a population-based comparison of outcomes

et al. 2021

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“…The use of robotic surgery in functional urology has expanded significantly over the past decade [23]. Its computer interface provides privileged access to record automated performance metrics (APMs) [24].…”

Section: Surgical Training/surgical Performancementioning

confidence: 99%

Artificial intelligence in functional urology: how it may shape the future

Bentellis

Guérin²,

Khene

et al. 2021

Current Opinion in Urology

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Purpose of review The aim of the present manuscript is to provide an overview on the current state of artificial intelligence (AI) tools in either decision making, diagnosis, treatment options, or outcome prediction in functional urology. Recent findings Several recent studies have shed light on the promising potential of AI in functional urology to investigate lower urinary tract dysfunction pathophysiology but also as a diagnostic tool by enhancing the existing evaluations such as dynamic magnetic resonance imaging or urodynamics. AI may also improve surgical education and training because of its automated performance metrics recording. By bringing prediction models, AI may also have strong therapeutic implications in the field of functional urology in the near future. AI may also be implemented in innovative devices such as e-bladder diary and electromechanical artificial urinary sphincter and could facilitate the development of remote medicine. Summary Over the past decade, the enthusiasm for AI has been rising exponentially. Machine learning was well known, but the increasing power of processors and the amount of data available has provided the platform for deep learning tools to expand. Although the literature on the applications of AI technology in the field of functional urology is relatively sparse, its possible uses are countless especially in surgical training, imaging, urodynamics, and innovative devices.

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“…These new ultrasound technologies could enable the development of personalised mesh design based on a CAD generated from these images, thereby taking 3D printing technologies to the next level of sophistication. Computer-assisted robotic surgery [ 163 , 164 ] is already becoming a routine surgical method due to its precision and minimal invasiveness. In future, we envision a personalised mesh, designed using a computer interface integrated with a pelvic ultrasound, that can be implanted using computer-assisted robotic surgery.…”

Section: Future Directionsmentioning

confidence: 99%

Emerging Nano/Micro-Structured Degradable Polymeric Meshes for Pelvic Floor Reconstruction

et al. 2020

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Pelvic organ prolapse (POP) is a hidden women’s health disorder that impacts 1 in 4 women across all age groups. Surgical intervention has been the only treatment option, often involving non-degradable meshes, with variable results. However, recent reports have highlighted the adverse effects of meshes in the long term, which involve unacceptable rates of erosion, chronic infection and severe pain related to mesh shrinkage. Therefore, there is an urgent unmet need to fabricate of new class of biocompatible meshes for the treatment of POP. This review focuses on the causes for the downfall of commercial meshes, and discusses the use of emerging technologies such as electrospinning and 3D printing to design new meshes. Furthermore, we discuss the impact and advantage of nano-/microstructured alternative meshes over commercial meshes with respect to their tissue integration performance. Considering the key challenges of current meshes, we discuss the potential of cell-based tissue engineering strategies to augment the new class of meshes to improve biocompatibility and immunomodulation. Finally, this review highlights the future direction in designing the new class of mesh to overcome the hurdles of foreign body rejection faced by the traditional meshes, in order to have safe and effective treatment for women in the long term.

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The current state and the future of robotic surgery in female pelvic medicine and reconstructive surgery

Abstract: I n d e x e d i n P u b M e d , W e b o f S c i e n c e a n d S c o p u s Yasemin Yuyucu Karabulut, et al.; The role of COL6A1 and PD-1 expressions in renal cell carcinoma.

Cited by 7 publications

References 68 publications

Partial versus total adrenalectomy for pheochromocytoma: a population-based comparison of outcomes

Partial versus total adrenalectomy for pheochromocytoma: a population-based comparison of outcomes

Artificial intelligence in functional urology: how it may shape the future

Emerging Nano/Micro-Structured Degradable Polymeric Meshes for Pelvic Floor Reconstruction

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