The Evidence Behind Robot-Assisted Abdominopelvic Surgery

Dhanani, Naila; Olavarria, Oscar A.; Bernardi, Karla; Lyons, Nicole B.; Holihan, Julie L.; Loor, Michele M.; Haynes, Alex B.; Liang, Mike K.

doi:10.7326/m20-7006

Cited by 36 publications

(27 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the reported oncologic efficacy and safety evidence associated with robotic surgery remain scant, 25 we may ultimately ascertain that robotic surgery is neither safer nor more efficacious than traditional laparoscopy surgery and open surgery. 9 , 10 Consequently, the FDA and the Centers for Medicare & Medicaid Services should remain vigilant regarding the ongoing presence of robotic surgery and ensure that until the clinical results are borne out (i.e., there is a distinct, incontrovertible clinical benefit derived from robotic surgery), this approach should not be readily integrated into the various surgical disciplines and needlessly considered standard of care practice.…”

Section: Discussionmentioning

confidence: 94%

Robotic-Assisted Surgery for the Treatment of Breast and Cervical Cancers

Micha

Rettenmaier

Bohart³

et al. 2022

JSLS

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 94%

Robotic-Assisted Surgery for the Treatment of Breast and Cervical Cancers

Micha

Rettenmaier

Bohart³

et al. 2022

JSLS

View full text Add to dashboard Cite

“…The widespread adoption of MIS, now largely robot-assisted in urology, particularly in the USA and Europe, has come with considerable commitment of medical center resources and operating room time. However, in a recent systematic review of 50 studies of abdominopelvic operations involving nearly 5000 patients, Dhanani et al [39] did not observe a clear advantage for robot-assisted, laparoscopic, or open approaches in terms of intraoperative complications, conversion rates, and long-term outcomes. Going forward, carefully conducted clinical trials, free of commercial bias and conflicts of interest, are essential for the medical community to accurately judge the oncologic and economic value of these innovative approaches and their comparative effectiveness [40] .…”

Section: Discussionmentioning

confidence: 98%

Outcomes for Atypical Tumor Recurrences Following Minimally Invasive Kidney Cancer Operations

Russo

Blum

Weng

et al. 2022

European Urology Open Science

View full text Add to dashboard Cite

“…Further developments in robotic and robot-assisted surgery which provide clear benefits to the patient will depend on the cooperative efforts of engineers and clinicians. It is difficult at present to demonstrate an objective benefit to patients from undergoing robot-assisted surgery [ 37 ], but some studies have shown benefits when difficult procedures are performed [ 75 , 77 ]. Stratification by difficulty may allow the identification of procedures, which will have an evidence-based benefit from the use of robot-assisted approaches.…”

Section: Discussionmentioning

confidence: 99%

“…The widespread use of robot-assisted minimally invasive surgery brought with it hope for improved clinical outcomes. Until the present time, there has been little proven clinical benefit from using robot-assisted minimally invasive surgery, especially compared to laparoscopic surgery, despite the increased cost and operative time associated with robot-assisted minimally invasive surgery [ 37 ]. It is hoped that further refinement of the technology and its use will benefit patients directly.…”

Section: Training Assessment and Simulation In Robot-assisted Surgerymentioning

confidence: 99%

Laparoscopic and Robot-Assisted Hepatic Surgery: An Historical Review

Shimizu

Ito

Lefor

2022

JCM

View full text Add to dashboard Cite

Hepatic surgery is a rapidly expanding component of abdominal surgery and is performed for a wide range of indications. The introduction of laparoscopic cholecystectomy in 1987 was a major change in abdominal surgery. Laparoscopic surgery was widely and rapidly adopted throughout the world for cholecystectomy initially and then applied to a variety of other procedures. Laparoscopic surgery became regularly applied to hepatic surgery, including segmental and major resections as well as organ donation. Many operations progressed from open surgery to laparoscopy to robot-assisted surgery, including colon resection, pancreatectomy, splenectomy thyroidectomy, adrenalectomy, prostatectomy, gastrectomy, and others. It is difficult to prove a data-based benefit using robot-assisted surgery, although laparoscopic and robot-assisted surgery of the liver are not inferior regarding major outcomes. When laparoscopic surgery initially became popular, many had concerns about its use to treat malignancies. Robot-assisted surgery is being used to treat a variety of benign and malignant conditions, and studies have shown no deterioration in outcomes. Robot-assisted surgery for the treatment of malignancies has become accepted and is now being used at more centers. The outcomes after robot-assisted surgery depend on its use at specialized centers, the surgeon’s personal experience backed up by extensive training and maintenance of international registries. Robot-assisted hepatic surgery has been shown to be associated with slightly less intraoperative blood loss and shorter hospital lengths of stay compared to open surgery. Oncologic outcomes have been maintained, and some studies show higher rates of R0 resections. Patients who need surgery for liver lesions should identify a surgeon they trust and should not be concerned with the specific operative approach used. The growth of robot-assisted surgery of the liver has occurred in a stepwise approach which is very different from the frenzy that was seen with the introduction of laparoscopic cholecystectomy. This approach allowed the identification of areas for improvement, many of which are at the nexus of engineering and medicine. Further improvements in robot-assisted surgery depend on the combined efforts of engineers and surgeons.

show abstract

The Evidence Behind Robot-Assisted Abdominopelvic Surgery

Cited by 36 publications

References 60 publications

Robotic-Assisted Surgery for the Treatment of Breast and Cervical Cancers

Robotic-Assisted Surgery for the Treatment of Breast and Cervical Cancers

Outcomes for Atypical Tumor Recurrences Following Minimally Invasive Kidney Cancer Operations

Laparoscopic and Robot-Assisted Hepatic Surgery: An Historical Review

Contact Info

Product

Resources

About