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Falola AF, Dada OS, Adeyeye A, Ezebialu CO, Fadairo RT, Okere MO, Ndong A. Analyzing the emergence of surgical robotics in Africa: a scoping review of pioneering procedures, platforms utilized, and outcome meta-analysis. JOURNAL OF MINIMALLY INVASIVE SURGERY 2024; 27:142-155. [PMID: 39300723 PMCID: PMC11416894 DOI: 10.7602/jmis.2024.27.3.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/27/2024] [Accepted: 08/25/2024] [Indexed: 09/22/2024]
Abstract
Purpose Surgical practice globally has undergone significant advancements with the advent of robotic systems. In Africa, a similar trend is emerging with the introduction of robots into various surgical specialties in certain countries. The need to review the robotic procedures performed, platforms utilized, and analyze outcomes such as conversion, morbidity, and mortality associated with robotic surgery in Africa, necessitated this study. This is the first study examining the status and outcomes of robotic surgery in Africa. Methods A thorough scoping search was performed in PubMed, Google Scholar, Web of Science, and African Journals Online. Of the 1,266 studies identified, 16 studies across 3 countries met the inclusion criteria. A meta-analysis conducted using R statistical software estimated the pooled prevalences with the 95% confidence interval (CI) of conversion, morbidity, and mortality. Results Surgical robots are reportedly in use in South Africa, Egypt, and Tunisia. Across four specialties, 1,328 procedures were performed using da Vinci (Intuitive Surgical), Versius (CMR Surgical), and Senhance (Asensus Surgical) surgical robotic platforms. Urological procedures (90.1%) were the major procedures performed, with robotic prostatectomy (49.3%) being the most common procedure. The pooled rate of conversion and prevalence of morbidity from the meta-analysis was 0.21% (95% CI, 0%-0.54%) and 21.15% (95% CI, 7.45%-34.85%), respectively. There was no reported case of mortality. Conclusion The outcomes highlight successful implementation and the potential for wider adoption. Based on our findings, we advocate for multidisciplinary and multinational collaboration, investment in surgical training programs, and policy initiatives aimed at addressing barriers to the widespread adoption of robotic surgery in Africa.
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Affiliation(s)
- Adebayo Feranmi Falola
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwasina Samuel Dada
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Ademola Adeyeye
- Significant Polyp and Early Colorectal Cancer (SPECC) Service, King’s College Hospital, London, United Kingdom
- Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
- Department of Surgery, University of Ilorin Teaching Hospital, Nigeria
| | - Chioma Ogechukwu Ezebialu
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Rhoda Tolulope Fadairo
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Madeleine Oluomachi Okere
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Medicine and Surgery, College of Medicine, University of Port Harcourt, Choba, Nigeria
| | - Abdourahmane Ndong
- General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
- Department of Surgery, Gaston Berger University, Saint-Louis, Senegal
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Ficarra V, Rossanese M, Giannarini G, Longo N, Viganò S, Russo D, Sorce G, Simonato A, Bartoletti R, Crestani A, Di Trapani E. Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature. EUR UROL SUPPL 2024; 67:7-25. [PMID: 39100226 PMCID: PMC11293526 DOI: 10.1016/j.euros.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Background and objective Several novel multiport robotic systems have been developed and introduced in clinical practice after regulatory approval. The objective of this systematic review was to assess the evolution status of novel robotic platforms approved for clinical use in urological surgery according to the IDEAL framework. Methods A systematic review was conducted using the Medline and Scopus databases according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (CRD42024503227). Comparative or noncomparative studies reporting on any urological procedures performed with novel robotic platforms (Hugo RAS; Versius, KangDuo, Senhance, REVO-I, Avatera, Hinotori, Dexter, or Toumai) were selected and included in the analysis. Key findings and limitations Seventy-four eligible studies were included, of which 67 (90.5%) were noncomparative surgical series representing developmental or explorative studies according to the IDEAL criteria. Only one randomised controlled trial (comparing KangDuo vs da Vinci robot-assisted partial nephrectomy) was included. The trial showed comparable perioperative outcomes between the two robotic systems. Four studies assessed clinical outcomes for patients undergoing urological procedures using a REVO-I (1 study), Senhance (2 studies), or Hinotori (1 study) system in comparison to the same procedures performed using a da Vinci system. All studies revealed outcomes comparable to those with the da Vinci system. Limitations include the small sample size in all studies, and assessment of first-generation novel platforms versus the fourth-generation multiarm da Vinci system in most of the comparative studies. Conclusions and clinical implications A few poor-quality studies have compared the use of novel robotic platforms to da Vinci systems in urological surgery and demonstrated comparable results. Most studies can be classified as developmental or explorative, representing the initial steps of clinical research. Large multicentre series are needed to understand whether these novel robots could offer advantages beyond cost reductions over the da Vinci systems. Patient summary We reviewed research on new robotic systems for surgery in urology. Several studies have shown the feasibility and safety of these new robots during the most common procedures. Very few studies have assessed clinical outcomes with the new robots in comparison to the reference standard, which is a fourth-generation da Vinci robot. Large multicentre studies are needed to understand whether the new robots could offer advantages other than cost savings over the da Vinci robot.
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Affiliation(s)
- Vincenzo Ficarra
- Department of Clinical and Experimental Medicine, Urologic Section, University of Messina, Messina, Italy
- Department of Oncology, Urologic Section, AOU G. Martino, Messina, Italy
| | - Marta Rossanese
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Gianluca Giannarini
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Nicola Longo
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Silvia Viganò
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Domenico Russo
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Gabriele Sorce
- Department of Oncology, Urologic Section, AOU G. Martino, Messina, Italy
| | - Alchiede Simonato
- Department of Precision Medicine in Medical, Surgical and Critical Care, Urology Unit, University of Palermo, Palermo, Italy
| | - Riccardo Bartoletti
- Department of Translational Research and New Technologies in Medicine and Surgery, Urology Unit, University of Pisa, Pisa, Italy
| | - Alessandro Crestani
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Ettore Di Trapani
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
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Li C, Zhang G, Zhao B, Xie D, Du H, Duan X, Hu Y, Zhang L. Advances of surgical robotics: image-guided classification and application. Natl Sci Rev 2024; 11:nwae186. [PMID: 39144738 PMCID: PMC11321255 DOI: 10.1093/nsr/nwae186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 04/19/2024] [Accepted: 05/07/2024] [Indexed: 08/16/2024] Open
Abstract
Surgical robotics application in the field of minimally invasive surgery has developed rapidly and has been attracting increasingly more research attention in recent years. A common consensus has been reached that surgical procedures are to become less traumatic and with the implementation of more intelligence and higher autonomy, which is a serious challenge faced by the environmental sensing capabilities of robotic systems. One of the main sources of environmental information for robots are images, which are the basis of robot vision. In this review article, we divide clinical image into direct and indirect based on the object of information acquisition, and into continuous, intermittent continuous, and discontinuous according to the target-tracking frequency. The characteristics and applications of the existing surgical robots in each category are introduced based on these two dimensions. Our purpose in conducting this review was to analyze, summarize, and discuss the current evidence on the general rules on the application of image technologies for medical purposes. Our analysis gives insight and provides guidance conducive to the development of more advanced surgical robotics systems in the future.
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Affiliation(s)
- Changsheng Li
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing 100081, China
| | - Gongzi Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing 100141, China
| | - Baoliang Zhao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Dongsheng Xie
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing 100081, China
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Hailong Du
- Department of Orthopedics, Chinese PLA General Hospital, Beijing 100141, China
| | - Xingguang Duan
- School of Mechatronical Engineering, Beijing Institute of Technology, Beijing 100081, China
- School of Medical Technology, Beijing Institute of Technology, Beijing 100081, China
| | - Ying Hu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Lihai Zhang
- Department of Orthopedics, Chinese PLA General Hospital, Beijing 100141, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
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Samalavicius NE, Dulskas A. First clinical experience using augmented intelligence in robotic colorectal surgery with the Senhance robotic platform. Ann Coloproctol 2024; 40:412-414. [PMID: 39228202 PMCID: PMC11375229 DOI: 10.3393/ac.2023.00815.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/14/2024] [Indexed: 09/05/2024] Open
Affiliation(s)
- Narimantas Evaldas Samalavicius
- Clinic of Abdominal and Thoracic Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Surgery, Republican Vilnius University Hospital, Vilnius, Lithuania
| | - Audrius Dulskas
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Surgical Oncology, National Cancer Institute, Vilnius, Lithuania
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Kallidonis P, Gkeka K, Tatanis V, Katsakiori P, Vrettos T, Liatsikos E. Novel Robotic Platforms for Robot-Assisted Laparoscopic Surgery in Urology: A Narrative Review. J Endourol 2024; 38:652-660. [PMID: 38753723 DOI: 10.1089/end.2023.0732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Robot-assisted surgery (RAS) has been integrated into clinical practice to overcome several limitations of conventional open or laparoscopic surgery. After the expiration of the long key patent period of Intuitive Surgical, various robotic systems (RSs) have been developed aiming at improving certain characteristics of the first robotic platform, the Da Vinci RS. This narrative review provides an overview of the current RSs used in urology along with the initial results from their application in urologic procedures. Nine robotic platforms are being analyzed regarding their unique characteristics as well as their efficacy, safety, feasibility, and outcomes in urologic, oncological, or non-oncological operations. The main barrier to the wide application of RAS has been the increased cost that refers to both acquisition and maintenance costs. Besides, the health inequality resulting from the lack of expert robotic surgeons and the difficulty of performing robot-assisted procedures in provincial hospitals should be overcome. However, large properly designed comparative studies are required to establish the role of newly introduced RSs. In addition, urologists should keep abreast of new developments and research in robot-assisted urologic procedures.
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Affiliation(s)
| | | | | | | | - Theofanis Vrettos
- Department of Anesthesiology and ICU, University of Patras, Patras, Greece
| | - Evangelos Liatsikos
- Department of Urology, University of Patras, Patras, Greece
- Department of Urology, Medical University of Vienna, Vienna, Austria
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6
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Kaneko G, Shirotake S, Oyama M, Koyama I. Utility of a 3 mm Bipolar Instrument in Laparoscopic Renal Surgery Using the Senhance Robotic System. Cureus 2024; 16:e65694. [PMID: 39211704 PMCID: PMC11358112 DOI: 10.7759/cureus.65694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
We report our initial experience and the utility of 3 mm bipolar forceps in laparoscopic renal surgery using the Senhance robotic system. We performed laparoscopic nephroureterectomy for upper tract urothelial carcinoma in two patients: an 80-year-old female with a left renal pelvic tumor and an 80-year-old male with a right ureteral tumor. Both surgeries were successfully completed without conversion to conventional laparoscopic surgery or laparotomy. The console times for the procedures were 101 and 108 minutes, with estimated blood losses of 5 and 50 milliliters, respectively. The postoperative courses were uncomplicated, with histopathological examinations confirming high-grade urothelial carcinoma with negative surgical margins in both patients. The 3 mm Maryland bipolar instrument was able to grasp membranes with sufficient gentleness and precision. The relatively narrow diameter of the shaft posed a challenge in terms of shaft strength; however, it did not deflect even when it was used to lift the kidney, indicating sufficient robustness. When utilized in the cutting mode, the incision capacity of the 3 mm Maryland bipolar instrument was higher than that of the 5 mm instrument, which allowed for expedient and precise incision. Since only the tissue held by the forceps was incised, it was possible to perform a safe incision even in areas near blood vessels and other organs. Although the tip of the 3 mm Maryland instrument is more sharply pointed than that of the 5 mm instrument, no tissue damage was observed even when the 3 mm instrument was used for blunt dissection. Our initial results suggest that the 3 mm Maryland bipolar instrument is efficacious for performing laparoscopic renal surgery. The instrument may be suitable for a range of surgical procedures in laparoscopic renal surgery using the Senhance system. Further studies are necessary to establish the role and effectiveness of this instrument in broader clinical applications.
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Affiliation(s)
- Go Kaneko
- Urologic Oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Suguru Shirotake
- Urologic Oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Masafumi Oyama
- Urologic Oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Isamu Koyama
- Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, JPN
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7
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Abendstein B, Prugger M, Rab A, Siaulys R, Nausediene V, Karpiciute R, Willeke F, Samalavicius NE. Exploring robotic total hysterectomies: a multi-site experience with the Senhance Surgical System. J Robot Surg 2024; 18:268. [PMID: 38922454 PMCID: PMC11208233 DOI: 10.1007/s11701-024-01944-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/06/2024] [Indexed: 06/27/2024]
Abstract
Robotic-assisted surgery emerged as a technological advancement in the twentieth century, with gynaecology being a key adopter of this approach. The Senhance Surgical System has gained prominence for total hysterectomies from single-site experiences, but multi-site reporting are still lacking in present literature. This multi-site study, conducted at Klaipeda University Hospital and Academic Teaching Hospital Feldkirch, aimed to explore the safety and feasibility of total hysterectomies with the Senhance Surgical System. The study involved 295 cases, showcasing a well-established routine with minimal procedure times. The average age of the patients was 53.5 years (SD: 10.3 years), ranging from 18 to 80 years. The patients' BMI averaged 25.6 kg/m2 (SD: 6.2 kg/m2), ranging from a minimum of 17.7 kg/m2 to a maximum of 69.5 kg/m2. The duration of surgery varied between 30 and 215 min, with a median of 95 min (IQR: 81-116). The docking time was a median of 3 (IQR: 2-5) min and varied between 1.0 and 30.0 min, with a minimum to a maximum range of 1.0 to 122 min. Conversion (3 cases, 1%) and adverse events (6 cases, 2%) were infrequent. Additionally, robotic malfunctions were recorded minimally in 4,1% (12 cases) of the procedures, and pain on a 0-10 visual pain scale was reduced from mild [2.7 (± 1.2)] one day postoperative to minimal [0.9 (± 0.5)] at discharge. Overall, a great routine with the Senhance Surgical System proves good control and, thus, feasibility and safety. Therefore, the Senhance Surgical System is a viable option for total hysterectomy.
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Affiliation(s)
- Burghard Abendstein
- Department of Gynaecology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria.
| | - Michael Prugger
- Department of Gynaecology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Attila Rab
- Department of Gynaecology, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria
| | - Raimondas Siaulys
- Department of Gynaecology, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Vaida Nausediene
- Clinic of Abdominal and Thoracic Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Faculty of Health Sciences, Management of Human Health Activities, Klaipeda University, Klaipeda, Lithuania
| | - Rita Karpiciute
- Department of Day Surgery, National Cancer Institute, Santariskiu 1, Vilnius, Lithuania
| | - Frank Willeke
- Department of General and Visceral Surgery, Marien Hospital, Siegen, Germany
| | - Narimantas Evaldas Samalavicius
- Clinic of Abdominal and Thoracic Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
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Leang YJ, Kong JCH, Mosharaf Z, Hensman CS, Burton PR, Brown WA. Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes. J Robot Surg 2024; 18:145. [PMID: 38554226 PMCID: PMC10981598 DOI: 10.1007/s11701-024-01887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024]
Abstract
Multiple novel multi-port robotic surgical systems have been introduced into clinical practice. This systematic review aims to evaluate the clinical outcomes of these novel robotic systems to conventional laparoscopic technique and established da Vinci robotic surgical platforms. A literature search of Embase, Medline, Pubmed, Cochrane library, and Google Scholar was performed according to the PRISMA guidelines from 2012 to May 2023. Studies comparing clinical outcomes of novel multi-port robotic surgical systems with laparoscopic or the da Vinci platforms were included. Case series with no comparison groups were excluded. Descriptive statistics were used to report patient and outcome data. A systematic narrative review was provided for each outcome. Twelve studies comprised of 1142 patients were included. A total of 6 novel multi-port robotic systems: Micro Hand S, Senhance, Revo-i MSR-5000, KangDuo, Versius, and Hugo™ RAS were compared against the laparoscopic or the da Vinci robotic platforms. Clinical outcomes of these novel robotic platforms were comparable to the established da Vinci platforms. When compared against conventional laparoscopic approaches, the robotic platforms demonstrated lower volume of blood loss, shorter length of stay but longer operative time. This systematic review highlighted the safe implementation and efficacy of 6 new robotic systems. The clinical outcomes achieved by these new robotic systems are comparable to the established da Vinci robotic system in simple to moderate case complexities. There is emerging evidence that these new robotic systems provide a viable alternative to currently available robotic platforms.
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Affiliation(s)
- Yit J Leang
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia.
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Joseph C H Kong
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
- Colorectal Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
| | - Zahin Mosharaf
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Chrys S Hensman
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Paul R Burton
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Wendy A Brown
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
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9
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Lin YC, Yuan LH, Tseng CS, Hsieh TY, Huang YW, Huang CY, Huang SW. Comparison of senhance and da vinci robotic radical prostatectomy: short-term outcomes, learning curve, and cost analysis. Prostate Cancer Prostatic Dis 2024; 27:116-121. [PMID: 37660219 DOI: 10.1038/s41391-023-00717-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/04/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND The Senhance® Robotic System is a new laparoscopy-based platform that has been increasingly used in radical prostatectomy (RP) procedures. The purpose of this study is to compare the outcome of Senhance RP (SRP) with da Vinci RP (DRP) cases. METHODS From August 2019 to April 2022, we prospectively recruited 63 cases of SRP. We compared the perioperative data, postoperative complication rates, short-term surgical outcomes (3-month postoperative undetectable prostate-specific antigen (PSA) and incontinence rates), learning curves, and cost analysis with data from 63 matched da Vinci Xi RP cases. RESULTS There was no difference in BL (180 versus 180 ml, p = 0.86) and postoperative surgical complication rate (Clavient -Dindo grade I-IV, 25.3 versus 22.2%, p = 0.21) between the SRP cases and the DRP. Regarding the oncologic and continence function, there was no difference between positive margin rate (36.5% versus 41.3%, p = 0.58), rate of undetectable PSA level at postoperative 3 months (68.3 versus 66.7%, p = 0.85), and incontinence rate (14.3 versus 15.9%, p = 1.0) at postoperative 3 months between the two cohorts. The learning curve showed a quick downward slope for laparoscopic experienced surgeons. The median pocket cost for SRP patients in our hospital was $4170, which was lower than $7675 for the DRP patients. CONCLUSIONS Safety and short-term outcomes are comparable between SRP and DRP. For experienced LRP surgeons, using the Senhance system to perform RP is straightforward. With a more affordable price as its biggest advantage, the Senhance system may serve as a safe and effective alternative for robotic RP.
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Affiliation(s)
- Yen-Chun Lin
- Department of Urology, National Taiwan University Hospital, Yunlin branch, Yunlin, Taiwan
| | - Lun-Hsiang Yuan
- Department of Urology, National Taiwan University Hospital, Yunlin branch, Yunlin, Taiwan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Shin Tseng
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsung-Yi Hsieh
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Wen Huang
- Department of Urology, National Taiwan University Hospital, Yunlin branch, Yunlin, Taiwan
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Shi-Wei Huang
- Department of Urology, National Taiwan University Hospital, Yunlin branch, Yunlin, Taiwan.
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Menke V, Hansen O, Schmidt J, Dechantsreiter G, Staib L, Davliatov M, Schilcher F, Hübner B, Bianco F, Kastelan Z, Kulis T, Hudolin T, Penezic L, Zekulic T, Andelic J, Juric I, Puda I, Siaulys R, Venckus R, Jasenus M, Eismontas V, Samalavicius NE. The stress for surgeons: exploring stress entities with the robotic senhance surgical system. J Robot Surg 2024; 18:94. [PMID: 38413542 DOI: 10.1007/s11701-024-01853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
Robotic surgery is on its way to revolutionizing traditional surgical procedures, offering precise and minimally invasive techniques hypothesized to shorten recovery times and improve patient outcomes. While there have been multiple publications on robotic systems' medical and procedural achievements, more emphasis should be put on the surgeon's experience, especially in comparison with laparoscopic surgery. The present report aims to systematically examine the stress impact on surgeons by comparing the robotic Senhance Surgical System (Asensus Surgical, Durham, North Carolina, U.S.A) to laparoscopic surgery. The well-established "SURG-TLX" survey is used to measure distinct stress entities. The "SURG-TLX" survey is a modified version of the NASA-TLX, validated for surgery by M. Willson. Based on a comprehensive database from six centers encompassing various disciplines and surgical procedures, our analysis indicates significantly reduced "overall stress" levels for robotic (cockpit) compared to laparoscopic surgeons. Exploring the "SURG-TLX" stress dimensions further between methods (robotic vs. laparoscopic) and surgeon position (laparoscopic, (robotic) bedside, or (robotic) cockpit) resulted in significantly more Mental (p.value < 0.015), less Physical Demands (p.value < 0.001) and less Distraction (p.value < 0.009) for robotic surgery, especially regarding the robotic cockpit surgeons. This finding suggests that robotic surgery with the Senhance Surgical System contributes to a favorable stress profile for surgeons, potentially enhancing their overall well-being and performance.
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Affiliation(s)
- Vivianda Menke
- Department of Surgery, Evangelisches Hospital Wesel, Wesel, Germany.
| | - Olaf Hansen
- Department of Surgery, Evangelisches Hospital Wesel, Wesel, Germany
| | - Johannes Schmidt
- Department of Surgery, Hospital Landshut-Achdorf, Landshut, Germany
| | | | - Ludger Staib
- Department of General and Visceral Surgery, Hospital Esslingen, Esslingen, Germany
| | - Mukhammad Davliatov
- Department of General and Visceral Surgery, Hospital Esslingen, Esslingen, Germany
| | - Florian Schilcher
- Department of General and Visceral Surgery, Hospital Esslingen, Esslingen, Germany
| | - Bodo Hübner
- Department of General and Visceral Surgery, Hospital Esslingen, Esslingen, Germany
| | - Francesco Bianco
- Department of Surgery, General, Minimally Invasive & Robotic Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Zeljko Kastelan
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Tomislav Kulis
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Tvrtko Hudolin
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Luka Penezic
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Toni Zekulic
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Jerko Andelic
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Ilija Juric
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Ivan Puda
- Department of Urology, University Hospital Center, Zagreb, Croatia
| | - Raimondas Siaulys
- Department of Surgery, Urology and Gynaecology, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Raimundas Venckus
- Department of Surgery, Urology and Gynaecology, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Marius Jasenus
- Department of Surgery, Urology and Gynaecology, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Vitalijus Eismontas
- Department of Surgery, Urology and Gynaecology, Klaipeda University Hospital, Klaipeda, Lithuania
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11
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Kulis T, Samalavicius NE, Hudolin T, Venckus R, Penezic L, Nausediene V, Willeke F, Kastelan Z. Robotic-assisted radical prostatectomy: a multicenter experience with the Senhance Surgical System. World J Urol 2024; 42:39. [PMID: 38244127 DOI: 10.1007/s00345-023-04732-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/28/2023] [Indexed: 01/22/2024] Open
Abstract
PURPOSE Robotic-assisted surgery for radical prostatectomy is becoming a standard treatment, and respective implementations are expanding. The Senhance Surgical System is a robotic system with existing but limited data on radical prostatectomy, including a lack of multicenter study experiences. The TRUST study aims to fill this gap and explores observations for radical prostatectomy with the Senhance Surgical System. METHODS Between August 2019 and November 2022, 375 patients met inclusion criteria from two European sites. Patients' surgical procedure times, data on conversion, malfunction, adverse events, and pain scores were registered and evaluated. Outcomes were calculated for both sides, combined as a total and compared between the initial (1st-150th case) and later (> 150th case) period. RESULTS The median operating time was 190 min (IQR: 167.5-215.0) and the median docking time was 3 min (IQR: 2.0-5.0). Eighteen cases (4.8%) were converted to standard laparoscopy and two (0.5%) to open. Two perioperative (0.5%) and eleven postoperative adverse events (2.9%) occurred, mostly (83.3%) categorized as mild. Pain scores were reduced from an average of 3.4 (± 1.4) on the postoperative day to 0.9 (± 0.7) at discharge. Compared to our previous data and based on a comparison between our initial and later period, operating time seems to plateau. However, docking time, complication, and conversion rates were successfully reduced. CONCLUSION We demonstrate progressing safety and efficiency for robotic-assisted radical prostatectomy with the Senhance Surgical System.
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Affiliation(s)
- Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Narimantas E Samalavicius
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
- Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Tvrtko Hudolin
- Department of Urology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Raimundas Venckus
- Department of Urology, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Luka Penezic
- Department of Urology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia.
| | - Vaida Nausediene
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Management of Human Health Activities, Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Frank Willeke
- Deparment of General and Visceral Surgery, Marien Hospital, Siegen, Germany
| | - Zeljko Kastelan
- Department of Urology, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
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12
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Gamal A, Moschovas MC, Jaber AR, Saikali S, Perera R, Headley C, Patel E, Rogers T, Roche MW, Leveillee RJ, Albala D, Patel V. Clinical applications of robotic surgery platforms: a comprehensive review. J Robot Surg 2024; 18:29. [PMID: 38231279 DOI: 10.1007/s11701-023-01815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024]
Abstract
Robotic surgery has expanded globally across various medical specialties since its inception more than 20 years ago. Accompanying this expansion were significant technological improvements, providing tremendous benefits to patients and allowing the surgeon to perform with more precision and accuracy. This review lists some of the different types of platforms available for use in various clinical applications. We performed a literature review of PubMed and Web of Science databases in May 2023, searching for all available articles describing surgical robotic platforms from January 2000 (the year of the first approved surgical robot, da Vinci® System, by Intuitive Surgical) until May 1st, 2023. All retrieved robotic platforms were then divided according to their clinical application into four distinct groups: soft tissue robotic platforms, orthopedic robotic platforms, neurosurgery and spine platforms, and endoluminal robotic platforms. Robotic surgical technology has undergone a rapid expansion over the last few years. Currently, multiple robotic platforms with specialty-specific applications are entering the market. Many of the fields of surgery are now embracing robotic surgical technology. We review some of the most important systems in clinical practice at this time.
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Affiliation(s)
- Ahmed Gamal
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA.
| | - Marcio Covas Moschovas
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
- University of Central Florida (UCF), Orlando, FL, USA
| | - Abdel Rahman Jaber
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Shady Saikali
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Roshane Perera
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Chris Headley
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Ela Patel
- Stanford University, Palo Alto, CA, USA
| | - Travis Rogers
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Martin W Roche
- Department of Arthroplasty, Hospital for Special Surgery Florida, West Palm Beach, FL, USA
| | | | - David Albala
- Associated Medical Professionals, Urology, Syracuse, NY, USA
| | - Vipul Patel
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
- University of Central Florida (UCF), Orlando, FL, USA
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13
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Brassetti A, Ragusa A, Tedesco F, Prata F, Cacciatore L, Iannuzzi A, Bove AM, Anceschi U, Proietti F, D’Annunzio S, Flammia RS, Chiacchio G, Ferriero M, Guaglianone S, Mastroianni R, Misuraca L, Tuderti G, Simone G. Robotic Surgery in Urology: History from PROBOT ® to HUGO TM. SENSORS (BASEL, SWITZERLAND) 2023; 23:7104. [PMID: 37631641 PMCID: PMC10458477 DOI: 10.3390/s23167104] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
The advent of robotic surgical systems had a significant impact on every surgical area, especially urology, gynecology, and general and cardiac surgery. The aim of this article is to delineate robotic surgery, particularly focusing on its historical background, its evolution, its present status, and its future perspectives. A comprehensive literature review was conducted upon PubMed/MEDLINE, using the keywords "robotic surgical system", "robotic surgical device", "robotics AND urology". Additionally, the retrieved articles' reference lists were investigated. Analysis concentrated on urological surgical systems for laparoscopic surgery that have been given regulatory approval for use on humans. From the late 1980s, before daVinci® Era in 2000s, ancestor platform as Probot® and PUMA 560 were described to outline historical perspective. Thus, new robotic competitors of Intuitive Surgical such as Senhance®, Revo-I®, Versius®, Avatera®, Hinotori®, and HugoTM RAS were illustrated. Although daVinci® had high level competitiveness, and for many years represented the most plausible option for robotic procedures, several modern platforms are emerging in the surgical market. Growing competition through unique features of the new robotic technologies might extend applications fields, improve diffusion, and increase cost-effectiveness procedures. More experiences are needed to identify the role of these new advancements in surgical branches and in healthcare systems.
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Affiliation(s)
| | - Alberto Ragusa
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00128 Rome, Italy; (A.B.); (F.T.); (F.P.); (L.C.); (A.I.); (A.M.B.); (U.A.); (F.P.); (S.D.); (R.S.F.); (G.C.); (M.F.); (S.G.); (R.M.); (L.M.); (G.T.); (G.S.)
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Marchegiani F, Siragusa L, Zadoroznyj A, Laterza V, Mangana O, Schena CA, Ammendola M, Memeo R, Bianchi PP, Spinoglio G, Gavriilidis P, de'Angelis N. New Robotic Platforms in General Surgery: What's the Current Clinical Scenario? MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1264. [PMID: 37512075 PMCID: PMC10386395 DOI: 10.3390/medicina59071264] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Robotic surgery has been widely adopted in general surgery worldwide but access to this technology is still limited to a few hospitals. With the recent introduction of new robotic platforms, several studies reported the feasibility of different surgical procedures. The aim of this systematic review is to highlight the current clinical practice with the new robotic platforms in general surgery. Materials and Methods: A grey literature search was performed on the Internet to identify the available robotic systems. A PRISMA compliant systematic review was conducted for all English articles up to 10 February 2023 searching the following databases: MEDLINE, EMBASE, and Cochrane Library. Clinical outcomes, training process, operating surgeon background, cost-analysis, and specific registries were evaluated. Results: A total of 103 studies were included for qualitative synthesis after the full-text screening. Of the fifteen robotic platforms identified, only seven were adopted in a clinical environment. Out of 4053 patients, 2819 were operated on with a new robotic device. Hepatopancreatobiliary surgery specialty performed the majority of procedures, and the most performed procedure was cholecystectomy. Globally, 109 emergency surgeries were reported. Concerning the training process, only 45 papers reported the background of the operating surgeon, and only 28 papers described the training process on the surgical platform. Only one cost-analysis compared a new robot to the existing reference. Two manufacturers promoted a specific registry to collect clinical outcomes. Conclusions: This systematic review highlights the feasibility of most surgical procedures in general surgery using the new robotic platforms. Adoption of these new devices in general surgery is constantly growing with the extension of regulatory approvals. Standardization of the training process and the assessment of skills' transferability is still lacking. Further studies are required to better understand the real clinical and economical benefit.
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Affiliation(s)
- Francesco Marchegiani
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Leandro Siragusa
- Department of Surgical Sciences, University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Alizée Zadoroznyj
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Vito Laterza
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Orsalia Mangana
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Carlo Alberto Schena
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
| | - Michele Ammendola
- Science of Health Department, Digestive Surgery Unit, University "Magna Graecia" Medical School, 88100 Catanzaro, Italy
| | - Riccardo Memeo
- Unit of Hepato-Pancreato-Biliary Surgery, General Regional Hospital "F. Miulli", 70021 Acquaviva delle Fonti, Italy
| | - Paolo Pietro Bianchi
- Division of General and Robotic Surgery, Department of Health Sciences, San Paolo Hospital, University of Milan, 20142 Milan, Italy
| | - Giuseppe Spinoglio
- Research Institute Against Digestive Cancer (IRCAD), 67000 Strasbourg, France
| | - Paschalis Gavriilidis
- Department of Surgery, Saint Helena General Hospital, Jamestown, Saint Helena STHL 1ZZ, South Atlantic Ocean, UK
| | - Nicola de'Angelis
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP, University of Paris Cité, Clichy, 92110 Paris, France
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15
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Puentes MC, Rojnica M, Sims T, Jones R, Bianco FM, Lobe TE. Senhance Robotic Platform in Pediatrics: Early US Experience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020178. [PMID: 36832307 PMCID: PMC9955020 DOI: 10.3390/children10020178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Different robotic systems have been used widely in human surgery since 2000, but pediatric patients require some features that are lacking in the most frequently used robotic systems. HYPOTHESIS The Senhance® robotic system is a safe and an effective device for use in infants and children that has some advantages over other robotic systems. METHODS All patients between 0 and 18 years of age whose surgery was amenable to laparoscopy were offered enrollment in this IRB-approved study. We assessed the feasibility, ease and safety of using this robotic platform in pediatric patients including: set-up time, operative time, conversions, complications and outcomes. RESULTS Eight patients, ranging from 4 months to 17 years of age and weighing between 8 and 130 kg underwent a variety of procedures including: cholecystectomy (3), inguinal herniorrhaphy (3), orchidopexy for undescended testes (1) and exploration for a suspected enteric duplication cyst (1). All robotic procedures were successfully performed. The 4-month-old (mo), 8 kg patient underwent an uneventful robotic exploration in an attempt to locate a cyst that was hidden in the mesentery at the junction of the terminal ileum and cecum, but ultimately the patient required an anticipated laparotomy to palpate the cyst definitively and to excise it completely. There was no blood loss and no complications. Robotic manipulation with the reusable 3 mm instruments proved successful in all cases. CONCLUSIONS Our initial experience with the Senhance® robotic platform suggests that this is a safe and effective device for pediatric surgery that is easy to use, and which warrants continued evaluation. Most importantly, there appears to be no lower age or weight restrictions to its use.
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Affiliation(s)
- Maria Consuelo Puentes
- Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL 60612, USA
- Hospital Luis Calvo Mackenna, Antonio Varas 360, Providencia 7500539, Chile
| | - Marko Rojnica
- Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL 60612, USA
- Mount Sinai Hospital, Chicago, IL 60608, USA
| | - Thomas Sims
- Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL 60612, USA
- Mount Sinai Hospital, Chicago, IL 60608, USA
| | | | - Francesco M. Bianco
- Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL 60612, USA
- Mount Sinai Hospital, Chicago, IL 60608, USA
| | - Thom E. Lobe
- Department of Surgery, The University of Illinois, 840 S Wood Street, Ste 416, Chicago, IL 60612, USA
- Mount Sinai Hospital, Chicago, IL 60608, USA
- Correspondence: ; Tel.: +1-(901)-550-1378
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16
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Khitaryan AG, Mezhunts AV, Veliev KS, Melnikov DA, Abovyan AA, Rogut AA. [The first experience of robot-assisted bariatric surgery using the Senhance system in patients with morbid obesity]. Khirurgiia (Mosk) 2023:82-88. [PMID: 38010021 DOI: 10.17116/hirurgia202311182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To study the results of robot-assisted bariatric surgery using the Senhance system in patients with morbid obesity. MATERIAL AND METHODS A prospective cohort study included 74 patients who underwent bariatric surgery (Senhance digital laparoscopy system) between January 2022 and May 2023. Of these, 12 patients underwent robot-assisted longitudinal gastrectomy, 20 patients - robot-assisted Roux-en-Y gastric bypass, 36 patients - robot-assisted gastric bypass with one anastomosis/mini-gastric bypass, 6 patients - surgical exploration. We assessed duration of surgery, docking, placement of trocars and robotic manipulators, the need for their intraoperative displacement, incidence of intraoperative complications and conversions to laparoscopic surgery, intraoperative blood loss and early postoperative complications, severity of pain syndrome on the 1st day after surgery. RESULTS Mean surgery time was 87 [67, 120], 116 [78, 139], 96 [79, 125] and 141 [112, 184] min, respectively. Intraoperative blood loss was less than 50 ml. There were no complications requiring surgical treatment, cardiovascular, respiratory and other complications within 1 month. CONCLUSION Robot-assisted bariatric surgery using the Senhance system is feasible and safe for patients. Immediate results of robotic surgery are comparable to those after laparoscopy. However, large experience and cost-effectiveness analysis are required to assess the feasibility of robotic systems in bariatric surgery.
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Affiliation(s)
- A G Khitaryan
- Rostov State Medical University, Rostov-on-Don, Russia
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
| | - A V Mezhunts
- Rostov State Medical University, Rostov-on-Don, Russia
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
| | - K S Veliev
- Rostov State Medical University, Rostov-on-Don, Russia
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
| | - D A Melnikov
- Rostov State Medical University, Rostov-on-Don, Russia
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
| | - A A Abovyan
- Rostov State Medical University, Rostov-on-Don, Russia
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
| | - A A Rogut
- Clinical Hospital «RZD-Medicine», Rostov-on-Don, Russia
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17
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Li X, Xu W, Fan S, Xiong S, Dong J, Wang J, Dai X, Yang K, Xie Y, Liu G, Meng C, Zhang Z, Cai L, Zhang C, Zhang Z, Ji Z, Shen C, Zhou L. Robot-assisted Partial Nephrectomy with the Newly Developed KangDuo Surgical Robot Versus the da Vinci Si Surgical System: A Double-center Prospective Randomized Controlled Noninferiority Trial. Eur Urol Focus 2023; 9:133-140. [PMID: 36446724 DOI: 10.1016/j.euf.2022.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/11/2022] [Accepted: 07/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The KangDuo surgical robot (KD-SR) was recently developed in China. OBJECTIVE To compare the safety and efficacy of the KD-SR versus the da Vinci Si Surgical System (DV-SS-Si) for robot-assisted partial nephrectomy (RAPN). DESIGN, SETTING, AND PARTICIPANTS A double-center prospective randomized controlled noninferiority trial of patients aged 18-75 yr with a suspicion of T1a N0M0 renal cancer (RENAL nephrometry score ≤9) was conducted. INTERVENTION RAPN with the KD-SR versus the DV-SS-Si. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary endpoint was the success rate of operation. The operation was successful if (1) there was no open or laparoscopic conversion, (2) the warm ischemia time was <30 min for RENAL nephrometry scores of 4-6 or 40 min for RENAL nephrometry scores of 7-9, and (3) the pathological margin was negative. The secondary endpoint was the estimated glomerular filtration rate (eGFR). A threshold of 10% was set to demonstrate noninferiority. RESULTS AND LIMITATIONS From September 2020 to March 2021, 100 participants were enrolled, of whom 99 (49 in the KD-SR group and 50 in the DV-SS-Si group) were finally included in the full analysis set and 98 (49 in the KD-SR group and -49 in the DV-SS-Si group) in the per-protocol set. Baseline demographic and clinical characteristics were similar between the two groups. All surgeries were completed successfully. The eGFR at postoperative weeks 4-12 and adverse events were similar between the two groups. The docking time and suture time per stitch were longer in the KD-SR group. The main limitation was that a negative margin was considered as the primary outcome rather than survival. CONCLUSIONS The KD-SR achieved noninferior outcomes as compared with the DV-SS-Si regarding safety and efficacy for T1a tumors. PATIENT SUMMARY The first trial comparing the KangDuo surgical robot (KD-SR) versus the da Vinci Si Surgical System for robot-assisted partial nephrectomy showed that the KD-SR is a viable option for minimally invasive treatment of T1a renal tumors.
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Affiliation(s)
- Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Weifeng Xu
- Department of urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shubo Fan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Shengwei Xiong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Jie Dong
- Department of urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Xiaofei Dai
- Department of Urology, Civil Aviation General Hospital, Civil Aviation Medical College of Peking University, Beijing, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Yi Xie
- Department of urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Guanghua Liu
- Department of urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chang Meng
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Zheng Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Lin Cai
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Cuijian Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Zhongyuan Zhang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China
| | - Zhigang Ji
- Department of urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Cheng Shen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China.
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University. National Urological Cancer Center, Beijing, China.
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Sasaki T, Tomohisa F, Nishimura M, Arifuku H, Ono T, Noda A, Otsubo T. Initial 30 cholecystectomy procedures performed with the Senhance digital laparoscopy system. Asian J Endosc Surg 2022; 16:225-232. [PMID: 36418001 DOI: 10.1111/ases.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The Senhance digital laparoscopy system (SDLS) is a novel platform developed for digitization in endoscopic surgery. This retrospective study aimed to evaluate the short-term outcome in the initial 30 consecutive patients. METHODS SDLS cholecystectomies were performed in 30 consecutive patients (13 male, 17 female) by a single surgeon from September 2020 to March 2022. The patients' median age (range) was 77.5 (27-82) years, and median body mass index was 23.3 (19-38) kg/m2 . Four trocars were used, three of which were docked to manipulator arms of the SDLS. Surgical procedures performed with the SDLS were almost the same as those by conventional surgery. RESULTS Median docking time, cockpit time, and operation time in minutes were 4 (3-13), 34 (13-81), and 69 (47-201), respectively. Operation time after the sixth case tended to shorten compared with that for the initial five cases. Three cases (10%) were converted to conventional laparoscopic surgery due to severe cholecystitis, but none required conversion to open surgery. Postoperative complications of Clavien-Dindo grade ≥II were not observed. CONCLUSION This retrospective study showed that cholecystectomy using the SDLS appeared to be safe and feasible in limited cases without severe inflammation.
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Affiliation(s)
- Takahiro Sasaki
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Furuhata Tomohisa
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Masashige Nishimura
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Hirotaka Arifuku
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Tatsunori Ono
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Akiyoshi Noda
- Digestive Disease Center, St. Marianna University Toyoko Hospital, Kawasaki, Japan
| | - Takehito Otsubo
- Department of Gastroenterological and General Surgery, St. Marianna University, Kawasaki, Japan
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Hans S, Baudouin R, Circiu MP, Couineau F, Lisan Q, Crevier-Buchman L, Lechien JR. Laryngeal Cancer Surgery: History and Current Indications of Transoral Laser Microsurgery and Transoral Robotic Surgery. J Clin Med 2022; 11:jcm11195769. [PMID: 36233637 PMCID: PMC9571943 DOI: 10.3390/jcm11195769] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 11/21/2022] Open
Abstract
The development of transoral laser microsurgery (TLM) was an important step in the history of conservative laryngeal surgery. TLM reported comparable oncological outcomes and better functional postoperative and rehabilitation outcomes than open partial laryngectomy. TLM is currently considered as the standard surgical approach for early-stage laryngeal carcinoma. However, TLM has many limitations, including the limited view of the surgical field through the laryngoscope, exposure difficulties for some tumor locations, and a long learning curve. The development of transoral robotic surgery (TORS) appears to be an important issue to overcome these limitations. The current robotic technologies used in surgery benefited from the research of the U.S. Military and National Aeronautics and Space Administration (NASA) in the 1970s and 1980s. The first application in humans started in the 2000s with the first robotic-assisted cholecystectomy in the US, performed by a surgeon located in France. The use of robots in otolaryngology occurred after the development of the Da Vinci system in digestive surgery, urology, and gynecology, and mainly concerns cT1-T2 and some selected cT3 oropharyngeal and supraglottic carcinomas. With the development of a new robotic system with smaller arms and instruments, TORS indications will probably evolve in the next few years, leading to better outcomes for laryngeal or hypopharyngeal carcinomas.
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Affiliation(s)
- Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Robin Baudouin
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Marta P. Circiu
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Florent Couineau
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Quentin Lisan
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Lise Crevier-Buchman
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
| | - Jerome R. Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), 92150 Paris, France
- Division of Laryngology and Broncho-Esophagology, EpiCURA Hospital, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
- Polyclinic of Poitiers—Elsan, 86000 Poitiers, France
- Correspondence:
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20
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Bozkurt E, Sijberden JP, Hilal MA. What Is the Current Role and What Are the Prospects of the Robotic Approach in Liver Surgery? Cancers (Basel) 2022; 14:4268. [PMID: 36077803 PMCID: PMC9454668 DOI: 10.3390/cancers14174268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
In parallel with the historical development of minimally invasive surgery, the laparoscopic and robotic approaches are now frequently utilized to perform major abdominal surgical procedures. Nevertheless, the role of the robotic approach in liver surgery is still controversial, and a standardized, safe technique has not been defined yet. This review aims to summarize the currently available evidence and prospects of robotic liver surgery. Minimally invasive liver surgery has been extensively associated with benefits, in terms of less blood loss, and lower complication rates, including liver-specific complications such as clinically relevant bile leakage and post hepatectomy liver failure, when compared to open liver surgery. Furthermore, comparable R0 resection rates to open liver surgery have been reported, thus, demonstrating the safety and oncological efficiency of the minimally invasive approach. However, whether robotic liver surgery has merits over laparoscopic liver surgery is still a matter of debate. In the current literature, robotic liver surgery has mainly been associated with non-inferior outcomes compared to laparoscopy, although it is suggested that the robotic approach has a shorter learning curve, lower conversion rates, and less intraoperative blood loss. Robotic surgical systems offer a more realistic image with integrated 3D systems. In addition, the improved dexterity offered by robotic surgical systems can lead to improved intra and postoperative outcomes. In the future, integrated and improved haptic feedback mechanisms, artificial intelligence, and the introduction of more liver-specific dissectors will likely be implemented, further enhancing the robots' abilities.
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Affiliation(s)
- Emre Bozkurt
- Department of Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy
- Department of Surgery, Hepatopancreatobiliary Surgery Division, Koç University Hospital, Istanbul 34010, Turkey
| | - Jasper P. Sijberden
- Department of Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Mohammed Abu Hilal
- Department of Surgery, Poliambulanza Foundation Hospital, 25124 Brescia, Italy
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
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21
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Hinata N, Yamaguchi R, Kusuhara Y, Kanayama H, Kohjimoto Y, Hara I, Fujisawa M. Hinotori Surgical Robot System, a novel robot‐assisted surgical platform: Preclinical and clinical evaluation. Int J Urol 2022; 29:1213-1220. [DOI: 10.1111/iju.14973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Nobuyuki Hinata
- Department of Urology Hiroshima University Graduate School of Biomedical and Health Sciences Hiroshima Japan
- Department of Urology Kobe University Graduate School of Medicine Kobe Japan
| | - Raizo Yamaguchi
- Department of Urology Kobe University Hospital International Clinical Cancer Research Center Kobe Japan
| | - Yoshito Kusuhara
- Department of Urology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Hiroomi Kanayama
- Department of Urology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Yasuo Kohjimoto
- Department of Urology Wakayama Medical University Wakayama Japan
| | - Isao Hara
- Department of Urology Wakayama Medical University Wakayama Japan
| | - Masato Fujisawa
- Department of Urology Kobe University Graduate School of Medicine Kobe Japan
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22
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Xu W, Dong J, Xie Y, Liu G, Zhou J, Wang H, Zhang S, Wang H, Ji Z, Cui L. Robot-assisted partial nephrectomy with a new robotic surgical system: feasibility and perioperative outcomes. J Endourol 2022; 36:1436-1443. [PMID: 35838131 DOI: 10.1089/end.2022.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate the feasibility and safety of a novel robotic system (KD-SR-01) for partial nephrectomy. METHODS Seventeen patients with small renal mass (SRM) (≤4 cm) underwent KD-SR-01 robotic partial nephrectomy (KD-RPN) from December 2020 to March 2021 in our institution. The operative outcomes and perioperative data, including clinical and histological data, were prospectively collected and analyzed. RESULTS In total, 10 men and 7 women, with a median age of 51 years, underwent KD-RPN. Four transperitoneal procedures and 13 retroperitoneal procedures were successfully performed without conversion to open or conventional laparoscopic surgery. The docking time and robotic operative time were 3.3 min and 68.6 min, respectively. The warm ischemia time was 16.9 min. No major intraoperative or postoperative complications (Clavien grade ≥ III) occurred. The duration of postoperative hospital stay was 5 days. Pathologic examination revealed nine clear cell carcinomas, two papillary cell carcinomas, one oncocytoma, and five angiomyolipoma. All surgical margins were negative. The estimated globular filtration rate (eGFR) on the 1st postoperative day was significantly decreased compared to the preoperative eGFR (91.7±12.9 ml/min vs. 97.9±10.7 ml/min, P =0.036). However, no significant difference was observed between the preoperative eGFR and the value on the 4th postoperative day (95.7±13.4 ml/min vs. 97.9±10.7 ml/min, P=0.427). CONCLUSION KD-RPN was safe and feasible for the treatment of SRM. The early oncologic and functional outcomes were promising. Long-term follow-up and well-designed prospective comparative studies with the da Vinci platform are needed to corroborate these findings.
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Affiliation(s)
- Weifeng Xu
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Jie Dong
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Yi Xie
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Guanghua Liu
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Jingmin Zhou
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Huizhen Wang
- Peking Union Medical College Hospital, 34732, Department of operating room, Beijing, China;
| | - Shengjie Zhang
- Peking Union Medical College Hospital, 34732, Department of operating room, Beijing, China;
| | - Hui Wang
- Peking Union Medical College Hospital, 34732, Department of operating room, Beijing, China;
| | - Zhigang Ji
- Peking Union Medical College Hospital, 34732, Department of Urology, Beijing, China;
| | - Liang Cui
- Civil Aviation General Hospital, 117987, Department of Urology, Beijing, China;
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23
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Sasaki M, Hirano Y, Yonezawa H, Shimamura S, Kataoka A, Fujii T, Okazaki N, Ishikawa S, Ishii T, Deguchi K, Sato H, Sakuramoto S, Okamoto K, Koyama I. Short-term results of robot-assisted colorectal cancer surgery using Senhance Digital Laparoscopy System. Asian J Endosc Surg 2022; 15:613-618. [PMID: 35484860 PMCID: PMC9321837 DOI: 10.1111/ases.13064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/11/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Senhance Digital Laparoscopy System (Asensus Surgical Inc, Morrisville, NC, United States), which was introduced for the first time in Japan by our hospital, is a new surgical assistive robot following the da Vinci Surgical System. We herein report the short-term outcomes of 55 colorectal cancer surgery cases using this system at our hospital to assess the feasibility and safety of our procedures. MATERIALS AND METHODS We retrospectively reviewed the patient backgrounds and surgical outcomes of 55 patients who underwent Senhance-assisted laparoscopic colorectal cancer surgery. RESULTS The median age was 71 years. There were 31 males and 24 females, and the median body mass index was 23.1 kg/m2 . Fifteen patients had a history of abdominal surgery. The most common surgical technique was ileocecal resection (18 cases, 32.7%), followed by high anterior resection (11 cases, 20.0%). D2 or D3 dissection was performed in each operation, and D3 dissection was performed in 41 cases (74.5%). The median operative time was 240 minutes, the median blood loss was 5 mL, there were no intraoperative complications, and there were no cases of intraoperative blood transfusion. The median postoperative hospital stay was 7 days, which was comparable to conventional laparoscopic surgery. Postoperative complications of grade 2 or higher in the Clavien-Dindo classification were observed in two cases. CONCLUSION The short-term results of 55 colorectal cancer surgery cases using the Senhance Digital Laparoscopy System were excellent and the system was introduced and surgery was safely performed.
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Affiliation(s)
- Megumi Sasaki
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Yasumitsu Hirano
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Hiroki Yonezawa
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Satoshi Shimamura
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Atsuko Kataoka
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Takatsugu Fujii
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Naoto Okazaki
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Shintaro Ishikawa
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Toshimasa Ishii
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Katsuya Deguchi
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Hiroshi Sato
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Shinichi Sakuramoto
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Kojun Okamoto
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
| | - Isamu Koyama
- Department of Gastroenterological SurgerySaitama Medical University International Medical CenterHidakaJapan
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24
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Samalavicius NE, Kaminskas T, Zidonis Z, Janusonis V, Deduchovas O, Eismontas V, Nausediene V, Dulskas A. Robotic cholecystectomy using Senhance robotic platform versus laparoscopic conventional cholecystectomy: a propensity score analysis. Acta Chir Belg 2022; 122:160-163. [PMID: 33502944 DOI: 10.1080/00015458.2021.1881332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Our study objective was to evaluate differences in intraoperative and postoperative outcomes of robotic cholecystectomy (RC) using Senhance robotic platform vs laparoscopic cholecystectomy (LC). MATERIAL AND METHODS A retrospective case - matched analysis was performed for all patients who underwent cholecystectomy from November 2018 to November 2019. RC cases were matched to LC. RC was performed using Senhance robotic platform. Propensity score matching analysis with a ratio of 1:1 (RC: LC) was performed. The groups were matched according to age, sex, body mass index (BMI). All procedures were performed by two same experienced robotic surgeons at Klaipeda University Hospital (O.D. and V.E.). Age, BMI, operative time, blood loss and length of hospital stay were collected and analysed between those patient groups. RESULTS A total of 40 patients underwent RC or LC. There were no statistical differences between groups in concern of length of hospital stay, blood loss or complications. There were no bile duct injuries in either group, no intraoperative complications, no conversions either RC to LC or LC to open surgery. One patient in robotic group was reoperated on postoperative day 5 regarding sub-hepatic haematoma. The only statistical significance was in operative time (p < .05) which was longer in RC group. Median docking time was 12 min (range 5-23). CONCLUSIONS Robotic cholecystectomy using Senhance robotic platform appears to be safe in comparison with laparoscopic cholecystectomy. Laparoscopic cholecystectomy might be feasible in gaining robotic surgery skills.
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Affiliation(s)
- Narimantas E. Samalavicius
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Tadas Kaminskas
- Department of Surgical Oncology, National Cancer Institute, Vilnius, Lithuania
| | - Zygimantas Zidonis
- Department of Surgical Oncology, National Cancer Institute, Vilnius, Lithuania
| | | | - Olegas Deduchovas
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
| | | | - Vaida Nausediene
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Audrius Dulskas
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
- Department of Surgical Oncology, National Cancer Institute, Vilnius, Lithuania
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25
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Samalavicius NE, Klimasauskiene V, Janusonis V, Samalavicius RS, Janusonis T, Dulskas A. Abdominoperineal resection for low rectal neuroendocrine carcinoma after neoadjuvant chemotherapy using the Senhance robotic system with articulating Radia instrument - A Video Vignette. Colorectal Dis 2022; 24:798-799. [PMID: 35068034 DOI: 10.1111/codi.16065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Narimantas E Samalavicius
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania.,Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Health Research and Innovation Science Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | | | - Vinsas Janusonis
- Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania
| | - Robertas S Samalavicius
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Lithuania Emergency Medicine Center, Vilnius University Hospital Santaros clinics, Vilnius, Lithuania
| | - Tomas Janusonis
- Department of Anaesthesiology and Intensive Care, Klaipeda University Hospital, Klaipeda, Lithuania.,Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Audrius Dulskas
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania.,Departament of Surgical Oncology, National Cancer Institute, Vilnius, Lithuania
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26
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Huscher C, Marchegiani F, Cobellis F, Tejedor P, Pastor C, Lazzarin G, Wheeler J, Di Saverio S. Robotic oncologic colorectal surgery with a new robotic platform (CMR Versius): hope or hype? A preliminary experience from a full-robotic case-series. Tech Coloproctol 2022; 26:745-753. [PMID: 35637355 PMCID: PMC9360145 DOI: 10.1007/s10151-022-02626-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 04/22/2022] [Indexed: 12/16/2022]
Abstract
Background The present case-series describes the first full-robotic colorectal resections performed with the new CMR Versius platform (Cambridge Medical Robotics Surgical, 1 Evolution Business Park, Cambridge, United Kingdom) by an experienced robotic surgeon. Methods In a period between July 2020 and December 2020, patients aged 18 years or older, who were diagnosed with colorectal cancer and were fit for minimally invasive surgery, underwent robotic colorectal resection with CMR Versius robotic platform at “Casa di Cura Cobellis” in Vallo della Lucania,Salerno, Italy. Three right colectomies, 2 sigmoid colectomies and 1 anterior rectal resection were performed. All the procedures were planned as fully robotic. Surgical data were retrospectively reviewed from a prospectively collected database. Results Four patients were male and 2 patients were female with a median (range) age of 66 (47–72) years. One covering ileostomy was created. Full robotic splenic flexure mobilization was performed. No additional laparoscopic gestures or procedures were performed in this series except for clipping and stapling which were performed by the assistant surgeon due to the absence of robotic dedicated instruments. Two ileocolic anastomoses, planned as robotic-sewn, were performed extracorporeally. One Clavien–Dindo II complication occurred due to a postoperative blood transfusion. Median total operative time was 160 (145–294) min for right colectomies, 246 (191–300) min for sigmoid colectomies and 250 min for the anterior rectal resection. Conclusions The present series confirms the feasibility of full-robotic colorectal resections while highlighting the strengths and the limitations of the CMR Versius platform in colorectal surgery. New devices will need more clinical development to be comparable to the current standard. Supplementary Information The online version contains supplementary material available at 10.1007/s10151-022-02626-9.
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Affiliation(s)
- Cristiano Huscher
- Casa di Cura Cobellis, Vallo della Lucania, Salerno, Italy
- Department of Surgical Oncology, Robotics and New Technologies, Policlinico Abano, Padua, Italy
| | - Francesco Marchegiani
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Francesco Cobellis
- Casa di Cura Cobellis, Vallo della Lucania, Salerno, Italy
- University of Padua, Padua, Italy
| | - Patricia Tejedor
- Department of Colorectal Surgery, University Hospital Gregorio Marañon, Madrid, Spain
| | - Carlos Pastor
- Department of Colorectal Surgery, University Clinic of Navarre, Madrid-Pamplona, Spain
| | - Gianni Lazzarin
- Department of Surgical Oncology, Robotics and New Technologies, Policlinico Abano, Padua, Italy
| | - James Wheeler
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Salomone Di Saverio
- General Surgery Department "Paride Stefanini", La Sapienza University of Rome, Rome, Italy.
- Department of General Surgery, Madonna del Soccorso Hospital, Asur Marche Area Vasta 5, San Benedetto del Tronto, Ascoli Piceno, Italy.
- Brighton and Sussex University Medical School , Brighton, UK.
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27
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Jung WB. Current status of robotic surgery for colorectal cancer: A review. INTERNATIONAL JOURNAL OF GASTROINTESTINAL INTERVENTION 2022. [DOI: 10.18528/ijgii220009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Won Beom Jung
- Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
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28
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Robotic Surgery in Rectal Cancer: Potential, Challenges, and Opportunities. Curr Treat Options Oncol 2022; 23:961-979. [PMID: 35438444 PMCID: PMC9174118 DOI: 10.1007/s11864-022-00984-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 12/09/2022]
Abstract
The current standard treatment for locally advanced rectal cancer is based on a multimodal comprehensive treatment combined with preoperative neoadjuvant chemoradiation and complete surgical resection of the entire mesorectal cancer. For ultra-low cases and cases with lateral lymph node metastasis, due to limitations in laparoscopic technology, the difficulties of operation and incidence of intraoperative complications are always difficult to overcome. Robotic surgery for the treatment of rectal cancer is an emerging technique that can overcome some of the technical drawbacks posed by conventional laparoscopic approaches, improving the scope and effect of radical operations. However, evidence from the literature regarding its oncological safety and clinical outcomes is still lacking. This brief review summarized the current status of robotic technology in rectal cancer therapy from the perspective of several mainstream surgical methods, including robotic total mesorectal excision (TME), robotic transanal TME, robotic lateral lymph node dissection, and artificial intelligence, focusing on the developmental direction of robotic approach in the field of minimally invasive surgery for rectal cancer in the future.
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29
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Sassani JC, Clark SG, McGough CE, Shepherd JP, Bonidie M. Sacrocolpopexy experience with a novel robotic surgical platform. Int Urogynecol J 2022; 33:3255-3260. [PMID: 35312804 DOI: 10.1007/s00192-022-05155-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/20/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective was to describe early experience performing sacrocolpopexy using a novel robotic surgical platform. METHODS This is a case series of all women who underwent robotic-assisted sacrocolpopexy using a new robotics platform (TransEnterix Senhance) between January 2019 and July 2021. All sacrocolpopexies were performed by a single Female Pelvic Medicine and Reconstructive surgeon at a large academic institution. Perioperative information including complications was abstracted from the medical record. Anatomical recurrence was defined as any anatomical point at or past the hymen (≥0). Data are descriptive, with Mann-Whitney U test used for comparison of operative time between the first and second half of the patients. RESULTS A total of 25 sacrocolpopexies were performed using the new robotics platform. Mean age was 62.3 years (±9.2) and mean BMI was 26.5 (±3.8). Ten (40.0%) patients had a prior hysterectomy. Most (n = 21, 84.0%) had stage III or IV prolapse preoperatively. Mean operative time was 210.2 min (±48.6) and median estimated blood loss was 35 ml (IQR 25-50). Mean operative time decreased between the first and second half of the patients (231.7 min vs 190.3 min, p = 0.047). There were no major intraoperative complications. Median follow-up time was 16 weeks (IQR 4-34) and there were no subjective recurrences or retreatments during this period. Two patients (8.0%) had anatomical recurrence without subjective bother. There were two postoperative readmissions (8.0%) within 30 days for small bowel obstruction, one treated surgically and the other with nonsurgical management. CONCLUSIONS Our case series demonstrates feasibility and successful early adoption of a new robotics platform for robotic sacrocolpopexy.
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Affiliation(s)
- Jessica C Sassani
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Stephanie Glass Clark
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christine E McGough
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jonathan P Shepherd
- Department of Obstetrics & Gynecology, University of Connecticut Health Center, Farmington, CT, USA
| | - Michael Bonidie
- Division of Urogynecology, Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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30
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Robotic colorectal surgery using the Senhance ® robotic system: a single center experience. Tech Coloproctol 2022; 26:437-442. [PMID: 35305181 DOI: 10.1007/s10151-022-02589-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 01/31/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the initial experience of a single robotic center with the Senhance® robotic systems (TransEnterix Surgical Inc, Morrisville, NC, USA) in colorectal surgery. METHODS We performed a retrospective analysis of prospectively collected data of patients who underwent colorectal surgery using the Senhance® robotic systems, from November 2018 to November 2020. Perioperative, intraoperative, and short-term postoperative data were assessed. RESULTS There were 57 patients (28 women and 29 men, mean age 61.7 ± 6.2 years [range 23-84 years]). Forty-eight (84.2%) patients underwent surgery for colorectal cancer (22 colon cancer and 26 rectal cancer) and 9 (15.8%) for benign conditions. Mean operating time was 194 min ± 57.8 min (range 90-380 min). In total, 27(47.4%) operations were performed on the colon and 30 (52.6%) on the rectum; mean length of postoperative hospital stay was 8 ± 6.2 days (range 3-48 days). There were 2 (3.4%) conversions to open surgery. No intraoperative complications occurred. Seven patients (12.3%) had postoperative complications 3 (5.3%) of whom had to be treated under general anesthesia. There was no mortality. In 48 patients operated on for colorectal cancer, the mean lymph-node harvest was 18 ± 7.9 (range 7-38 lymph nodes). In the rectal cancer group of 26 patients, the distal resection margin was 3.3 ± 1.8 cm. CONCLUSIONS In our experience, surgery using the new Senhance® robotic system was safe and feasible in surgery of the colon and rectum. Randomized controlled trials comparing this type of colorectal surgery with laparoscopic and/or other types of robotic surgery are needed.
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Ayoub CH, El-Asmar JM, Abdulfattah S, El-Hajj A. Telemedicine and Telementoring in Urology: A Glimpse of the Past and a Leap Into the Future. Front Surg 2022; 9:811749. [PMID: 35273996 PMCID: PMC8901873 DOI: 10.3389/fsurg.2022.811749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring. During the COVID-19 pandemic, telemedicine has played a vital role in combatting the health implications of confinements. Challenges of telemedicine implementation include cost, ethical considerations, security, bandwidth, latency, legal, and licensure difficulties. Nevertheless, the future of telemedicine, specifically telementoring, promises several improvements and innovative advancements that aim to bridge the gap in technological divides of urologic care. In this review, we build on what is already known about telemedicine focusing specifically on aspects related to telementoring, telestration, and telesurgery. Furthermore, we discuss its historical role in healthcare with a special emphasis on current and future use in urology.
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Affiliation(s)
- Christian Habib Ayoub
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jose M. El-Asmar
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Suhaib Abdulfattah
- American University of Beirut Medical School, American University of Beirut, Beirut, Lebanon
| | - Albert El-Hajj
- Department of Surgery, Division of Urology, American University of Beirut Medical Center, Beirut, Lebanon
- *Correspondence: Albert El-Hajj
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32
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Holzer J, Beyer P, Schilcher F, Poth C, Stephan D, von Schnakenburg C, van Gemert W, Staib L. First Pediatric Pyeloplasty Using the Senhance® Robotic System—A Case Report. CHILDREN 2022; 9:children9030302. [PMID: 35327674 PMCID: PMC8947751 DOI: 10.3390/children9030302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 12/28/2022]
Abstract
A pediatric robotic pyeloplasty has been performed with the Senhance® robotic system for the first time in January 2021 on a 1.5-year-old girl with symptomatic ureteropelvic junction stenosis. A Senhance® robotic system (Asensus Surgical® Inc., Durham, NC, USA) with three arms and 5 mm instruments was used, providing infrared eye tracking of the 5 mm camera and haptic feedback for the surgeon, facilitating suturing of the anastomosis and double-J stent insertion. The robotic surgery lasted 4.5 h, was uneventful and successful, without recurrence of the ureteropelvic junction obstruction after six months, and with normal development of the patient’s growth and organ function. The use of the robotic system was shown to be safe and feasible; long term follow-up will be conducted subsequently in pediatric surgery.
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Affiliation(s)
- Juergen Holzer
- Department of Pediatric Surgery, Klinikum, D-73730 Esslingen, Germany; (J.H.); (P.B.)
| | - Peter Beyer
- Department of Pediatric Surgery, Klinikum, D-73730 Esslingen, Germany; (J.H.); (P.B.)
| | - Florian Schilcher
- Department of General and Visceral Surgery, Klinikum, D-73730 Esslingen, Germany; (F.S.); (C.P.)
| | - Clemens Poth
- Department of General and Visceral Surgery, Klinikum, D-73730 Esslingen, Germany; (F.S.); (C.P.)
| | - Dietmar Stephan
- Department of General and Visceral Surgery, Marienkrankenhaus, D-57072 Siegen, Germany;
| | | | - Wim van Gemert
- Department of Pediatric Surgery, University of Maastricht, 6202 AZ Maastricht, The Netherlands;
| | - Ludger Staib
- Department of General and Visceral Surgery, Klinikum, D-73730 Esslingen, Germany; (F.S.); (C.P.)
- Correspondence:
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Narsinh KH, Paez R, Mueller K, Caton MT, Baker A, Higashida RT, Halbach VV, Dowd CF, Amans MR, Hetts SW, Norbash AM, Cooke DL. Robotics for neuroendovascular intervention: Background and primer. Neuroradiol J 2022; 35:25-35. [PMID: 34398721 PMCID: PMC8826289 DOI: 10.1177/19714009211034829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The simultaneous growth of robotic-assisted surgery and telemedicine in recent years has only been accelerated by the recent coronavirus disease 2019 pandemic. Robotic assistance for neurovascular intervention has garnered significant interest due to opportunities for tele-stroke models of care for remote underserved areas. Lessons learned from medical robots in interventional cardiology and neurosurgery have contributed to incremental but vital advances in medical robotics despite important limitations. In this article, we discuss robot types and their clinical justification and ethics, as well as a general overview on available robots in thoracic/abdominal surgery, neurosurgery, and cardiac electrophysiology. We conclude with current clinical research in neuroendovascular intervention and a perspective on future directions.
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Affiliation(s)
- Kazim H Narsinh
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA,Kazim H Narsinh and Daniel L Cooke, UCSF
Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, L-309, San
Francisco, CA 94117, USA. ;
| | - Ricardo Paez
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | | | - M Travis Caton
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Amanda Baker
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Randall T Higashida
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Van V Halbach
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Christopher F Dowd
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Matthew R Amans
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | - Steven W Hetts
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA
| | | | - Daniel L Cooke
- Department of Radiology and
Biomedical Imaging, University of California San Francisco, USA,Kazim H Narsinh and Daniel L Cooke, UCSF
Department of Radiology and Biomedical Imaging, 505 Parnassus Avenue, L-309, San
Francisco, CA 94117, USA. ;
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34
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Farinha R, Puliatti S, Mazzone E, Amato M, Rosiello G, Yadav S, De Groote R, Piazza P, Bravi CA, Koukourikis P, Rha KH, Cacciamani G, Micali S, Wiklund P, Rocco B, Mottrie A. Potential Contenders for the Leadership in Robotic Surgery. J Endourol 2021; 36:317-326. [PMID: 34579555 DOI: 10.1089/end.2021.0321] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose: To summarize the scientific published literature on new robotic surgical platforms with potential use in the urological field, reviewing their evolution from presentation until the present day. Our goal is to describe the current characteristics and possible prospects for these platforms. Materials and Methods: A nonsystematic search of the PubMed, Cochrane library's Central, EMBASE, MEDLINE, and Scopus databases was conducted to identify scientific literature about new robotic platforms other than the Da Vinci® system, reviewing their evolution from inception until December 2020. Only English language publications were included. The following keywords were used: "new robotic platforms," "Revo-I robot," "Versius robot," and "Senhance robot." All relevant English-language original studies were analyzed by one author (R.F.) and summarized after discussion with an independent third party (E.M., S.Y., S.P., and M.A.). Results: Since 1995, Intuitive Surgical, Inc., with the Da Vinci surgical system, is the leading company in the robotic surgical market. However, Revo-I®, Versius®, and Senhance® are the other three platforms that recently appeared on the market with available articles published in peer-reviewed journals. Among these three new surgical systems, the Senhance robot has the most substantial scientific proof of its capacity to perform minimally invasive urological surgery and as such, it might become a contender of the Da Vinci robot. Conclusions: The Da Vinci surgical platform has allowed the diffusion of robotic surgery worldwide and showed the different advantages of this type of technique. However, its use has some drawbacks, especially its price. New robotic platforms characterized by unique features are under development. Of note, they might be less expensive compared with the Da Vinci robotic system. We found that these new platforms are still at the beginning of their technical and scientific validation. However, the Senhance robot is in a more advanced stage, with clinical studies supporting its full implementation.
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Affiliation(s)
- Rui Farinha
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Urology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,Urology Department, Lusíadas Hospital, Lisbon, Portugal
| | - Stefano Puliatti
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Elio Mazzone
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Amato
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Rosiello
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Siddharth Yadav
- Department of Urology & Renal Transplant, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ruben De Groote
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium
| | - Pietro Piazza
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlo Andrea Bravi
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Periklis Koukourikis
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.,Second Department of Urology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Koon Ho Rha
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alexandre Mottrie
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium
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Kulis T, Hudolin T, Penezic L, Zekulic T, Saic H, Knezevic N, Kastelan Z. Comparison of extraperitoneal laparoscopic and extraperitoneal Senhance radical prostatectomy. Int J Med Robot 2021; 18:e2344. [PMID: 34662926 DOI: 10.1002/rcs.2344] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/10/2021] [Accepted: 10/15/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Senhance is novel robotic platform which can be used to perform radical prostatectomy (RP). We compare our results of robotic RP to similar patients operated with laparoscopic technique. PATIENTS AND METHODS A prospective study of 61 patients operated laparoscopically and 107 patients operated using the Senhance robotic system. We have analysed operative and postoperative results in both groups. RESULTS There was no difference in the operative time, estimated blood loss, positive surgical margins, length of hospitalisation and catheterisation. There were 4 (6.5%) Clavien-Dindo grade I complications, and 5 (8.1%) late complications in laparoscopy. There were 6 (5.6%) Clavien-Dindo grade I, 3 (2.8%) grade II, 1 (0.9%) grade IV complications and 2 (1.9%) late complications in robotic group. CONCLUSION Senhance robot-assisted RP is safe, feasible and offers good and comparable functional and oncological outcomes to laparoscopy. The transition to robotic surgery with a relatively fast learning curve can be done effectively for surgeons with previous laparoscopic experience.
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Affiliation(s)
- Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tvrtko Hudolin
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luka Penezic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Toni Zekulic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Hrvoje Saic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Nikola Knezevic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zeljko Kastelan
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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36
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Rodríguez RAC, Noguera RJS. New Horizons in Robotic Surgery: DaVinci Begins to Compete. Rev Urol 2021. [DOI: 10.1055/s-0041-1737013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rafael Andrés Clavijo Rodríguez
- Fundación Universitaria de Ciencias de La Salud, Bogotá, Colombia
- Department of Urology, Hospital Infantil Universitario de San José, Bogotá, Colombia
| | - René Javier Sotelo Noguera
- Institute of Urology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States
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37
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Samalavicius NE, Dulskas A, Sirvys A, Klimasauskiene V, Janusonis V, Janusonis T, Eismontas V, Deduchovas O, Stephan D, Darwich I, Poth C, Schilcher F, Slabadzin Y, Kukharchuk M, Willeke F, Staib L. Inguinal hernia TAPP repair using Senhance ® robotic platform: first multicenter report from the TRUST registry. Hernia 2021; 26:1041-1046. [PMID: 34591213 DOI: 10.1007/s10029-021-02510-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this article was to provide feasibility and safety results of robotic transabdominal preperitoneal inguinal hernia repair (Robotic TAPP). METHODS We included 271 cases of robotic inguinal hernia TAPP repair using the Senhance® robotic platform from four different centers between March 2017 and March 2020. Key data points were intraoperative and postoperative complication rate, operating time, length of hospital stay, postoperative pain score and time required to get back to a daily routine that were inserted in the TransEnterix European Patient Registry for Robotic assisted Laparoscopic Procedures in Urology, Abdominal Surgery, Thoracic and Gynecologic Surgery (TRUST). RESULTS We report 203 cases of unilateral and 68 cases of bilateral inguinal hernia repairs. Mean operative time was 74 ± 35 min (range 32-265 min), postoperative complications occurred in five (1.85%) cases, the intraoperative complication rate was five (1.85%). The average subjective patient-related pain score after the procedure was 3 ± 1.9 (range 1-9), length of hospital stay was 39 ± 28 h (range 4-288 h), and recovery time was 9.65 ± 8 days (range 1-36 days). CONCLUSION Robotic inguinal hernia TAPP repair shows inspiring results. It is a safe and doable procedure. However, cost analysis should be performed in future to show the superiority over other techniques.
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Affiliation(s)
- N E Samalavicius
- Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str, 92288, Klaipeda, Lithuania.,Clinic of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 2 Santariskiu Str., 08660, Vilnius, Lithuania.,Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, 84 H. Manto str., 92294, Klaipeda, Lithuania
| | - A Dulskas
- Clinic of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, 2 Santariskiu Str., 08660, Vilnius, Lithuania. .,Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 1 Santariskiu Str., 08406, Vilnius, Lithuania.
| | - A Sirvys
- Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania
| | | | - V Janusonis
- Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str, 92288, Klaipeda, Lithuania.,Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, 84 H. Manto str., 92294, Klaipeda, Lithuania
| | - T Janusonis
- Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Anesthesiology and Intensive Care, Klaipeda University Hospital, Klaipeda, Lithuania
| | - V Eismontas
- Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str, 92288, Klaipeda, Lithuania
| | - O Deduchovas
- Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str, 92288, Klaipeda, Lithuania
| | - D Stephan
- Department of General and Visceral Surgery, Minimal Invasive Surgery and Robotics, St. Marien-Krankenhaus, Siegen, Germany
| | - I Darwich
- Department of General and Visceral Surgery, Minimal Invasive Surgery and Robotics, St. Marien-Krankenhaus, Siegen, Germany
| | - C Poth
- Department of General and Visceral Surgery, Klinikum Esslingen, Esslingen, Germany
| | - F Schilcher
- Department of General and Visceral Surgery, Klinikum Esslingen, Esslingen, Germany
| | - Y Slabadzin
- Republican Clinical Medical Center of the Administration of the President of the Republic of Belarus, Minsk, Belarus
| | - M Kukharchuk
- Republican Clinical Medical Center of the Administration of the President of the Republic of Belarus, Minsk, Belarus
| | - F Willeke
- Department of General and Visceral Surgery, Minimal Invasive Surgery and Robotics, St. Marien-Krankenhaus, Siegen, Germany
| | - L Staib
- Department of General and Visceral Surgery, Klinikum Esslingen, Esslingen, Germany
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Lei X, Yang L, Huang Z, Shi H, Zhou Z, Tang C, Li T. No beneficial effect on survival but a decrease in postoperative complications in patients with rectal cancer undergoing robotic surgery: a retrospective cohort study. BMC Surg 2021; 21:355. [PMID: 34583670 PMCID: PMC8477518 DOI: 10.1186/s12893-021-01309-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 07/09/2021] [Indexed: 01/21/2023] Open
Abstract
Background Robotic surgery has been taken as a new modality to surpass the technical limitations of conventional surgery. Here we aim to compare the oncologic outcomes of patients with rectal cancer receiving robotic vs. laparoscopic surgery. Methods Data from patients diagnosed with rectal cancer between March 2011 and December 2018 were obtained for outcome assessment at the First Affiliated Hospital of Nanchang University. All patients were separated into two groups: a robot group (patients receiving robotic surgery, n = 314) and a laparoscopy group (patients receiving laparoscopic surgery, n = 220). The primary endpoint was survival outcomes. The secondary endpoints were the general conditions of the operation, postoperative complications and pathological characteristics. Results The 5-year overall survival (OS) and disease-free survival (DFS) at years 1, 3 and 5 were 96.6%, 88.7%, and 87.7% vs. 96.7%, 88.1%, and 78.4%, and 98.6%, 80.2-, and 73.5% vs. 96.2-, 87.2-, and 81.1% in the robot and laparoscopy groups, respectively (P > 0.05). In the multivariable-adjusted analysis, robotic surgery was not an independent prognostic factor for OS and DFS (P = 0.925 and 0.451, respectively). With respect to the general conditions of the operation, patients in the robot group had significantly shorter operation times (163.5 ± 40.9 vs. 190.5 ± 51.9 min), shorter times to 1st gas passing [2(1) vs. 3(1)d] and shorter hospital stay days [7(2) vs. 8(3)d] compared to those in the laparoscopy group (P < 0.01, respectively). After the operation, the incidence of short- and long-term complications in the robot group was significantly lower than that in the laparoscopy group (15.9% vs. 32.3%; P < 0.001), especially for urinary retention (1.9% vs. 7.3%; 0.6% vs. 4.1%, P < 0.05, respectively). With regard to pathological characteristics, TNM stages II and III were more frequently observed in the robot group than in the laparoscopy group (94.3% vs. 83.2%, P < 0.001). No significant difference were observed in lymph nodes retrieved, lymphovascular invasion and circumferential resection margin involvement between the two groups (P > 0.05, respectively). Conclusions This monocentre retrospective comparative cohort study revealed short-term advantages of robot-assisted rectal cancer resection but similar survival compared to conventional laparoscopy.
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Affiliation(s)
- Xiong Lei
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China. .,Gastrointernal Surgical Institute, Nanchang University, Nanchang, 330006, Jiangxi, China.
| | - Lingling Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhixiang Huang
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.,Gastrointernal Surgical Institute, Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Haoran Shi
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Zhen Zhou
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Cheng Tang
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
| | - Taiyuan Li
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China. .,Gastrointernal Surgical Institute, Nanchang University, Nanchang, 330006, Jiangxi, China.
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Rodríguez-Luna MR, Vilallonga R, Roriz-Silva R, Rangarajan M, García Ruiz de Gordejuela A, Caubet E, Gonzalez O, Palermo M, Fort JM, Armengol M. A Comparison of Clinical Outcomes Between Two Different Models of Surgical Robots in Roux-en-Y Gastric Bypass. J Laparoendosc Adv Surg Tech A 2021; 31:969-977. [PMID: 34525316 DOI: 10.1089/lap.2021.0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: For the past 20 years, robotic surgical systems have been used for the Roux-en-Y gastric bypass (RYGB). The da Vinci Surgical System (Intuitive Surgical, Inc.) has been one of the most used robotic platforms. This study aims to retrospectively compare the performance of two models of surgical robots. Materials and Methods: A retrospective comparative study was conducted from a prospective database including all patients who underwent robotic RYGB (RRYGB) from 2011 to 2020. Results: Of a total of 277 patients included, 134 were in the RRYGB using the da Vinci S™ (RRYGB-S™) group and 143 were in the RRYGB using the da Vinci Xi™ (RRYGB-Xi™) group. The mean operative time in the RRYGB-S and RRYGB-Xi groups was 154 ± 28 and 151 ± 32 minutes, respectively (P = .510). The was no statistically significant difference in terms of intraoperative complications between the groups with regard to positive blue test, bleeding, and failure of stapler line. The readmission rate was higher in the RRGB-S group (14.1%) than in the RRYGB-Xi group (3.4%) (P = .004), and it was mainly due to major complications (P = .003) including pouch and gastrojejunostomy anastomotic leaks (P = .001). The nonsurgical complications were statistically significantly higher in the RRYGB-S group (7.4%) than in the RRYGB-Xi group (2.1%) (P < .05), as well as the surgical complications were higher in the RRYGB-S group (7.5%) than in the RRYGB-Xi group (0%) (P < .001). The mean percentage of the total weight loss at 1 and 2 years of follow-up did not show any statistically significant difference (P = .547). Conclusions: The higher complication rate in the S surgical system might be correlated with the initial learning curve and stressed the need for proper robotic surgical training and accurate strategies when introducing emerging technologies into the surgical practice.
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Affiliation(s)
- María Rita Rodríguez-Luna
- Research Institute against Digestive Cancer, IRCAD, Department of Surgery, Strasbourg, France
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Ramon Vilallonga
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
- ELSAN, Department of Surgery, Clinique St-Michel, Toulon, France
| | - Renato Roriz-Silva
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
- Department of Medicine, Federal University of Rondônia - UNIR, Pôrto Velho, Brazil
- Division of General Surgery, Hospital de Base of Porto Velho, Pôrto Velho, Brazil
| | | | - Amador García Ruiz de Gordejuela
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Enric Caubet
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Oscar Gonzalez
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Mariano Palermo
- Daicim Foundation, Department of Surgery, Training, Research, and Clinical activity in Minimally Invasive Surgery, Buenos Aires, Argentina
| | - José Manuel Fort
- Endocrine, Metabolic and Bariatric Unit, Department of Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain
| | - Manel Armengol
- General Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
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Tagliabue F, Burati M, Chiarelli M, Cioffi U, Zago M. Robotic surgery in colon cancer: current evidence and future perspectives – narrative review. Artif Intell Gastrointest Endosc 2021; 2:110-116. [DOI: 10.37126/aige.v2.i4.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/14/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023] Open
Abstract
In the last 10 years, surgery has been developing towards minimal invasiveness; therefore, robotic surgery represents the consequent evolution of laparoscopic surgery. Worldwide, surgeons’ performances have been upgraded by the ergonomic developments of robotic systems, leading to several benefits for patients. The introduction into the market of the new Da Vinci Xi system has made it possible to perform all types of surgery on the colon, an in selected cases, to combine interventions in other organs or viscera at the same time. Optimization of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic resection. From this perspective, single-port robotic colectomy, has reduced the number of robotic ports needed, allowing a better anesthetic outcome and faster recovery. The introduction on the market of new surgical robotic systems from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes.
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Affiliation(s)
- Fulvio Tagliabue
- Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco 23900, Italy
| | - Morena Burati
- Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco 23900, Italy
| | - Marco Chiarelli
- Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco 23900, Italy
| | - Ugo Cioffi
- Department of Surgery, University of Milan, Milano 20122, Italy
| | - Mauro Zago
- Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco 23900, Italy
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Robotic-assisted radical prostatectomy with the Senhance ® robotic platform: single center experience. World J Urol 2021; 39:4305-4310. [PMID: 34313810 DOI: 10.1007/s00345-021-03792-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To describe our institution's initial experience with robot-assisted radical prostatectomy (RARP) using the Senhance® robotic system. PATIENTS AND METHODS A prospective analysis of 127 robot-assisted radical prostatectomies was performed. Patient demographics, preoperative and intraoperative parameters, histopathological examination results, intraoperative and early postoperative complications were obtained and analyzed. RESULTS The median patient age was 61.0 ± 6.36 (from 37 to 73) years, with a mean body mass index of 26.2 ± 3.79 kg/m2. Of 127 patients, 16.5% (n = 21) underwent a pelvic lymph node dissection, 29.1% (n = 37) underwent one sided or bilateral nerve sparing. Post-operative extracapsular invasion (≥ pT3) was found in 15% (n = 19) of the cases and a Gleason score ≥ 7 in 74.8% of all patients. Our median operative time was 180 ± 41.98 min [interquartile range (IQR) 150-215], and median blood loss was 250 ± 236 (IQR 175-430) ml. Of 127 patients, 33.9% (n = 43) had positive margins, of them 28.7% in pT2 and 57.9% in pT3. Fifteen patients (11.8%) experienced complications, of them only three had Clavien-Dindo ≥ 3. Operation time decreased by about 60 min and estimated blood loss decreased by about 200 ml from the initial experience of each surgeon. CONCLUSIONS Robotic prostatectomy using a Senhance® robotic system is feasible, and warrants further study to determine whether it can improve patient outcomes.
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Hale GR, Shahait M, Lee DI, Lee DJ, Dobbs RW. Measuring Quality of Life Following Robot-Assisted Radical Prostatectomy. Patient Prefer Adherence 2021; 15:1373-1382. [PMID: 34188454 PMCID: PMC8236265 DOI: 10.2147/ppa.s271447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Prostate cancer (PCa) represents the most common solid organ malignancy in men. Fortunately, at the time of diagnosis, the majority of cases are staged as localized or regional disease, conferring excellent 5- and 10-year cure rates. There are several first line treatment options including surgical approaches such as robot-assisted radical prostatectomy (RARP) and radiation therapy (RT) available to patients with localized disease that offer similar PCa oncologic outcomes but are associated with potentially significant side effects which may impact health-related quality of life (HRQOL) domains. Recently, clinicians and investigators have sought to better understand these changes in HRQOL metrics with the utilization of patient-reported outcomes (PRO). Given that RARP represents the most common surgical treatment for PCa in the United States, there has been a particular interest in assessing these outcomes derived by patient perspectives to more fully appreciate treatment-related impact on quality of life following RARP. OBJECTIVE This narrative review sought to explore the instruments available to measure quality of life after RARP, a review of the PRO data after RARP, and future directions for assessing and improving quality of life outcomes following this surgery. CLINICAL USE There are several treatment options for men diagnosed with local and regional prostate cancer with similar oncologic outcomes but differing patterns of side effects affecting post-treatment quality of life. Understanding data reported directly by patients following RARP about their side effects and quality of life gives providers additional information for appropriate preoperative counseling for patients choosing between treatment options for their prostate cancer.
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Affiliation(s)
- Graham R Hale
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | - Mohammed Shahait
- Department of Urology, King Hussein Cancer Foundation and Center, Amman, Jordan
| | - David I Lee
- Department of Urology, University of California at Irvine, Irvine, CA, USA
| | - Daniel J Lee
- Division of Urology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ryan W Dobbs
- Division of Urology, Cook County Health and Hospitals System, Chicago, IL, USA
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Abstract
PURPOSE OF REVIEW The landscape of robotic surgical systems in urology is changing. Several new instruments have been introduced internationally into clinical practice, and others are in development. In this review, we provide an update and summary of recent surgical systems and their clinical applications in urology. RECENT FINDINGS Robotic-assisted laparoscopic surgery is increasingly becoming a standard skillset in the urologist's technical armamentarium. The current state of the robotic surgery market is monopolized because of a number of regulatory and technical factors but there are several robotic surgical systems approved for clinical use across the world and numerous others in development. Next-generation surgical systems commonly include a modular design, open access consoles, haptic feedback, smaller instruments, and machine learning. SUMMARY Numerous robotic surgical systems are in development, and several have recently been introduced into clinical practice. These new technologies are changing the landscape of robotic surgery in urology and will likely transform the marketplace of robotic surgery across surgical subspecialties within the next 10--20 years.
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Kastelan Z, Hudolin T, Kulis T, Knezevic N, Penezic L, Maric M, Zekulic T. Upper urinary tract surgery and radical prostatectomy with Senhance ® robotic system: Single center experience-First 100 cases. Int J Med Robot 2021; 17:e2269. [PMID: 33900026 DOI: 10.1002/rcs.2269] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The Senhance® robotic surgery system is a novel robotic platform used in several European and World centres. We present our experience in urologic surgery using this platform. PATIENTS AND METHODS From May 2019 to December 2020, we performed 30 operations of upper urinary tract (UUT) and 70 extraperitoneal radical robotic prostatectomies (RRP). Relevant data were prospectively collected for key outcomes. RESULTS The median age for UUT was 51, and for RRP 65 years. The average estimated blood loss for UUT was 30, and for RRP 200 ml. The average operating time for UUT was 160, and for RRP 200 min. In-hospital stay for UUT was on average 4, and for RRP 5 days. In UUT group, one patient had Clavien-Dindo complication grade II and one had IIIb. In RRP, three patients had grade I complications and three patients had grade II complications. Catheter was removed on average 8 days after RRP. CONCLUSION The Senhance® robotic system is a safe and feasible approach to urological surge.
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Affiliation(s)
- Zeljko Kastelan
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tvrtko Hudolin
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nikola Knezevic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Luka Penezic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Marjan Maric
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Toni Zekulic
- Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
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Kaneko G, Shirotake S, Oyama M, Koyama I. Initial experience of laparoscopic radical nephrectomy using the Senhance ® robotic system for renal cell carcinoma. Int Cancer Conf J 2021; 10:228-232. [PMID: 34221837 DOI: 10.1007/s13691-021-00487-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023] Open
Abstract
The Senhance® robotic system (TransEnterix, Morrisville, NC, USA), previously called the TELELAP Alf-X system, is a novel robotic system with a telesurgical concept. We herein describe our initial experience of Senhance® assisted laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) with detailed figures and videos. Case 1: A left renal tumor was incidentally detected in a 52-year-old female on ultrasonography. Case 2: A right renal tumor was detected in a 67-year-old male with epigastric pain on computed tomography. They were referred for further examination and diagnosed with RCC (clinical T1bN0M0 and clinical T2aN0M0, respectively). Senhance® assisted LRN was completed without conversion to conventional LRN or open surgery in both cases. The pneumoperitoneum time, console time and estimated blood loss in case 1 and case 2 were 173 min, 143 min and 3 mL, and 154 min, 122 min and 50 mL, respectively. The postoperative course was uneventful. Senhance® assisted LRN for RCC was safely and precisely performed. Furthermore, the operator was comfortable during the surgery. Although further surgical experience and long-term follow-up are required to assess surgical and oncological outcomes, Senhance® assisted LRN for RCC may be a promising procedure. Supplementary information The online version contains supplementary material available at 10.1007/s13691-021-00487-x.
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Affiliation(s)
- Go Kaneko
- Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
| | - Suguru Shirotake
- Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
| | - Isamu Koyama
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298 Japan
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Coussons H, Feldstein J, McCarus S. Senhance surgical system in benign hysterectomy: A real-world comparative assessment of case times and instrument costs versus da Vinci robotics and laparoscopic-assisted vaginal hysterectomy procedures. Int J Med Robot 2021; 17:e2261. [PMID: 33860631 DOI: 10.1002/rcs.2261] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Comparison of retrospective, learning curve benign hysterectomy cost and case time data from Senhance total laparoscopic hysterectomy (TLH) cases with similar da Vinci robot cases and laparoscopic-assisted vaginal hysterectomy (LAVH) cases. METHODS Instrument costs, console time, and case time analysis from six surgeons at four U.S. and European hospitals compared with retrospective, sequential da Vinci TLH and standard laparoscopic LAVH cases extracted from the CAVAlytics database. RESULTS Senhance Gyn surgeons in their learning curve when compared to da Vinci learning curve Gyn surgeons achieved lower median instrument costs ($559 vs. $1393, respectively, p < 0.001) with comparable console times (91.5 vs. 96 min, p = 0.898); Senhance and LAVH case costs were comparable ($559 vs. $498, p = 0.336). CONCLUSION In benign hysterectomy, the Senhance system may present a lower-cost approach with equivalent case times compared with similar da Vinci robotic cases.
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Affiliation(s)
| | - Josh Feldstein
- CAVA Robotics International, Amherst, Massachusetts, USA
| | - Steve McCarus
- AdventHealth Winter Park Hospital, Winter Park, Florida, USA
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Boehm F, Graesslin R, Theodoraki MN, Schild L, Greve J, Hoffmann TK, Schuler PJ. Current Advances in Robotics for Head and Neck Surgery-A Systematic Review. Cancers (Basel) 2021; 13:1398. [PMID: 33808621 PMCID: PMC8003460 DOI: 10.3390/cancers13061398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
Background. In the past few years, surgical robots have recently entered the medical field, particularly in urology, gynecology, and general surgery. However, the clinical effectiveness and safety of robot-assisted surgery (RAS) in the field of head and neck surgery has not been clearly established. In this review, we evaluate to what extent RAS can potentially be applied in head and neck surgery, in which fields it is already daily routine and what advantages can be seen in comparison to conventional surgery. Data sources. For this purpose, we conducted a systematic review of trials published between 2000 and 2021, as well as currently ongoing trials registered in clinicaltrials.gov. The results were structured according to anatomical regions, for the topics "Costs," "current clinical trials," and "robotic research" we added separate sections for the sake of clarity. Results. Our findings show a lack of large-scale systematic randomized trials on the use of robots in head and neck surgery. Most studies include small case series or lack a control arm which enables a comparison with established standard procedures. Conclusion. The question of financial reimbursement is still not answered and the systems on the market still require some specific improvements for the use in head and neck surgery.
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Affiliation(s)
- Felix Boehm
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Rene Graesslin
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Marie-Nicole Theodoraki
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Leon Schild
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Patrick J. Schuler
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
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Hirano Y, Kondo H, Yamaguchi S. Robot-assisted surgery with Senhance robotic system for colon cancer: our original single-incision plus 2-port procedure and a review of the literature. Tech Coloproctol 2021; 25:467-471. [PMID: 33587212 DOI: 10.1007/s10151-020-02389-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Senhance robotic system provides such advantages as an eye-tracking camera control system, haptic feedback, operator comfort, and reusable endoscopic instruments. The aim of this small study was to assess the feasibility and safety of performing a reduced-port robot-assisted colectomy for colon cancer with the use of a novel robotic system. METHODS This was a single-center retrospective study of eight patients with colon cancer who underwent single-incision plus 2-port robot-assisted colectomy with the Senhance robotic system (SILS+2-S) between December 2019 and March 2020 at our hospital. Data on perioperative outcomes, which included operative time, operative blood loss, length of hospitalization, postoperative complications, and histopathological results, were collected prospectively. RESULTS The mean patient age was 70.9 years and the mean body mass index was 24.4 kg/m2. One patient was converted to laparoscopy due to a damaged scope holder. The mean operative and console times were 229.1 and 139.1 min, respectively. The mean intraoperative blood loss was 49.4 ml. The mean length of the umbilical incision was 3.0 cm. The mean number of harvested lymph nodes was 18.3. The surgical margins were negative in all eight patients. There was neither morbidity nor mortality associated with the procedure, and no Clavien-Dindo classification Grade II-IV complications occurred. CONCLUSIONS SILS+2-S is a safe and feasible approach for patients with colon cancer. Further studies are needed to validate the advantages of SILS+2-S and to evaluate the long-term oncological outcomes.
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Affiliation(s)
- Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan.
| | - Hiroka Kondo
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
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Abstract
Robot-assisted surgery (RAS) has already been approved for several clinical applications in head and neck surgery. In some Anglo-American regions, RAS is currently the common standard for treatment of oropharyngeal diseases. Systematic randomized studies comparing established surgical procedures with RAS in a large number of patients are unavailable so far. Experimental publications rather describe how to reach poorly accessible anatomical regions using RAS, or represent feasibility studies on the use of transoral robotic surgery (TORS) in established surgical operations. With general application of RAS in clinical practice, the question of financial reimbursement arises. Furthermore, the technical applications currently on the market still require some specific improvements for routine use in head and neck surgery.
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50
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The TransEnterix European Patient Registry for Robotic-Assisted Laparoscopic Procedures in Urology, Abdominal, Thoracic, and Gynecologic Surgery ("TRUST"). Surg Technol Int 2021. [PMID: 33513657 DOI: 10.52198/21.sti.38.gs1394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Robotic surgery was first introduced in the mid-1980s, and at the end of the '90s, the da Vinci® System (Intuitive Surgical Inc., Sunnyvale, California) was introduced in Europe and held a monopoly for years afterward. In 2016, Senhance™ digital laparoscopic platform (TransEnterix Inc., Morrisville, North Carolina) came to the market. This new platform is based on laparoscopic movements and is designed for laparoscopic surgeons. This study shows the surgical outcomes of patients after different visceral, colorectal, gynecological, and urological surgical procedures done with the Senhance™ digital laparoscopic platform with a focus on safety. MATERIALS AND METHODS The study population consists of 871 patients who underwent robotic surgery with the Senhance™ platform. The most common procedures were hernia repairs (unilateral and bilateral), cholecystectomies, and prostatectomies. The procedures were performed in five centers in Europe between February 2017 and July 2020 by experienced laparoscopic surgeons. RESULTS 220 (25.3 %) out of 871 patients had a unilateral hernia repair, 70 (8.0%) a bilateral hernia repair, 159 (18.3%) underwent a cholecystectomy, and 168 (19.3%) a prostatectomy. The other procedures included visceral, colorectal, and gynecological surgery procedures. The median docking time was 7.46 minutes for the four most common procedures. The duration of surgery varied from 32 to 313 minutes, the average time was 114.31 minutes. Adverse events were rare overall. There were 48 (5.5 %) adverse events out of 871 patients, 24 of them (2.8 % of all cases) were severe. Out of all 24 severe adverse events, five events (20.8%) were likely related to the robot, 17 events (70.8%) were unlikely related to the robot, and two events (8.3%) could not be categorized. Regarding complications following unilateral hernia repairs, data from 212 patients was available. Thirteen (6.1%) complications occurred, and six of those (2.8%) were serious. Out of 68 patients with a bilateral hernia repair, six patients (8.8%) developed complications, three of which were severe (4.4%). The complication rate was 2.8% in the patients following a cholecystectomy (4/144); two of them serious. After prostatectomy, six out of 141 patients (4.3 %) had complications; one serious (0.7%) No mortality was observed. Data about unplanned conversions to laparoscopic surgery could be collected from 761 patients which is a rate of 3.7%. There were 12 conversions out of 760 procedures to open surgery (1.6%). CONCLUSIONS Our series shows these procedures are safe and reproducible. The findings suggest that the surgical results after robotic surgery with the Senhance™ system are promising. Long-term data regarding complication rates should be the subject of future studies.
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