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Robot‐assisted radical prostatectomy training: Description of a canine cadaveric model. Int J Med Robot 2022; 18:e2381. [DOI: 10.1002/rcs.2381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/15/2022] [Accepted: 02/01/2022] [Indexed: 11/07/2022]
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Allakhverdiev ES, Khabatova VV, Kossalbayev BD, Zadneprovskaya EV, Rodnenkov OV, Martynyuk TV, Maksimov GV, Alwasel S, Tomo T, Allakhverdiev SI. Raman Spectroscopy and Its Modifications Applied to Biological and Medical Research. Cells 2022; 11:cells11030386. [PMID: 35159196 PMCID: PMC8834270 DOI: 10.3390/cells11030386] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/17/2022] [Accepted: 01/22/2022] [Indexed: 02/06/2023] Open
Abstract
Nowadays, there is an interest in biomedical and nanobiotechnological studies, such as studies on carotenoids as antioxidants and studies on molecular markers for cardiovascular, endocrine, and oncological diseases. Moreover, interest in industrial production of microalgal biomass for biofuels and bioproducts has stimulated studies on microalgal physiology and mechanisms of synthesis and accumulation of valuable biomolecules in algal cells. Biomolecules such as neutral lipids and carotenoids are being actively explored by the biotechnology community. Raman spectroscopy (RS) has become an important tool for researchers to understand biological processes at the cellular level in medicine and biotechnology. This review provides a brief analysis of existing studies on the application of RS for investigation of biological, medical, analytical, photosynthetic, and algal research, particularly to understand how the technique can be used for lipids, carotenoids, and cellular research. First, the review article shows the main applications of the modified Raman spectroscopy in medicine and biotechnology. Research works in the field of medicine and biotechnology are analysed in terms of showing the common connections of some studies as caretenoids and lipids. Second, this article summarises some of the recent advances in Raman microspectroscopy applications in areas related to microalgal detection. Strategies based on Raman spectroscopy provide potential for biochemical-composition analysis and imaging of living microalgal cells, in situ and in vivo. Finally, current approaches used in the papers presented show the advantages, perspectives, and other essential specifics of the method applied to plants and other species/objects.
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Affiliation(s)
- Elvin S. Allakhverdiev
- Russian National Medical Research Center of Cardiology, 3rd Cherepkovskaya St., 15A, 121552 Moscow, Russia; (E.S.A.); (O.V.R.); (T.V.M.)
- Biology Faculty, Lomonosov Moscow State University, Leninskie Gory 1/12, 119991 Moscow, Russia;
| | - Venera V. Khabatova
- K.A. Timiryazev Institute of Plant Physiology, RAS, Botanicheskaya str., 35, 127276 Moscow, Russia; (V.V.K.); (E.V.Z.)
| | - Bekzhan D. Kossalbayev
- Geology and Oil-gas Business Institute Named after K. Turyssov, Satbayev University, Satpaeva, 22, Almaty 050043, Kazakhstan;
- Department of Biotechnology, Faculty of Biology and Biotechnology, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, Almaty 050038, Kazakhstan
| | - Elena V. Zadneprovskaya
- K.A. Timiryazev Institute of Plant Physiology, RAS, Botanicheskaya str., 35, 127276 Moscow, Russia; (V.V.K.); (E.V.Z.)
| | - Oleg V. Rodnenkov
- Russian National Medical Research Center of Cardiology, 3rd Cherepkovskaya St., 15A, 121552 Moscow, Russia; (E.S.A.); (O.V.R.); (T.V.M.)
| | - Tamila V. Martynyuk
- Russian National Medical Research Center of Cardiology, 3rd Cherepkovskaya St., 15A, 121552 Moscow, Russia; (E.S.A.); (O.V.R.); (T.V.M.)
| | - Georgy V. Maksimov
- Biology Faculty, Lomonosov Moscow State University, Leninskie Gory 1/12, 119991 Moscow, Russia;
- Department of Physical Materials Science, Technological University “MISiS”, Leninskiy Prospekt 4, Office 626, 119049 Moscow, Russia
| | - Saleh Alwasel
- Zoology Department, College of Science, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Tatsuya Tomo
- Department of Biology, Faculty of Science, Tokyo University of Science, 1-3 Kagurazaka, Shinjuku-ku, Tokyo 162-8601, Japan;
| | - Suleyman I. Allakhverdiev
- K.A. Timiryazev Institute of Plant Physiology, RAS, Botanicheskaya str., 35, 127276 Moscow, Russia; (V.V.K.); (E.V.Z.)
- Zoology Department, College of Science, King Saud University, Riyadh 12372, Saudi Arabia;
- Institute of Basic Biological Problems, RAS, Pushchino, 142290 Moscow, Russia
- Correspondence:
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Pure Single-site Robot-assisted Radical Prostatectomy Using Single-port Versus Multiport Robotic Radical Prostatectomy: A Single-institution Comparative Study. Eur Urol Focus 2020; 7:964-972. [DOI: 10.1016/j.euf.2020.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/24/2020] [Accepted: 10/14/2020] [Indexed: 12/28/2022]
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Valero R, Sawczyn G, Garisto J, Yau R, Kaouk J. Multiquadrant Combined Robotic Radical Prostatectomy And Left Partial Nephrectomy: A Combined procedure by A Single Approach. Actas Urol Esp 2020; 44:119-124. [PMID: 31864774 DOI: 10.1016/j.acuro.2019.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/23/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION To present the first case of a concomitant robotic radical prostatectomy and a left robotic partial nephrectomy performed by a single-port approach using the SP® da Vinci surgical system (Intuitive Surgical, Sunnyvale CA, EE.UU.). PATIENT AND METHODS A 66-year-old male diagnosed with localized prostate cancer and a left kidney renal mass incidentally found on computed tomography (CT) scan during prostate cancer evaluation. Procedures were performed using a single supra-umbilical 3cm incision, plus one additional laparoscopic port, utilizing a standard Gelpoint® (Applied Medical, Rancho Santa Margarita, CA, EE.UU.) and replicating the technique previously described for single-port transperitoneal radical prostatectomy and partial nephrectomy with the use of the SP® robotic platform. RESULTS Total operative time was 256minutes (min) with a console time of 108min for radical prostatectomy, and 101min for the partial nephrectomy respectively, including a warm ischemia time of 26min. Estimated blood loss was 250cc. Blood transfusion was not needed. Final pathology for prostate was adenocarcinoma Gleason 7 (4+3) and for the kidney lesion was renal cell carcinoma. After two months of follow-up, PSA was undetectable and no complications or recurrence were detected. CONCLUSIONS The single-port approach has advantages as easier surgical planning and transition for combined and multi-quadrants surgeries: faster recovery, minimal postoperative pain and need for opioids, and excellent cosmetic outcome. We suggest that combined procedures should be performed only in high volume institutions by surgeons with vast experience in robotic surgery in selected patients.
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Brinkman W, de Angst I, Schreuder H, Schout B, Draaisma W, Verweij L, Hendrikx A, van der Poel H. Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach? Surg Endosc 2016; 31:281-287. [PMID: 27194262 PMCID: PMC5216079 DOI: 10.1007/s00464-016-4970-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/03/2016] [Indexed: 11/27/2022]
Abstract
Introduction The following research questions were answered: (1) What are the training pathways followed by the current robot professionals? (2) Are there any differences between the surgical specialties in robot training and robot use? (3) What is their opinion about multidisciplinary basic skills training? Methods An online questionnaire was sent to 91 robot professionals in The Netherlands. The questionnaire contained 21 multiple-choice questions focusing on demographics, received robot training, and their opinion on basic skills training in robotic surgery. Results The response rate was 62 % (n = 56): 13 general surgeons, 16 gynecologists, and 27 urologists. The urologists performed significantly more robotic procedures than surgeons and gynecologists. The kind of training of all professionals varied from a training program by Intuitive Surgical, master-apprenticeship with or without duo console, fellowship, and self-designed training programs. The training did neither differ significantly among the different specialties nor the year of starting robotic surgery. Majority of respondents favor an obliged training program including an examination for the basics of robot skills training. Conclusion Training of the current robot professionals is mostly dependent on local circumstances and the manufacturer of the robot system. Training is independent of the year of start with robotic surgery and speciality. To guarantee the quality of future training of residents and fellows in robot-assisted surgery, clear training goals should be formulated and implemented. Since this study shows that current training of different specialities does not differ, training in robotic surgery could be started by a multidisciplinary basic skills training and assessment. Electronic supplementary material The online version of this article (doi:10.1007/s00464-016-4970-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Willem Brinkman
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
| | - Isabel de Angst
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
| | - Henk Schreuder
- UMC Utrecht Cancer Center, Department of Gynaecologic Oncology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Barbara Schout
- Department of Urology, Alrijne Hospital, Leiden, The Netherlands
| | - Werner Draaisma
- Department of Surgery, Meander Medical Centre, Amersfoort, The Netherlands
| | - Lisanne Verweij
- The Netherlands Institute of Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Ad Hendrikx
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | - Henk van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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Bai Y, Pu C, Yuan H, Tang Y, Wang X, Li J, Wei Q, Han P. Assessing the Impact of Barbed Suture on Vesicourethral Anastomosis During Minimally Invasive Radical Prostatectomy: A Systematic Review and Meta-analysis. Urology 2015; 85:1368-75. [DOI: 10.1016/j.urology.2015.02.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 01/20/2015] [Accepted: 02/27/2015] [Indexed: 10/25/2022]
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Fisher RA, Dasgupta P, Mottrie A, Volpe A, Khan MS, Challacombe B, Ahmed K. An over-view of robot assisted surgery curricula and the status of their validation. Int J Surg 2015; 13:115-123. [DOI: 10.1016/j.ijsu.2014.11.033] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/20/2014] [Accepted: 11/25/2014] [Indexed: 10/24/2022]
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Oncologic results, functional outcomes, and complication rates of robotic-assisted radical prostatectomy: multicenter experience in Turkey including 1,499 patients. World J Urol 2014; 33:1095-102. [PMID: 25216924 DOI: 10.1007/s00345-014-1393-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 08/24/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Robot-assisted radical prostatectomy (RARP) is a rising minimally invasive treatment of localized prostate cancer (PC). We present our multicenter experience of 1,499 consecutive cases with an analysis of complication rates, oncologic, and functional outcomes. PATIENTS AND METHODS From March 2005 through December 2012, details of 1,499 patients were retrospectively analyzed. Transperitoneal approach using a da-Vinci robotic system was used to perform RARP. Perioperative characteristics and postoperative oncologic and functional outcomes are reported. RESULTS The mean age was 61.3 years (37-77). Mean PSA level was 8.3 ng/ml. According to D'Amico classification, the percentage of patients with low-, intermediate-, and high-risk disease cases were 65.0, 30.1, and 4.8 %, respectively. Mean operative time was 181.9 min. Mean estimated blood loss was 225.4 cc (30-1,250). Positive surgical margin (PSM) was detected in 212 (14.1 %) patients. PSM rates in pT2, pT3, and pT4 stages were 6.1, 37.1, and 100 %, respectively. The overall complication rate due to modified Clavien classification was 6.1 %. Mean follow-up time was 26.7 months. Continence, potency, and biochemical recurrence rates were 88.7, 58.2, and 2.9 %, respectively. CONCLUSIONS Our analyses including high-volume centers, which is the first largest series in Turkey, show that RARP is a safe procedure, has low PSM rates, high continence, and potency rates for the treatment of localized PC at experienced centers.
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Singla N, Singla AK. Robotic-Assisted Surgery: Urological Applications and Outcomes. ACTA ACUST UNITED AC 2014; 1:33-37. [PMID: 31942445 DOI: 10.1166/ajrs.2014.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The introduction of robotic technology and minimally invasive surgical techniques has revolutionized the field of urological surgery over the last 25 years. Robotic technology has been proven to be both safe and efficacious in the management of several urological malignancies and benign urological conditions. While some robotic applications have been well established, others are still at varying stages of evolution. In comparison to conventional open approaches, the robot has been shown to enhance intraoperative visualization and precision, mitigate surgeon tremor, hasten post-operative recovery, and shorten length of hospital stay for certain indications. This technology has not yet been universally adopted, however, due to its relatively high cost, longer associated operative times, and limited outcomes data. We herein review the current applications, outcomes, and drawbacks of robotic technology within the field of urological surgery and speculate on the future directions and implications within the field.
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Affiliation(s)
- Nirmish Singla
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - Ajay K Singla
- Department of Urology, University of Toledo Medical Center, Toledo, OH, USA
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Woo Y, Choi GH, Min BS, Hyung WJ. Novel application of simultaneous multi-image display during complex robotic abdominal procedures. BMC Surg 2014; 14:13. [PMID: 24628761 PMCID: PMC4008309 DOI: 10.1186/1471-2482-14-13] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 02/24/2014] [Indexed: 01/18/2023] Open
Abstract
Background The surgical robot offers the potential to integrate multiple views into the surgical console screen, and for the assistant’s monitors to provide real-time views of both fields of operation. This function has the potential to increase patient safety and surgical efficiency during an operation. Herein, we present a novel application of the multi-image display system for simultaneous visualization of endoscopic views during various complex robotic gastrointestinal operations. All operations were performed using the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) with the assistance of Tilepro, multi-input display software, during employment of the intraoperative scopes. Three robotic operations, left hepatectomy with intraoperative common bile duct exploration, low anterior resection, and radical distal subtotal gastrectomy with intracorporeal gastrojejunostomy, were performed by three different surgeons at a tertiary academic medical center. Results The three complex robotic abdominal operations were successfully completed without difficulty or intraoperative complications. The use of the Tilepro to simultaneously visualize the images from the colonoscope, gastroscope, and choledochoscope made it possible to perform additional intraoperative endoscopic procedures without extra monitors or interference with the operations. Conclusion We present a novel use of the multi-input display program on the da Vinci Surgical System to facilitate the performance of intraoperative endoscopies during complex robotic operations. Our study offers another potentially beneficial application of the robotic surgery platform toward integration and simplification of combining additional procedures with complex minimally invasive operations.
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Affiliation(s)
| | | | | | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong Seodaemun-gu, Seoul 120-752, Republic of Korea.
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The learning curve for robot-assisted total mesorectal excision for rectal cancer. Surg Laparosc Endosc Percutan Tech 2013; 22:400-5. [PMID: 23047381 DOI: 10.1097/sle.0b013e3182622c2d] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We evaluated the learning curve for achieving expertise in robotic rectal cancer surgery based primarily on operative time and short-term outcomes. Sixty-two consecutive patients with rectal cancer underwent robot surgery (abdominoperineal excision n = 1, low anterior resection n = 50, ultra-low anterior resection n = 10, Hartmann operation n = 1). Robotic cases were grouped by consecutive 10 cases. There were 48 cases of mid and low rectal tumor (preoperative chemoradiation n = 9). Mean operative time was 390 minutes and postoperative complication rate was 12.9%. Robotic surgery for mid and low rectal tumors was commonly performed after 10 cases. The operative time and console time of robot surgery showed first decrease after 20 cases. There were no differences in postoperative complications including anastomosis leakage, lymph node count, and distal margin between the learning periods. An experienced open surgeon with limited laparoscopy experience may begin to perform robotic rectal surgery safely without a long learning period.
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Yiou R, De Laet K, Hisano M, Salomon L, Abbou C, Lefaucheur J. Neurophysiological Testing to Assess Penile Sensory Nerve Damage After Radical Prostatectomy. J Sex Med 2012; 9:2457-66. [DOI: 10.1111/j.1743-6109.2012.02793.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Abstract
Current surgical treatment of prostate cancer is typically accomplished by either open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALRP). Intra-operative procedural differences between the two surgical approaches may alter the molecular composition of resected surgical specimens, which are indispensable for molecular analysis and biomarker evaluation. The objective of this study is to investigate the effect of different surgical procedures on RNA quality and genome-wide expression signature. RNA integrity number (RIN) values were compared between total RNA samples extracted from consecutive LRP (n=11) and ORP (n=24) prostate specimens. Expression profiling was performed using the Agilent human whole-genome expression microarrays. Expression differences by surgical type were analyzed by Volcano plot analysis and gene ontology analysis. Quantitative reverse transcription (RT)-PCR was used for expression validation in an independent set of LRP (n=8) and ORP (n=8) samples. The LRP procedure did not compromise RNA integrity. Differential gene expression by surgery types was limited to a small subset of genes, the number of which was smaller than that expected by chance. Unexpectedly, this small subset of differentially expressed genes was enriched for those encoding transcription factors, oxygen transporters and other previously reported surgery-induced stress-response genes, and demonstrated unidirectional reduction in LRP specimens in comparison to ORP specimens. The effect of the LRP procedure on RNA quality and genome-wide transcript levels is negligible, supporting the suitability of LRP surgical specimens for routine molecular analysis. Blunted in vivo stress response in LRP specimens, likely mediated by CO(2) insufflation but not by longer ischemia time, is manifested in the reduced expression of stress-response genes in these specimens.
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Athanasiou T, Ashrafian H, Rowland SP, Casula R. Robotic cardiac surgery: advanced minimally invasive technology hindered by barriers to adoption. Future Cardiol 2012; 7:511-22. [PMID: 21797747 DOI: 10.2217/fca.11.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Robotic cardiac surgery utilizes the most advanced surgical technology to offer patients a minimally invasive alternative to open surgery in the treatment of a broad range of cardiac pathologies. Although robotics may offer substantial benefits to physicians, patients and healthcare institutions, there are important barriers to its adoption that includes inadequate funding, competition from alternate therapies and challenges in training. There is a growing body of evidence to demonstrate the efficacy of robotic cardiac surgery. Technological innovations are improving patient safety and expanding the indications for robotic cardiac surgery beyond the treatment of mitral valve and coronary artery disease. Robotic cardiac surgery is rapidly becoming a feasible, safe and effective option for the definitive treatment of cardiac disease in the context of 21st century challenges to healthcare provision such as diabetes, obesity and an aging population.
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Affiliation(s)
- Thanos Athanasiou
- Department of Surgery & Cancer, Imperial College London, London W2 1NY, UK.
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Jung JH, Arkoncel FRP, Lee JW, Oh CK, Yusoff NAM, Kim KJ, Rha KH. Initial clinical experience of simultaneous robot-assisted bilateral partial nephrectomy and radical prostatectomy. Yonsei Med J 2012; 53:236-9. [PMID: 22187260 PMCID: PMC3250319 DOI: 10.3349/ymj.2012.53.1.236] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 11/03/2010] [Accepted: 11/09/2010] [Indexed: 12/19/2022] Open
Abstract
A 62-year-old male patient with prostate cancer and bilateral renal cell carcinoma underwent a simultaneous robot-assisted bilateral partial nephrectomy and radical prostatectomy. We describe our initial experience of combined operation with a port strategy allowing reuse of ports and surgical considerations because of prolonged pneumoperitoneum.
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Affiliation(s)
- Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | | | - Jae Won Lee
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
| | - Cheol Kyu Oh
- Department of Urology, Inje University College of Medicine, Busan, Korea
| | | | - Kwang Jin Kim
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Koon Ho Rha
- Department of Urology, Yonsei University College of Medicine, Seoul, Korea
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Mucksavage P, Kerbl DC, Lee JY. The da Vinci(®) Surgical System overcomes innate hand dominance. J Endourol 2011; 25:1385-8. [PMID: 21815795 DOI: 10.1089/end.2011.0093] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND PURPOSE The robotic surgical platform has allowed for improved ergonomics, tremor filtration, and more precise surgical movements during minimally invasive surgery. We examined the impact of the da Vinci(®) Surgical System on the lateralization of manual dexterity, or handedness, innate to most surgeons. METHODS Manual dexterity assessments were conducted among 19 robotic novices using two different skills tests: The Purdue Pegboard Test and a needle targeting test. After an initial robotic basic skills training seminar, subjects underwent testing using both open and robotic approaches. Test performance using both approaches was then compared among all subjects. RESULTS The majority of subjects (84%) were right handed, and all subjects described their dominant hand as significantly or moderately more dexterous than their nondominant hand. The participants had significant differences between the dominant and nondominant hand in open skills tasks using the Purdue Pegboard test (15.4 vs 14.6 pegs, P=0.023) and needle targeting test (4.5 vs 3.7 targets, P=0.015). When the same tasks were performed using the robot, the differences in handedness were no longer observed (P=0.203, P=0.764). CONCLUSION The da Vinci robot is capable of eliminating innate dexterity or handedness among novice surgical trainees. This provides evidence of another beneficial aspect of robot-assisted surgery over traditional laparoscopic surgery and may facilitate operative performance of complex tasks.
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Affiliation(s)
- Phillip Mucksavage
- University of California , Irvine, Medical Center, Orange, California, USA.
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Gao L, Zhou H, Thrall MJ, Li F, Yang Y, Wang Z, Luo P, Wong KK, Palapattu GS, Wong STC. Label-free high-resolution imaging of prostate glands and cavernous nerves using coherent anti-Stokes Raman scattering microscopy. BIOMEDICAL OPTICS EXPRESS 2011; 2:915-26. [PMID: 21483613 PMCID: PMC3072130 DOI: 10.1364/boe.2.000915] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/25/2011] [Accepted: 03/07/2011] [Indexed: 05/18/2023]
Abstract
A custom built coherent anti-Stokes Raman scattering (CARS) microscope was used to image prostatic glands and nerve structures from 17 patients undergoing radical prostatectomy. Imaging of glandular and nerve structures showed distinctive cellular features that correlated to histological stains. Segmentation of cell nucleus was performed to establish a cell feature-based model to separate normal glands from cancer glands. In this study, we use a single parameter, average cell neighbor distance based on CARS imaging, to characterize normal and cancerous glandular structures. By combining CARS with our novel classification model, we are able to characterize prostate glandular and nerve structures in a manner that potentially enables real-time, intra-operative assessment of surgical margins and neurovascular bundles. As such, this method could potentially improve outcomes following radical prostatectomy.
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Affiliation(s)
- Liang Gao
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
- Department of Bioengineering, Rice University, Houston, Texas 77005
| | - Haijun Zhou
- Department of Urology, The Methodist Hospital, and Weill Cornell Medical College, Houston, Texas 77030
| | - Michael J. Thrall
- Department of Pathology and Laboratory Medicine, The Methodist Hospital and Weill Cornell Medical College, Houston, Texas 77030
| | - Fuhai Li
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
| | - Yaliang Yang
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
| | - Zhiyong Wang
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
| | - Pengfei Luo
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
| | - Kelvin K. Wong
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
- Department of Radiology, The Methodist Hospital, Weill Cornell Medical College, Houston, Texas 77030
| | - Ganesh S. Palapattu
- Department of Urology, The Methodist Hospital, and Weill Cornell Medical College, Houston, Texas 77030
| | - Stephen T. C. Wong
- Bioengineering and Bioinformatics Program, The Methodist Hospital Research Institute
- Department of Radiology, The Methodist Hospital, Weill Cornell Medical College, Houston, Texas 77030
- Department of Bioengineering, Rice University, Houston, Texas 77005
- Department of Pathology and Laboratory Medicine, The Methodist Hospital and Weill Cornell Medical College, Houston, Texas 77030
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deSouza AL, Prasad LM, Ricci J, Park JJ, Marecik SJ, Zimmern A, Blumetti J, Abcarian H. A comparison of open and robotic total mesorectal excision for rectal adenocarcinoma. Dis Colon Rectum 2011; 54:275-82. [PMID: 21304296 DOI: 10.1007/dcr.0b013e3182060152] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE This retrospective study was designed to compare open with robot-assisted total mesorectal excision for rectal adenocarcinoma. METHODS With use of predefined exclusion criteria, all consecutive laparoscopic-assisted (51 patients) and robot-assisted (36 patients) rectal resections for adenocarcinoma from August 2005 to November 2009 at a single institution were considered. Hand-assisted laparoscopy was used for splenic flexure mobilization in all cases. Patients were assigned into robotic and open groups on the basis of the technique used for total mesorectal excision. All 36 robot-assisted resections had the total mesorectal excision performed with robotic assistance and were included in the robotic group. Forty-six of the 51 patients who received a laparoscopic-assisted procedure had the total mesorectal excision performed through the hand port using open surgical technique and were included in the open group. Both groups were compared with respect to patient demographics, perioperative outcomes, and pathology. RESULTS The robotic and open groups were comparable in age, sex, body mass index, history of prior abdominal surgery, ASA class, number of patients receiving neoadjuvant chemoradiation, and tumor stage. There were more abdominoperineal resections (P = .019) and more low and mid rectal tumors (P = .007) in the robotic group. Total procedure time was longer in the robotic group (P = .003), but blood loss was less (P = .036). Lymph node yield, intraoperative and postoperative complications, and length of stay were all comparable. There were 3 positive circumferential margins in the open group vs none in the robotic group, but this did not reach statistical significance. CONCLUSIONS Robotic total mesorectal excision is feasible and safe, and is comparable to open total mesorectal excision in terms of perioperative and pathological outcomes. The longer operative time associated with robotic total mesorectal excision could decrease as experience with this relatively new technique increases. Large randomized trials are necessary to validate the potential benefits of less blood loss and lower margin positivity rates observed in this study.
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Affiliation(s)
- Ashwin L deSouza
- Division of Colon and Rectal Surgery, University of Illinois, Chicago, IL, USA
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Hatiboglu G, Teber D, Hohenfellner M. Robot-assisted prostatectomy: the new standard of care. Langenbecks Arch Surg 2011; 397:343-52. [DOI: 10.1007/s00423-011-0743-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 01/18/2011] [Indexed: 11/29/2022]
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Bova F. Computer Based Guidance in the Modern Operating Room: A Historical Perspective. IEEE Rev Biomed Eng 2010; 3:209-22. [DOI: 10.1109/rbme.2010.2089370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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