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Gaia G, Sighinolfi MC, Terzoni S, Afonina M, Morandi A, Iannuzzi V, Assumma S, LA Marca A, Spinillo A, Marconi AM. Versius robotic surgery training. Minerva Obstet Gynecol 2024; 76:298-300. [PMID: 37791904 DOI: 10.23736/s2724-606x.23.05317-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Giorgia Gaia
- Department of Gynecology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Maria C Sighinolfi
- Department of Urology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Stefano Terzoni
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy -
| | - Margarita Afonina
- Department of Gynecology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Alessandro Morandi
- Department of Gynecology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Veronica Iannuzzi
- Department of Gynecology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Simone Assumma
- Department of Urology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Antonio LA Marca
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Arsenio Spinillo
- Unit of Obstetrics and Gynecology, Department of Pediatrics, San Matteo Hospital, Pavia, Italy
| | - Anna Maria Marconi
- Department of Gynecology, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
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Pinto RD, Trauczynski P, Lima DL, Cavazzola LT. Implementation of the Versius Surgical System in Complex Abdominal Wall Repair: First Reported Case of an Robotic ETEP/TAR Procedure. Surg Laparosc Endosc Percutan Tech 2024; 34:330-333. [PMID: 38752657 DOI: 10.1097/sle.0000000000001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/22/2023] [Indexed: 06/04/2024]
Abstract
BACKGROUND Robotic ventral hernia repair has been increasing globally, with comparable outcomes to laparoscopic repair and lower rates of conversion to open surgery. Robotic surgery is increasing in popularity, and there is a number of new robotic systems entering the marketing. We report the first case of a Roboic eTEP using the Versius robotic system in a patient with an incisional hernia. METHODS Surgery was performed using the Versius system from CMR surgical which consists of bedside units for each instrument and a console. The patient presented with an incisional hernia measuring 9.5×5 cm in the left flank. RESULTS The patient was discharged on postoperative day (POD) 2 with a drain. There was no need for opioids. The drain was removed at POD 7. The patient presented at POD 10 with erythema and cellulitis in the area that previously had tape on it, and it was resolved with a short course of oral antibiotics. CONCLUSION The eTEP technique for hernia surgery was safe and feasible using the Versius robotic system. Implementation is possible in experienced hands with minimal changes to the surgical techniques.
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Affiliation(s)
- Renato D Pinto
- Hospital Unimed Litoral, Balneario Camboriu, Santa Catarina
| | | | | | - Leandro T Cavazzola
- Department of Surgery, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
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Oner M. Initial experience of a single surgeon for safety and feasibility of the Versius Robotic System in robot-assisted cholecystectomy and hernia repair. J Robot Surg 2024; 18:162. [PMID: 38578369 DOI: 10.1007/s11701-024-01936-4] [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: 01/12/2024] [Accepted: 01/27/2024] [Indexed: 04/06/2024]
Abstract
This study aimed to evaluate the feasibility, safety, and perioperative outcomes of cholecystectomy and hernia repair performed with the Versius Robotic System by a surgeon with no prior robotic surgery experience. A retrospective analysis was conducted on adult patients who underwent cholecystectomy, inguinal, or umbilical hernia repair using the Versius Robotic System between August 2021 and June 2023 et al. Zahra Hospital, Dubai, UAE. A total of 105 patients (mean age 38.9 ± 9.2 years) were included. Significant correlations existed between the number of robot-assisted cholecystectomies and the operative metrics. As the number increased, the duration of the total operative (r = - 0.755, p < 0.001), docking (r = - 0.683, p < 0.001), and console (r = - 0.711, p < 0.001) times decreased, indicating improved efficiency with experience. This study demonstrates the safety and feasibility of the Versius Robotic System for cholecystectomy and hernia repair, even for surgeons lacking prior robotic surgery experience.
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Affiliation(s)
- Muharrem Oner
- Department of Surgery, Al-Zahra Hospital, Al Barsha 1, P.O. Box 124412, Dubai, United Arab Emirates.
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Pisani Ceretti A, Mariani NM, Perego M, Giovenzana M, Salaj A, Formisano G, Gheza F, Gloria G, Bernardo R, Bianchi PP. Proposal of set-up standardization for general surgery procedures with the CMR Versius system, a new robotic platform: our initial experience. Langenbecks Arch Surg 2024; 409:107. [PMID: 38565787 DOI: 10.1007/s00423-024-03291-2] [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: 09/20/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The article describes our initial experience using CMR Versius platform for several procedures in general surgery. METHODS Between September 2022 and April 2023, seventy patients underwent robotic surgery in a multi-robotic referral center (San Paolo University Hospital, Milan, Italy). Three surgeons with only laparoscopic experience performed 24 cholecystectomies, 13 inguinal hernia repairs, 9 ventral hernia repairs, 7 right hemicolectomies, 11 left hemicolectomies, 1 sigmoidectomy, 1 ileocecal resection, 1 ventral rectopexy, 1 Nissen fundoplication, 1 total splenectomy, and 1 exploration with multiple biopsies. RESULTS All surgeries were full-robotic, with only one conversion to laparoscopy. The short length of stay and low rate of severe morbidity are promising findings. Although operative time was lengthened, clinical outcomes were not affected. CONCLUSIONS Our experience demonstrates that the adoption of Versius system is safe and feasible in general surgery. The standardization of port placement and BSU set-up can certainly reduce the operative time.
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Affiliation(s)
- Andrea Pisani Ceretti
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.
| | - Nicolò Maria Mariani
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.
| | - Marta Perego
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Marco Giovenzana
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Adelona Salaj
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Giampaolo Formisano
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Federico Gheza
- Division of General Surgery, Department of Clinical and Experimental Sciences, University of Brescia and Civili Hospital, Brescia, Italy
| | - Gaia Gloria
- Division of Gynecology, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Rocco Bernardo
- Division of Urology, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
| | - Paolo Pietro Bianchi
- Division of General and Robotic Surgery, Department of Health Sciences, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy
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Ai L, Kazanzides P, Azimi E. Mixed reality based teleoperation and visualization of surgical robotics. Healthc Technol Lett 2024; 11:179-188. [PMID: 38638499 PMCID: PMC11022216 DOI: 10.1049/htl2.12079] [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] [Received: 12/14/2023] [Accepted: 01/11/2024] [Indexed: 04/20/2024] Open
Abstract
Surgical robotics has revolutionized the field of surgery, facilitating complex procedures in operating rooms. However, the current teleoperation systems often rely on bulky consoles, which limit the mobility of surgeons. This restriction reduces surgeons' awareness of the patient during procedures and narrows the range of implementation scenarios. To address these challenges, an alternative solution is proposed: a mixed reality-based teleoperation system. This system leverages hand gestures, head motion tracking, and speech commands to enable the teleoperation of surgical robots. The implementation focuses on the da Vinci research kit (dVRK) and utilizes the capabilities of Microsoft HoloLens 2. The system's effectiveness is evaluated through camera navigation tasks and peg transfer tasks. The results indicate that, in comparison to manipulator-based teleoperation, the system demonstrates comparable viability in endoscope teleoperation. However, it falls short in instrument teleoperation, highlighting the need for further improvements in hand gesture recognition and video display quality.
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Affiliation(s)
- Letian Ai
- The Laboratory for Computational Sensing and RoboticsJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Peter Kazanzides
- Department of Computer ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Ehsan Azimi
- Department of Computer ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
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Dibitetto F, Fede Spicchiale C, Castellucci R, Sansalone S, Akhundov A, Defidio L, De Dominicis M. Extraperitoneal robot assisted laparoscopic prostatectomy with Versius system: single centre experience. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00810-6. [PMID: 38491207 DOI: 10.1038/s41391-024-00810-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Versius Surgical System (CMR Surgical, Cambridge, UK) is a novel tele-operated robotic surgical system designed to assist surgeons for minimally invasive surgery which is gaining momentum in the world of robotic surgery. We describe our single centre experience with Versius and report the advantages and challenges posed by this new robotic system in a series of 53 extraperitoneal robotic assisted laparoscopic prostatectomies (eRALP) for prostate cancer (PCa). MATERIALS AND METHODS Data of 53 eRALP performed with Versius in our centre were collected and analysed, Descriptive statistics were used to report our results. RESULTS In 16 months we performed 53 eRALP: 18 (34%) with PLND, 33 (62%) nerve sparing cases. Mean setup time was 15 min, mean console time was 100 min and mean operative time was 130 min. We observed a substantial reduction of console time and set-up time after only 5 procedures. In the first 4 procedures, the dissection of the neurovascular bundle was performed laparoscopically, to switch back to robotic assisted approach afterwards. No major system failures were observed. No major intra-operative and post-operative complications occurred. Mean follow-up time was 9 months (range 3-15 months); no patients experienced biochemical recurrence or metastatic progression over this period, 8 (15%) patients had adjuvant radiotherapy based on unfavourable pathology report (positive surgical margins or positive limphnodes). CONCLUSION This represents to our knowledge the largest extraperitoneal RALP case series with Versius, and it aims to provide solid clinical proof of the safety, effectiveness and versatility of this innovative system. In our experience, this platform represents a good option for every urologic surgeon who wants to start a robotic programme and it appears particularly suitable for urologists with a large laparoscopic expertise.
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Affiliation(s)
- F Dibitetto
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - C Fede Spicchiale
- Department of Urology, University Hospital Monklands, NHS Lanarkshire, Airdrie, UK.
| | - R Castellucci
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - S Sansalone
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - A Akhundov
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - L Defidio
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - M De Dominicis
- Uroclinic, Casa di Cura Nuova Villa Claudia, Rome, Italy
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Lima DL, Pinto RD, Trauczynski P, Liu J, Cavazzola LT. Feasibility of Image Inversion for Ventral Hernia Repair Using the Versius System. J Laparoendosc Adv Surg Tech A 2024; 34:144-146. [PMID: 38054942 DOI: 10.1089/lap.2023.0404] [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: 12/07/2023] Open
Abstract
Background: The aim of our technical report is to demonstrate the image inversion technique in the new Versius Robotic System. Methods: We report a step-by-step surgical maneuver for robotic surgeons when performing robotic ventral hernia repair (VHR) with the Versius Robotic System. Technical Report: The image inversion artifice consists in rotating 180° with the scope using the surgeon's master control in a specific rotation command in the right-hand joystick. The assisting surgeon can do a manual inversion of the camera without the console being aware that the scope is inverted. In this scenario, the 30° Up configuration should be used while informing the console that the scope is looking down. The surgeon can reassign instruments to each joystick. This results in the right joystick controlling the left instrument and left control controlling the right instrument. Since the image is inverted, the movements will look natural on the surgeon console. Conclusions: The use of the image inversion technique with the Versius Robotic System is effective in aiding surgeons to perform the hernia defect closure during robotic VHRs.
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Affiliation(s)
| | - Renato Danesi Pinto
- Department of Surgery, Hospital Unimed Litoral, Balneario Camboriu, Santa Catarina, Brazil
| | | | - Jack Liu
- Department of Surgery, Montefiore Medical Center, New York, New York, USA
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Sighinolfi MC, De Maria M, Meneghetti I, Felline M, Ceretti AP, Mosillo L, Catalano C, Morandi A, Calcagnile T, Panio E, Sangalli M, Turri F, Terzoni S, Assumma S, Sarchi L, Afonina M, Marconi A, Bianchi PP, Micali S, Rocco B, Gaia G. The use of Versius CMR for pelvic surgery: a multicentric analysis of surgical setup and early outcomes. World J Urol 2024; 42:31. [PMID: 38217724 PMCID: PMC10787883 DOI: 10.1007/s00345-023-04730-3] [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: 07/11/2023] [Accepted: 10/16/2023] [Indexed: 01/15/2024] Open
Abstract
INTRODUCTION Versius CMR is a novel robotic system characterized by an open surgical console and independent bedside units. The system has potentials of flexibility and versatility, and has been used in urological, gynecological, and general surgical procedure. The aim is to depict a comprehensive analysis of the Versius system for pelvic surgery. METHODS This is a study involving two Institutions, ASST Santi Paolo and Carlo, Milan, and Apuane Hospital, Massa, Italy. All interventions performed in the pelvic area with the Versius were included. Data about indications, intra-, and post-operative course were prospectively collected and analyzed. RESULTS A total of 171 interventions were performed with the Versius. Forty-two of them involved pelvic procedures. Twenty-two had an oncological indication (localized prostate cancer), the remaining had a non-oncological or functional purpose. The mostly performed pelvic procedure was radical prostatectomy (22) followed by annexectomy (9). No intra-operative complication nor conversion to other approaches occurred. A Clavien II complication and one Clavien IIIb were reported. Malfunctioning/alarms requiring a power cycle of the system occurred in 2 different cases. An adjustment in trocar placement according to patients' height was required in 2 patients undergoing prostatectomy, in which the trocar was moved caudally. In two cases, a pelvic prolapse was repaired concomitant with other gynecological procedures. CONCLUSIONS Pelvic surgery with the Versius is feasible without major complications; either dissection and reconstructive steps could be accomplished, provided a proper OR setup and trocar placement are pursued. Versius can be easily adopted by surgeons of different disciplines and backgrounds; a further multi-specialty implementation is presumed and long-term oncological and functional outcomes are awaited.
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Affiliation(s)
| | | | | | - Mauro Felline
- Unit of Gynecology, ASST Santi Paolo and Carlo, Milan, Italy
| | | | | | | | | | | | - Enrico Panio
- Unit of Urology, ASST Santi Paolo and Carlo, Milan, Italy
| | | | - Filippo Turri
- Unit of Urology, ASST Santi Paolo and Carlo, Milan, Italy
| | | | - Simone Assumma
- Unit of Urology, ASST Santi Paolo and Carlo, Milan, Italy
| | - Luca Sarchi
- Unit of Urology, ASST Santi Paolo and Carlo, Milan, Italy
| | | | | | | | - Salvatore Micali
- Unit of Urology, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Bernardo Rocco
- Unit of Urology, ASST Santi Paolo and Carlo, Milan, Italy
| | - Giorgia Gaia
- Unit of Gynecology, ASST Santi Paolo and Carlo, Milan, Italy
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Polom W, Matuszewski M. Initial experience of the Versius robotic system in robot-assisted radical prostatectomy: a study of 58 cases. Cent European J Urol 2024; 77:30-36. [PMID: 38645822 PMCID: PMC11032037 DOI: 10.5173/ceju.2023.241] [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] [Received: 10/16/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction The study presents the initial outcomes of robot-assisted radical prostatectomies (RARPs) using the Versius robotic system in a urological centre with no prior robotic surgery experience. Material and methods A retrospective analysis of 58 RARPs was conducted, including patients' parameters as well as Versius system performance. Results The study involved 58 patients (average age 66.9 years). Median preoperative prostate specific antigen (PSA) was 9.8 ng/ml, with 48% having ISUP grade group ≥ 3 on biopsy and 25.8% showing extraprostatic extension on MRI. Median blood loss was 437 ml, with complications (10.3% Clavien-Dindo grade II and 4 grade III cases). One conversion to open surgery occurred (0.58%). Final pathology revealed 46.5% extraprostatic disease, and 25.8% had positive margins. Post-surgery, 96.5% had undetectable PSA at 6 weeks. Continence rates were 89.7% at 6 weeks, increasing to 91.3% at 12 months. Median catheter duration was 7.9 days, and the hospital stay was 4.5 days. Console time averaged 150.9 minutes, with a median operative time of 213 minutes. The Versius system reported medium priority alarms in 24.1% of operations, including 1266 alarms related to robotic arm clashes and 43 instrument swaps. One bedside unit exchange occurred with no console or robotic system failures. Conclusions The Versius robotic system can be successfully introduced in a urological centre without prior robotic surgery experience. Our setup and operating room positioning are effective, safe, and reproducible. We encountered and resolved surgical and technical challenges. Further follow-up studies are needed to assess the system's performance.
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Affiliation(s)
- Wojciech Polom
- Department of Urology, Faculty of Medicine, Medical University od Gdansk, Gdansk, Poland
| | - Marcin Matuszewski
- Department of Urology, Faculty of Medicine, Medical University od Gdansk, Gdansk, Poland
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Alkatout I, O’Sullivan O, Peters G, Maass N. Expanding Robotic-Assisted Surgery in Gynecology Using the Potential of an Advanced Robotic System. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:53. [PMID: 38256313 PMCID: PMC10818539 DOI: 10.3390/medicina60010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 12/17/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024]
Abstract
Minimally invasive surgery (MIS) in gynecology was introduced to achieve the same surgical objectives as traditional open surgery while minimizing trauma to surrounding tissues, reducing pain, accelerating recovery, and improving overall patient outcomes. Minimally invasive approaches, such as laparoscopic and robotic-assisted surgeries, have become the standard for many gynecological procedures. In this review, we aim to summarize the advantages and main limitations to a broader adoption of robotic-assisted surgery compared to laparoscopic surgeries in gynecology. We present a new surgical system, the Dexter Robotic System™ (Distalmotion, Switzerland), that facilitates the transition from laparoscopy expertise to robotic-assisted surgery.
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Affiliation(s)
- Ibrahim Alkatout
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany
| | - Odile O’Sullivan
- Distalmotion SA, Route de la Corniche 3b, 1066 Epalinges, Switzerland;
| | - Göntje Peters
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany
| | - Nicolai Maass
- Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany
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Bjerrum F, Collins JW, Butterworth J, Slack M, Konge L. Competency assessment for the Versius surgical robot: a validity investigation study of a virtual reality simulator-based test. Surg Endosc 2023; 37:7464-7471. [PMID: 37400688 DOI: 10.1007/s00464-023-10221-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/16/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND When introducing new equipment like robotic surgical systems, it is essential to ensure that surgeons have the basic skills before operating on patients. The objective was to investigate the validity evidence for a competency-based test for basic robotic surgical skills using the Versius® trainer. METHODS We recruited medical students, residents, and surgeons which were classified based on data on clinical experience with the Versius system as either novices (0 min), intermediates (1-1000 min), or experienced (> 1000 min). All participants completed three rounds of eight basic exercises on the Versius trainer, where the first was used for familiarization and the final two for data analysis. The simulator automatically recorded data. Validity evidence was summarized using Messick's framework, and the contrasting groups' standard-setting method was used to define pass/fail levels. RESULTS 40 participants completed the three rounds of exercises. The discriminatory abilities of all parameters were tested, and five exercises including relevant parameters were selected to be part of the final test. 26 of 30 parameters could differentiate between novices and experienced surgeons but none of the parameters could discriminate between the intermediate and experienced surgeons. Test-retest reliability analysis using Pearson's r or Spearman's rho showed only 13 of 30 parameters had moderate or higher reliability. Non-compensatory pass/fail levels were defined for each exercise and showed that all novices failed all the exercises and that most experienced surgeons either passed or nearly passed all five exercises. CONCLUSION We identified relevant parameters for five exercises that could be used to assess basic robotic skills for the Versius robotic system and defined a credible pass/fail level. This is the first step in developing a proficiency-based training program for the Versius system.
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Affiliation(s)
- Flemming Bjerrum
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark.
- Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
- Copenhagen Academy for Medical Education and Simulation (CAMES), Ryesgade 53B, 4th floor, 2100, Copenhagen, Denmark.
| | - Justin W Collins
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK
- Wellcome/ESPRC Centre for Interventional and Surgical Sciences (WEISS), University College London, London, UK
- Division of Uro-Oncology, University College London Hospital, London, UK
- CMR Surgical Ltd, Cambridge, UK
| | | | - Mark Slack
- CMR Surgical Ltd, Cambridge, UK
- Clinical School, University of Cambridge, Cambridge, UK
- Addenbrooke's Hospital, Cambridge, UK
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, The Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
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Burns HR, McLennan A, Xue EY, Yu JZ, Selber JC. Robotics in Microsurgery and Supermicrosurgery. Semin Plast Surg 2023; 37:206-216. [PMID: 38444959 PMCID: PMC10911899 DOI: 10.1055/s-0043-1771506] [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: 03/07/2024]
Abstract
Microsurgery has changed the ability to perform highly precise and technical surgeries through the utilization of high-powered microscopes and specialized instruments to manipulate and repair anatomical structures as small as a few millimeters. Since the first human trials of robotic-assisted microsurgery in 2006, the expansion of microsurgery to supermicrosurgery (luminal diameter less than 1 mm) has enabled successful repair of previously inaccessible structures. Surgical robotic systems can offer two distinct operative advantages: (1) minimal access surgery-by entering body cavities through ports, flap harvest can be redesigned to affect a minimally invasive approach for flaps such as the rectus abdominis muscle, the latissimus flap, and the deep inferior epigastric perforator flap; and (2) precision-by eliminating physiologic tremor, improving ergonomics, increasing accessibility to difficult spaces, and providing motion scaling, precision is significantly enhanced. Robotic-assisted microsurgery is a promising application of robotics for the plastic surgeon and has played an important role in flap harvest, head and neck reconstruction, nerve reconstruction, gender-affirming surgery, and lymphatic reconstruction-all the while minimizing surgical morbidity. This article aims to review the history, technology, and application of microsurgery and supermicrosurgery in plastic surgery.
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Affiliation(s)
- Heather R. Burns
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Alexandra McLennan
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Erica Y. Xue
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
- Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
| | - Jessie Z. Yu
- Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jesse C. Selber
- Department of Plastic Surgery, Corewell Health, Grand Rapids, Michigan
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The Availability, Cost, Limitations, Learning Curve and Future of Robotic Systems in Urology and Prostate Cancer Surgery. J Clin Med 2023; 12:jcm12062268. [PMID: 36983269 PMCID: PMC10053304 DOI: 10.3390/jcm12062268] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/17/2023] Open
Abstract
Robot-assisted surgical systems (RASS) have revolutionised the management of many urological conditions over the last two decades with robot-assisted radical prostatectomy (RARP) now being considered by many to be the preferred surgical approach. Intuitive Surgical has dominated the market during this time period with successive iterations of the da Vinci model. The expiration of patents has opened the RASS market and several new contenders have become available or are currently in development. This comprehensive narrative review aims to explore the merits of each robotic system as well as the evidence and barriers to their use. The newly developed RASS have increased the versality of robotic surgical systems to a wider range of settings through advancement in technology. The increased competition may result in an overall reduction in cost, broadening the accessibility of RASS. Learning curves and training remain a barrier to their use, but the situation appears to be improving through dedicated training programmes. Outcomes for RARP have been well investigated and tend to support improved early functional outcomes. Overall, the rapid developments in the field of robot-assisted surgery indicate the beginning of a promising new era to further enhance urological surgery.
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Robot-assisted Radical Prostatectomy with the Versius Robotic Surgical System: First Description of a Clinical Case. EUR UROL SUPPL 2023; 48:82-83. [PMID: 36624894 PMCID: PMC9823130 DOI: 10.1016/j.euros.2022.11.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 01/03/2023] Open
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