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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. Correction: The use of Versius CMR for pelvic surgery: a multicentric analysis of surgical setup and early outcomes. World J Urol 2024; 42:86. [PMID: 38372831 PMCID: PMC10876755 DOI: 10.1007/s00345-024-04850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
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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Meneghetti I, Sighinolfi MC, Dibitetto F, Collins JW, Mosillo L, Catalano C, Rocco B, De Dominicis M, De Maria M. Partial nephrectomy series using Versius robotic surgical system: technique and outcomes of an initial experience. J Robot Surg 2024; 18:73. [PMID: 38349425 DOI: 10.1007/s11701-024-01843-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/21/2024] [Indexed: 02/15/2024]
Abstract
Partial nephrectomy (PN) represents a procedure where the use of a robot has further enabled successful completion of this complex surgery. The results of this procedure using Versius Robotic Surgical System (VRSS) still need to be evaluated. Our working group described the technique and reported the initial results of a series of PN using VRSS. We presented our setting, surgical technique and outcomes for PN, using VRSS. Between 2022 and 2023, 15 patients underwent PN performed by two surgeons in two different centers. Fifteen patients underwent PN. The median lesion size identified on preoperative imaging was 4 (IQR 2.3-5) cm. Median PADUA score was 8 (IQR 7-9). Two procedures were converted to radical nephrectomy for enhanced oncological disease control. Of the 13 nephrectomies that were completed as partial, 7 were performed clampless and 6 with warm ischemia clamping. Median clamping time was 10 (IQR 9-11) minutes. No procedure was converted to open. Median blood loss was 200 (IQR 100-250) mL. Median total operative time was 105 (IQR 100-110) minutes. Median console time was 75 (IQR 66-80) minutes. Median set-up time was 13 (IQR 12-14) minutes. No intraoperative complications were reported. The median hospitalization time was 4 (IQR 3.5-4) days. None of the patients were transfused and none of the patients required readmission. In a pathology report, one patient had a positive surgical margin. Our initial experience suggests that performing PN using VRSS is feasible with good short-term outcomes.
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Affiliation(s)
| | | | - Francesco Dibitetto
- Department of Urology, Uroclinic Casa di Cura Nuova Villa Claudia, Rome, Italy
| | - Justin W Collins
- Division of Surgery and Interventional Science, Research Department of Targeted Intervention, University College London, London, UK
- Division of Uro-oncology, University College London Hospital, London, UK
- CMR Surgical, Cambridge, UK
| | - Luca Mosillo
- Department of Urology, Apuane Hospital, Massa, Italy
| | | | - Bernardo Rocco
- Department of Urology, ASST Santi Paolo e Carlo, Milan, Italy
| | - Mauro De Dominicis
- Department of Urology, Uroclinic Casa di Cura Nuova Villa Claudia, Rome, Italy
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De Maria M, Meneghetti I, Mosillo L, Collins JW, Catalano C. Versius robotic surgical system: case series of 18 robot-assisted radical prostatectomies. BJU Int 2024; 133:197-205. [PMID: 37604773 DOI: 10.1111/bju.16156] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To present the results of the first series of patients treated with robot-assisted radical prostatectomy (RARP) with the use of the Versius® Surgical System (CMR Surgical Ltd., Cambridge, UK). RARP has demonstrated better perioperative outcomes compared to open RP. However, RARP remains limited by platform availability and cost-effectiveness issues. The increasing competition from new robotic surgical platforms may further drive utilisation of the robotic approach. PATIENTS AND METHODS Data were collected prospectively for our first 18 consecutive patients with localised prostate cancer who underwent RARP at our centre over a 3-month period. We recorded parameters, including patient demographics and perioperative outcomes. We also report our optimised set-up with regard to trocar placement, bedside unit placement, and overall composition of the operating room for this procedure. Describing the incremental modifications carried out to achieve reductions in set-up and operating times to optimise utilisation of the Versius system. RESULTS The median (interquartile range [IQR]) set-up time was 8.5 (7-10) min. The median (IQR) console time was 201 (170-242) min. The median (IQR) operative time was 213 (186-266) min. The median (IQR) total surgery time was 226 (201-277) min. Bilateral pelvic lymphadenectomy median (IQR) time was 19 (17-20) min. There were no complications and/or limitations related to the use of the Versius system including need for conversion. There were no relevant intra- or postoperative complications at the 1-month follow-up related to the use of the Versius system. Patients were discharged after a median (IQR) of 4 (3.75-5) days, and the transurethral catheter was removed after a mean (range) of 8 (7-14) days. Continence at 2 months was achieved in 72.2% of the patients. CONCLUSIONS Performing RARP using the Versius system is feasible, safe, and easily reproducible. Our set-up enables a rapid docking approach and efficient completion of the surgery.
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Affiliation(s)
| | | | - Luca Mosillo
- Urology Department, Ospedale Apuane, Massa, Italy
| | - Justin W Collins
- Division of Surgery and Interventional Science, Research Department of Targeted Invention, University College London, London, UK
- Division of Uro-Oncology, University College London Hospital, London, UK
- Associate Medical Director, CMR Surgical, Cambridge, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Meneghetti I, Tarantino FP, Mosillo L, Catalano C. Treatment of a hemorrhage secondary to nephrostomy tube placement for derivation of monstrous hydronephrosis in upper tract urothelial carcinoma. Urol Ann 2023; 15:238-241. [PMID: 37304515 PMCID: PMC10252770 DOI: 10.4103/ua.ua_23_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/13/2023] Open
Abstract
A 85-year-old female patient underwent nephrostomy tube insertion for a huge hydronephrosis due to a papillary mass involving the right ureteral ostium diagnosed by at computed tomography scan. As soon as the nephrostomy tube was inserted, a pulsatile bleeding was found and a renal angiography was done. A massive bleeding from the main and unique right renal artery was found such as to require prompt endovascular embolization. A transurethral resection of the bladder was performed and the pathology report confirmed high-grade pTa transitional cell carcinoma. An open drainage was then placed to empty the contents of the pyelocalyceal system of the kidney. Once obtained the volumetric reduction of the abdominal mass the patient underwent the right nephroureterectomy.
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Affiliation(s)
| | | | - Luca Mosillo
- Department of Urology, Ospedale Apuane, Massa, Italy
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Di Vico T, Meneghetti I, Mosillo L, Piccirilli A, Catalano C, Lorenzi L, Vocaturo V. Prostatic artery embolization versus transurethral resection of the prostate: assessment of safety and efficacy. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gobinet L, Tesi L, Vuong N, Mosillo L, Percot M, Dupitout L, Simeon H, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Gross Goupil M, Bernhard JC. Monocentric experience of Robot-assisted radical nephrectomy with vena cava thrombectomy: Technique and results. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01631-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gobinet L, Tesi L, Vuong N, Mosillo L, Percot M, Dupitout L, Simeon H, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Bensadoun H, Ferrière J, Bernhard J. Expérience monocentrique de la chirurgie robotique des cancers du rein avec thrombus cave : technique et résultats. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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De Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Mosillo L, Percot M, Blanc P, Bensadoun H, Bladou F, Robert G, Capon G, Estrade V, Ferrière J, Bos F, Gill I, Bernhard J. Intérêt de modèles tridimensionnels virtuels et physiques pour évaluation de la complexité tumorale rénale et la planification opératoire des néphrectomies partielles (étude UroCCR-63 : 3D-planning). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Clement K, Debard C, Mosillo L, Bladou F, Capon G, Robert G, Bensadoun H, Ferriere J, Bernhard J. Technique d’énucléation robot-assistée d’une tumeur rénale endophytique endosinusale. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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De Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Mosillo L, Percot M, Blanc P, Bensadoun H, Bladou F, Robert G, Capon G, Estrade V, Ferrière J, Bos F, Bernhard J. La modélisation 3D, un support efficace de l’information-patient avant chirurgie rénale. (Étude UroCCR-39 : Rein-3D-Print). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sadighi A, Tocco MP, Mosillo L, Ioni L, Pascazio C, Fernandes E, Ioni P. [Middle lobectomy for bronchiectasis: clinical case and review of the literature]. Chir Ital 2001; 53:115-24. [PMID: 11280820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Over the past few years bronchiectasis, among the chronic lung diseases, has been the second most important after tuberculosis in terms of frequency and mortality. Although the incidence of the disease has been decreasing in recent years, the illness is currently of great surgical interest because of an upsurge of cases among people considered to be below the bread line. The authors present the clinical case and surgical treatment of a young adult with middle lobe bronchiectasis, with a 10-year primary IgG deficiency and severe bronchopneumonia requiring hospitalisation. Medical treatment, long regarded as the treatment of choice in this condition, has reduced the short-term morbidity of patients suffering from the disease, without affecting its ultimate mortality which is still very high today. The policy in the past to reserve surgery only for the most complicated cases or for patients not responding to medical treatment can now be considered obsolete, due to the reduced surgical risks (less than 1%) and to faster patient recovery. Further surgical indications are mono- or bilaterally located forms of the disease and failure to respond to medical treatment for more than 2 years. A review of the literature enables the authors to affirm that in the absence of randomised trials on the effectiveness of surgical vs medical treatment, it seems clear that surgical therapy is the best option, being curative and safe, with a high percentage of complete remission of disease and very low operative risks and mortality. It can therefore guarantee good quality of life, radically changing the prognosis which otherwise is fatal in 1/3 of patients suffering from this orphan disease.
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Affiliation(s)
- A Sadighi
- Dipartimento di Chirurgia Pietro Valdoni Università degli Studi di Roma La Sapienza
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Leone A, Violino P, Ghirardo D, Fioranti L, Borrelli M, Scarrone A, Ambrogi C, Mosillo L, Segre D, Quaranta L, Ferro C. [The role of portography with computed tomography in the diagnosis of liver metastases from colorectal neoplasms]. Radiol Med 1996; 91:86-90. [PMID: 8614738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This study was performed to confirm the high sensitivity of CT during arterial portography (CTAP) versus US and dynamic CT in the diagnosis of liver metastases from colorectal cancer. Ninety patients with 108 colorectal cancers underwent US, dynamic CT and CTAP to investigate the presence of liver metastases. US depicted 39 metastases in 26 patients, dynamic CT 46 metastases in 29 patients and CTAP 54 lesions in 34 patients. CTAP detected 8 metastases missed at dynamic CT; 4 of them were < 1 cm in diameter, 3 ranged 1-2 cm and one metastasis > 2 cm in diameter. After preoperative investigations only 7 patients were considered for hepatic resection. At surgery, palpation and intraoperative US of the liver detected two more metastases in the same patients. Our experience, in agreement with recent studies, confirms CTAP as the most sensitive preoperative method in detecting liver metastases and its superiority to be most apparent in lesions < 1 cm in diameter. Therefore, we consider CTAP an essential imaging technique for planning the correct treatment of liver metastases.
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Affiliation(s)
- A Leone
- Servizio di Radiodiagnostica, Ospedale S. Croce, Cuneo
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Frittelli P, Chichi GL, Del Grande E, Nisi P, Mosillo L, Della Casa U, Teneriello F, Caporale A. [Use of fibrin glue in the treatment of entero-cutaneous fistulas]. G Chir 1990; 11:163-4. [PMID: 2223490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors present methods and results of the treatment of chronic fistulas complicating abdominal surgery in 5 patients. The use of human fibrin glue is described and its therapeutical usefulness is pointed out.
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Affiliation(s)
- P Frittelli
- I Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi La Sapienza, Roma
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Caporale A, Frittelli P, Della Casa U, Rengo M, Agrò GA, Mosillo L, Pasquini G. [Surgical treatment of hydatid cysts of the hepatic dome ruptured into the thoracic cavity]. G Chir 1990; 11:23-8. [PMID: 2223465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Two cases of hydatid cyst of the hepatic dome, complicated by rupture in the thoracic cavity, are reported. The Authors stress the frequency of human hydatidosis, still high in Italy, and the severity of the above mentioned complication. Surgical treatment is also discussed.
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Affiliation(s)
- A Caporale
- Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi La Sapienza, Roma
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