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Ishizuka C, Ishikawa T, Yagi H, Yamamoto Y, Koro D, Nishikoshi T, Koshizuka Y, Yanagida N, Shibaki T, Akabane H, Yasuda S, Ishibashi K, Taketomi A. Robot-assisted distal gastrectomy and local resection for gastric cancer and gastrointestinal stromal tumor. Asian J Endosc Surg 2024; 17:e13310. [PMID: 38623612 DOI: 10.1111/ases.13310] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
Gastrointestinal stromal tumors surrounding the esophagogastric junction are often challenging to resect, with no consensus regarding the optimal surgical technique. Here in, we present a case of concurrent gastric cancer in the antrum and gastrointestinal stromal tumors adjacent to the esophagogastric junction. The patient underwent simultaneous distal gastrectomy and local resection assisted by a surgical robot, avoiding the need for total gastrectomy. The utilization of robot-assisted surgery has become an increasingly popular technique, holding promise for simplifying complex surgical procedures across diverse medical settings.
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Affiliation(s)
- Chihiro Ishizuka
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Takahisa Ishikawa
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Hayato Yagi
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Yoichi Yamamoto
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Daisuke Koro
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Takahiro Nishikoshi
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Yasuyuki Koshizuka
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Naoyuki Yanagida
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Taiichiro Shibaki
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Hiromitsu Akabane
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Shunsuke Yasuda
- Department of General Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
- Department of Respiratory Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Kei Ishibashi
- Department of Respiratory Surgery, Asahikawa-Kosei General Hospital, Asahikawa, Japan
| | - Akinobu Taketomi
- Department of Gastroenterological Surgery 1, Hokkaido University Graduate School, Sapporo, Japan
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He J, Zhang Q, Wang X, Fu M, Zhang H, Song L, Pu R, Jiang Z, Yang G. In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer-assisted implant surgery. Clin Implant Dent Relat Res 2024; 26:385-401. [PMID: 38214435 DOI: 10.1111/cid.13302] [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: 08/10/2023] [Revised: 12/04/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To assess the accuracy of autonomous robotic and fully guided static computer-assisted implant surgery (sCAIS) performed on models and patients. MATERIALS AND METHODS This study was divided into in vitro and in vivo sections. In vitro, 80 operators were assigned to two groups randomly. Forty operators performed forty autonomous robotic implant (ARI group) surgeries and the remaining forty operators carried out forty fully guided sCAIS (FGI group) surgeries on maxillary models, respectively. Each operator placed an implant in one maxillary model. In vivo, 60 patients with 113 implants from 2019 to 2023 (ARI group: 32 patients, 58 implants; FGI group: 28 patients, 55 implants) receiving implant surgeries were incorporated in this retrospective research. The preoperative and postoperative cone beam computer tomographs (CBCTs) were utilized to estimate the linear deviations and angular deviations in two-dimensional (2D) and three-dimensional (3D) space. The Pearson's chi-square test, Shapiro-Wilk test, Student's t test, Mann-Whitney U test and mixed models were applied, and p <0.05 was considered statistically significant. RESULTS In vitro, a total of 80 implants were enrolled and significant differences were found between the two groups (p < 0.001): The 3D deviation at the platform of ARI and FGI group was 0.58 ± 0.60 mm and 1.50 ± 1.46 mm, respectively, at the apex was 0.58 ± 0.60 mm and 1.78 ± 1.35 mm, respectively, and angle was 1.01 ± 0.87° and 2.93 ± 1.59°, respectively. Also, except for mesiodistal deviation at the implant platform, the rest linear and angular deviations in the ARI group were significantly lower than those in the FGI group in 2D space (p < 0.001). In vivo, a significantly lower mean of angular deviation (0.95 ± 0.50°, p < 0.001) and the linear deviation at both platform (0.45 ± 0.28 mm, p < 0.001) and apex (0.47 ± 0.28 mm, p < 0.001) were observed in ARI group when compared to the FGI group (4.31 ± 2.60°; 1.45 ± 1.27 mm; 1.77 ± 1.14 mm). CONCLUSIONS The use of autonomous robotic technology showed significantly higher accuracy than the fully guided sCAIS.
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Affiliation(s)
- Jin He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Qinmeng Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xueting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Mengdie Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Hui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Luyao Song
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Rui Pu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Zhiwei Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Guoli Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Hermans T, Snoeks JM, vom Dorp F, Wiesner C, Steiner T, von Rundstedt F. Validation of a 3D-printed robot-assisted partial nephrectomy training model. BJUI Compass 2024; 5:90-100. [PMID: 38179024 PMCID: PMC10764170 DOI: 10.1002/bco2.269] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives Most renal tumours can be treated with a partial nephrectomy, with robot-assisted partial nephrectomy becoming the new gold standard. This procedure is challenging to learn in a live setting, especially the enucleation and renorraphy phases. In this study, we attempted to evaluate face, content, and preliminary construct validity of a 3D-printed silicone renal tumour model in robotic training for robot-assisted partial nephrectomy. Materials and Methods We compared the operative results of three groups of surgeons with different experience levels (>20 partial nephrectomies, 1-20 partial nephrectomies and no experience at all) performing a robotic tumour excision of a newly developed silicone model with four embedded 3D-printed renal tumours. We evaluated the participants' performance using surgical margins, excision time, total preserved parenchyma, tumour injury and GEARS score (as assessed by two blinded experts) for construct validity. Postoperatively, the participants were asked to complete a survey to evaluate the usefulness, realism and difficulty of the model as a training and/or evaluation model. NASA-TLX scores were used to evaluate the operative workload. Results Thirty-six participants were recruited, each group consisting of 10-14 participants. The operative performance was significantly better in the expert group as compared to the beginner group. NASA-TLX scores proved the model to be of an acceptable difficulty level.Expert group survey results showed an average score of 6.3/10 on realism of the model, 8.2/10 on the usefulness as training model and 6.9/10 score on the usefulness as an evaluation tool. GEARS scores showed a non-significant tendency to improve between trials, emphasizing its potential as a training model. Conclusion Face and content validity of our 3D renal tumour model were demonstrated. The vast majority of participants found the model realistic and useful for training and for evaluation. To evaluate construct and predictive validity, we require further research, aiming to compare the results of 3D-model trained surgeons with those of untrained surgeons in real-life surgery.
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Affiliation(s)
- Thomas Hermans
- Department of UrologyHelios University Hospital Wuppertal, University of Witten/HerdeckeWuppertalGermany
| | - Joren M. Snoeks
- Community Ecology Lab, Department of BiologyVrije Universiteit Brussel (VUB)BrusselsBelgium
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Tashiro Y, Ishitoya S, Yamamoto R, Sugiyama K, Takada H, Matsumoto K, Tsuchihashi K. A case of renal cell carcinoma with antiphospholipid syndrome treated by robot-assisted partial nephrectomy. IJU Case Rep 2024; 7:8-10. [PMID: 38173463 PMCID: PMC10758908 DOI: 10.1002/iju5.12654] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 09/28/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Antiphospholipid syndrome is an autoimmune disease that presents with thrombus hyperplasia. Although very rare, this disease is reported to become severe after the surgical invasion and other interventions. To our knowledge, there are no reports of partial nephrectomy in patients with antiphospholipid. Case presentation A 45-year-old man visited our hospital for treatment of left renal cell carcinoma. He had a history of antiphospholipid syndrome and took two antithrombotic agents. We performed a robot-assisted partial nephrectomy. We selectively ligated only the feeding branch during the procedure. Postoperatively, there were no complications, and the patient was discharged on postoperative day 10. One year after surgery, there was no worsening of antiphospholipid syndrome. Conclusion We reported the first case of robot-assisted partial nephrectomy for an antiphospholipid syndrome patient. Selective ligation of the renal artery might not have contributed to the severe antiphospholipid syndrome.
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Affiliation(s)
- Yu Tashiro
- Department of UrologyOtsu Red Cross HospitalOtsuShigaJapan
| | | | - Ryo Yamamoto
- Department of UrologyOtsu Red Cross HospitalOtsuShigaJapan
| | | | - Hideaki Takada
- Department of UrologyKyoto University Graduate School of MedicineSakyo‐KuKyotoJapan
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Mizoguchi M, Kizuki M, Iwata N, Tokunaga M, Fushimi K, Kinugasa Y, Fujiwara T. Comparison of short-term outcomes between robot-assisted and laparoscopic rectal surgery for rectal cancer: A propensity score-matched analysis using the Japanese Nationwide diagnosis procedure combination database. Ann Gastroenterol Surg 2023; 7:955-967. [PMID: 37927934 PMCID: PMC10623962 DOI: 10.1002/ags3.12707] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 11/07/2023] Open
Abstract
Background The use of robot-assisted surgery for rectal cancer is increasing, but its short-term results remain unclear. We compared the short-term outcomes of robot-assisted and laparoscopic surgery for rectal cancer using a nationwide inpatient database. Methods We analyzed patients registered in the Japanese Diagnosis Procedure Combination database who underwent robot-assisted or laparoscopic surgery for rectal cancer from April 2018 to March 2020. Postoperative complication rates, anesthesia time, length of hospital stay, and cost were compared using propensity score matching for low anterior resection (LAR), high anterior resection (HAR), and abdominoperineal resection (APR). Results Among 38 090 rectal cancer cases, 1992 LAR, 357 HAR, and 310 APR pairs were generated by propensity score matching and analyzed. Anesthesia time was longer for robot-assisted surgery compared with laparoscopic surgery (LAR: 388.6 vs. 452.8 min, p < 0.001; HAR: 300.9 vs. 393.5 min, p < 0.001; APR: 4478.5 vs. 533.5 min, p < 0.001). Robot-assisted surgery was associated with significantly shorter hospital stay for LAR (22.3 vs. 20.0 days, p < 0.001) and APR (29.2 vs. 25.9 days, p = 0.029). Total costs for LAR were significantly lower for robot-assisted surgery (2031511.6 vs. 1955216.6 JPY, p < 0.001). The complication rates for robot-assisted surgery tended to be fewer than laparoscopic surgery for all procedures, but the differences were not significant. Conclusions Although the anesthesia time was longer for robot-assisted surgery, the procedure resulted in shorter hospital stay for LAR and APR, and lower costs for LAR compared with laparoscopic surgery. Robot-assisted surgery can thus help to reduce costs and can be performed safely.
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Affiliation(s)
- Masako Mizoguchi
- Department of Gastrointestinal SurgeryTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Masashi Kizuki
- Department of Tokyo Metropolitan Health Policy AdvisementTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Noriko Iwata
- Department of Gastrointestinal SurgeryTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Masanori Tokunaga
- Department of Gastrointestinal SurgeryTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Kiyohide Fushimi
- Department of Health Policy and InformaticsTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Yusuke Kinugasa
- Department of Gastrointestinal SurgeryTokyo Medical and Dental UniversityBunkyo‐kuJapan
| | - Takeo Fujiwara
- Department of Global Health PromotionTokyo Medical and Dental UniversityBunkyo‐kuJapan
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Ohzeki T, Kita H, Kunishige R, Hayashi T, Nishioka T. Giant adrenal pseudocyst removed using robot-assisted surgery. IJU Case Rep 2023; 6:141-143. [PMID: 36874999 PMCID: PMC9978075 DOI: 10.1002/iju5.12571] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/18/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction Adrenal cysts are relatively rare and often asymptomatic. Surgical treatment is indicated for symptomatic cases with cysts >6 cm, suspected bleeding, and those that cannot be distinguished from malignant illness based on imaging findings. There have often been cases of giant cysts that were difficult to treat using laparoscopic surgery. Case presentation A 39-year-old woman presented with fever and upper abdominal pain. Abdominal computed tomography and magnetic resonance imaging revealed a 95 × 80-mm left adrenal cyst. As malignant disease could not be ruled out, and the patient was symptomatic, we opted for robot-assisted left adrenalectomy. The pathological findings indicated an adrenal pseudocyst. Conclusions This is the second report of the successful robot-assisted removal of a giant adrenal cyst.
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Affiliation(s)
- Takayuki Ohzeki
- Department of Urology Izumi City General Hospital Izumi Osaka Japan
| | - Hiroyuki Kita
- Department of Urology Izumi City General Hospital Izumi Osaka Japan
| | - Remon Kunishige
- Department of Urology Izumi City General Hospital Izumi Osaka Japan
| | - Taiji Hayashi
- Department of Urology Izumi City General Hospital Izumi Osaka Japan
| | - Tsukasa Nishioka
- Department of Urology Izumi City General Hospital Izumi Osaka Japan
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Nishikimi T, Yoshino Y, Yamada H, Mizuno H, Yamauchi Y, Ohashi T, Isiguro S, Morikami H, Okamura K. Two cases of pelvic schwannomas simultaneously resected with the prostate by robot-assisted surgery. IJU Case Rep 2021; 4:277-281. [PMID: 34497982 PMCID: PMC8413211 DOI: 10.1002/iju5.12323] [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: 02/17/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Schwannoma is a rare benign tumor of peripheral nerves arising from Schwann cells of the ubiquitous nerve sheath. The operative steps and technical aspects of robotic resection of pelvic schwannoma are described herein. CASE PRESENTATION We describe two patients with pelvic tumors simultaneously resected with the prostate by robot-assisted surgery: a 69-year-old man with schwannoma of the right side of the pelvic floor and a 68-year-old man with schwannoma in the left pelvis. As metastasis of prostate cancer could not be ruled out, tumorectomy was performed using robotic-associated prostatectomy. Malignancy was absent in the two pelvic tumors, and the patients were diagnosed with schwannoma. CONCLUSION For surgery in a narrow deep pelvis, robot-assisted surgery is minimally invasive, offers excellent mobility of robotic instruments and visibility of three-dimensional view, and is a useful approach.
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Affiliation(s)
| | - Yasushi Yoshino
- Department of UrologyNagoya Medical CenterNaka‐ku Nagoya‐shiAichiJapan
| | - Hiroshi Yamada
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Hideki Mizuno
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Yushi Yamauchi
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Tomoyoshi Ohashi
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Shigeki Isiguro
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Hiroko Morikami
- Department of UrologyNagoya Daini Red Cross HospitalShowa‐kuNagoyaJapan
| | - Kikuo Okamura
- Department of UrologyHigashinagoya National HospitalNagoyaAichiJapan
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