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Gonçalves-Costa D, Barbosa JP, Quesado R, Lopes V, Barbosa J. Robotic surgery versus Laparoscopic surgery for anti-reflux and hiatal hernia surgery: a short-term outcomes and cost systematic literature review and meta-analysis. Langenbecks Arch Surg 2024; 409:175. [PMID: 38842610 PMCID: PMC11156741 DOI: 10.1007/s00423-024-03368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/26/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE The objective of this study is to compare the operative time, intraoperative complications, length of stay, readmission rates, overall complications, mortality, and cost associated with Robotic Surgery (RS) and Laparascopic Surgery (LS) in anti-reflux and hiatal hernia surgery. METHODS A comprehensive literature search was conducted using MEDLINE (via PubMed), Web of Science and Scopus databases. Studies comparing short-term outcomes and cost between RS and LS in patients with anti-reflux and hiatal hernia were included. Data on operative time, complications, length of stay, readmission rates, overall complications, mortality, and cost were extracted. Quality assessment of the included studies was performed using the MINORS scale. RESULTS Fourteen retrospective observational studies involving a total of 555,368 participants were included in the meta-analysis. The results showed no statistically significant difference in operative time, intraoperative complications, length of stay, readmission rates, overall complications, and mortality between RS and LS. However, LS was associated with lower costs compared to RS. CONCLUSION This systematic review and meta-analysis demonstrates that RS has non-inferior short-term outcomes in anti-reflux and hiatal hernia surgery, compared to LS. LS is more cost-effective, but RS offers potential benefits such as improved visualization and enhanced surgical techniques. Further research, including randomized controlled trials and long-term outcome studies, is needed to validate and refine these findings.
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Affiliation(s)
- Diogo Gonçalves-Costa
- Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - José Pedro Barbosa
- MEDCIDS - Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Stomatology, São João University Hospital Center, Porto, Portugal
| | - Rodrigo Quesado
- Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Vítor Lopes
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of General Surgery, São João University Hospital Center, Porto, Portugal
| | - José Barbosa
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of General Surgery, São João University Hospital Center, Porto, Portugal
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Noshiro H, Ide T, Nomura A, Yoda Y, Hiraki M, Manabe T. Introduction of a new surgical robot platform "hinotori™" in an institution with established da Vinci surgery™ for digestive organ operations. Surg Endosc 2024:10.1007/s00464-024-10918-4. [PMID: 38839604 DOI: 10.1007/s00464-024-10918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND New platforms for robotic surgery have recently become available for clinical use; however, information on the introduction of new surgical robotic platforms compared with the da Vinci™ surgical system is lacking. In this study, we retrospectively determined the safe introduction of the new "hinotori™" surgical robot in an institution with established da Vinci surgery using four representative digestive organ operations. METHODS Sixty-one patients underwent robotic esophageal, gastric, rectal, and pancreatic operations using the hinotori system in our department in 2023. Among these, 22 patients with McKeown esophagectomy, 12 with distal gastrectomy, 11 with high- and low-anterior resection of the rectum, and eight with distal pancreatectomy procedures performed by hinotori were compared with historical controls treated using da Vinci surgery. RESULTS The console (cockpit) operation time for distal gastrectomy and rectal surgery was shorter in the hinotori group compared with the da Vinci procedure, and there were no significant differences in the console times for the other two operations. Other surgical results were almost similar between the two robot surgical groups. Notably, the console times for hinotori surgeries showed no significant learning curves, determined by the cumulative sum method, for any of the operations, with similar values to the late phase of da Vinci surgery. CONCLUSIONS This study suggests that no additional learning curve might be required to achieve proficient surgical outcomes using the new hinotori surgical robotic platform, compared with the established da Vinci surgery.
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Affiliation(s)
- Hirokazu Noshiro
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Takao Ide
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Akinari Nomura
- Department of Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yukie Yoda
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Masatsugu Hiraki
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Tatsuya Manabe
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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Long X, Chen J, Li J, Luo Z. The current status and global trends of clinical trials related to robotic surgery: a bibliometric and visualized study. J Robot Surg 2024; 18:193. [PMID: 38693446 DOI: 10.1007/s11701-024-01940-8] [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: 03/05/2024] [Accepted: 04/01/2024] [Indexed: 05/03/2024]
Abstract
Conducting clinical trials can evaluate the effectiveness and safety of surgical robots. To promote the advancement of academic robotic programs in surgery, this study captures the development trend and research hotspots of clinical trials related to surgical robots by bibliometric analysis. Bibliometrix package in R software was used to analyze the publication year, authors, countries, institutes, and journals. The visualization maps of keywords were formed using VOSviewer. The keywords with the strongest citation bursts and the institutional collaboration map were created by CiteSpace. Urology dominates with 31.3% of publications and the controlled clinical trials in urology and orthopedic accounted for the highest proportion, reaching 73%. North America, the USA, and Seoul National University lead in productivity. The most productive country, region and institution are North America, USA and Seoul National University, respectively. The trend of collaboration is regional instead of international. Keyword and burst keyword analysis revealed a primary focus in clinical research on robotic surgery: evaluating process improvements, comparing robotic and traditional surgery, and assessing feasibility. Long-term clinical trials assess surgical robots not only intraoperative performance but also postoperative complications and overall surgical outcomes. The development in the field is unbalanced between regions and countries. To promote multi-center clinical trials, governments can streamline review procedures and establish international consensus review standards, while academic institutions can form academic alliances. Also, the study offers recommendations for the development of academic robotic programs and regional collaboration units in robotic surgery, which may provide researchers with a strong reference for future research.
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Affiliation(s)
- Xinrui Long
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, China
- Xiangya School of Medicine, Central South University, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Hunan, China
- Furong Lab, Central South University, Hunan, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Jiaqi Chen
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Jiaqi Li
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Zhonglin Luo
- Department of Dermatology, Xiangya Hospital, Central South University, Hunan, China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Hunan, China.
- Furong Lab, Central South University, Hunan, China.
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China.
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Totaro A, Scarciglia E, Marino F, Campetella M, Gandi C, Ragonese M, Bientinesi R, Palermo G, Bizzarri FP, Cretì A, Presutti S, Russo A, Aceto P, Bassi P, Pierconti F, Racioppi M, Sacco E. Robot-Assisted Radical Prostatectomy Performed with the Novel Surgical Robotic Platform Hugo™ RAS: Monocentric First Series of 132 Cases Reporting Surgical, and Early Functional and Oncological Outcomes at a Tertiary Referral Robotic Center. Cancers (Basel) 2024; 16:1602. [PMID: 38672683 PMCID: PMC11049006 DOI: 10.3390/cancers16081602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/07/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Robotic-assisted surgery is the gold standard for performing radical prostatectomy (RARP), with new robotic devices such as HugoTM RAS gaining prominence worldwide. OBJECTIVE We report the surgical, perioperative, and early postoperative outcomes of RARP using HugoTM RAS. DESIGN, SETTING, AND PARTICIPANTS Between April 2022 and October 2023, we performed 132 procedures using the Montsouris technique with a four-robotic-arm configuration in patients with biopsy-proven prostate cancer (PCa). OUTCOME MEASURES We collected intraoperative and perioperative data during hospitalization, along with follow-up data at predefined postoperative intervals of 3 and 6 months. RESULTS AND LIMITATIONS Lymphadenectomy was performed in 25 procedures, with a bilateral nerve-sparing technique in 33 and a monolateral nerve-sparing technique in 33 cases. The mean total surgery time was 242 (±57) min, the mean console time was 124 (±48) min, and the mean docking time was 10 (±2) min. We identified 17 system errors related to robotic arm failures, 9 robotic instrument breakdowns, and 8 significant conflicts between robotic arms. One post-operative complication was classified as Clavien-Dindo 3b. None of the adverse events, whether singular or combined, increased the operative time. Positive margins (pR1) were found in 54 (40.9%) histological specimens, 37 (28.0%) of which were clinically significant. At 3 and 6 months post-surgery, the PSA levels were undetectable in 94.6% and 92.1% of patients, respectively. Social urinary continence was regained in 86% after 6 months. Limitations of our study include its observational monocentric case-series design and the short follow-up data for functional and oncological outcomes. CONCLUSIONS Our initial experience highlights the reliability of the HugoTM RAS system in performing RARP. Additionally, we also list problems and solutions found in our daily work.
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Affiliation(s)
- Angelo Totaro
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Eros Scarciglia
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Filippo Marino
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Marco Campetella
- Department of Urology, Isola Tiberina—Gemelli Isola Hospital, Catholic University Medical School, 00167 Rome, Italy
| | - Carlo Gandi
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Mauro Ragonese
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Riccardo Bientinesi
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Giuseppe Palermo
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Francesco Pio Bizzarri
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Antonio Cretì
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Simona Presutti
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Andrea Russo
- Department of Anesthesia, Emergency and Intensive Care Medicine, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Paola Aceto
- Department of Anesthesia, Emergency and Intensive Care Medicine, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Pierfrancesco Bassi
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Francesco Pierconti
- Department of Pathological Anatomy, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Marco Racioppi
- Department of Urology, Agostino Gemelli Hospital Foundation—IRCCS, Catholic University Medical School, 00167 Rome, Italy
| | - Emilio Sacco
- Department of Urology, Isola Tiberina—Gemelli Isola Hospital, Catholic University Medical School, 00167 Rome, Italy
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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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Adhikari K, Penmetsa GK, Krishnappa D, Taori R, Raghunath SK. Revolutionizing urology: the advancements and applications of robotic platforms. J Robot Surg 2024; 18:106. [PMID: 38436766 DOI: 10.1007/s11701-023-01758-w] [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: 09/01/2023] [Accepted: 10/14/2023] [Indexed: 03/05/2024]
Abstract
Robot-assisted surgery is developing as an acme of minimally invasive surgery, given its utmost dominance over laparoscopic surgery. The objective was to review the status of robotic surgery in urological practice with its advantages and disadvantages in current scenario. We conducted a literature search using MEDLINE and identified 72 articles which were relevant to urology. Single-port and various multiport robotic platforms like Da Vinci, Versius, Hugo RAS, Revo-I, Senhance, Mantra, Avatera, Hinotori, and MicroSurge are described with pros and cons. With a surge in different medical surgical robots purging into the market and a race to become the next standard of care in robotic surgery, it is only a matter of time when robotic surgery becomes financially comparable to laparoscopic surgeries.
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Affiliation(s)
- Kinju Adhikari
- Department of Uro Oncology and Robotic Surgery, HCG Cancer Center, Bengaluru, India
| | | | - Deepak Krishnappa
- Department of Uro Oncology and Robotic Surgery, HCG Cancer Center, Bengaluru, India
| | - Ravi Taori
- Department of Uro Oncology and Robotic Surgery, HCG Cancer Center, Bengaluru, India
| | - S K Raghunath
- Department of Uro Oncology and Robotic Surgery, HCG Cancer Center, Bengaluru, India.
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Devine M, Morris M, Kavanagh D. Transferability of Technical Skills Across Robotic Surgery Platforms: A Scoping Review. Cureus 2024; 16:e56429. [PMID: 38638798 PMCID: PMC11024662 DOI: 10.7759/cureus.56429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
As the application of robotic approaches to surgery continues to broaden, new consoles have been introduced to the market. Due to the global utilization of a single platform, previously validated curricula have not been assessed on new robotic systems. Surgery by its nature occurs in a high-stakes environment, potentially exacerbated by non-standardized robotic systems. The aim of this review is to critique the evidence available regarding the transferability of technical skills across robotic platforms. A scoping review utilizing the Medline (Pubmed) and Cochrane Databases was conducted. Full texts were reviewed and appraised. Selected articles were eligible for inclusion if they investigated the ability or implications of the transfer of skill across robotic platforms. Data was extracted, coded inductively, and themes synthesized. NVIVO software was used as an adjunct for this qualitative analysis. Following the removal of duplicates a total of 278 papers were screened according to the eligibility criteria. Fifty full-text articles were reviewed and four met the criterion for inclusion. Novices' performance across platforms was comparable. Increasing levels of prior robotic experience revealed an improvement in technical performance on a novel robotic platform. Safety metrics appear comparable across systems. Quantifying learning curves across robotic platforms and their implications for the robotic surgeon in training remains to be determined. Future research needs to address the gaps in the literature by clearly defining the extent of technical skills transfer between robotic platforms. These factors will guide the next iteration of surgical training curriculums and regulations for robotic surgery.
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Affiliation(s)
- Michael Devine
- Department of Surgical Affairs, Royal College of Surgeons in Ireland/Hermitage Medical Clinic, Dublin, IRL
| | - Marie Morris
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Dara Kavanagh
- Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, IRL
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Xu L, Li X, Fan S, Li Z, Zuo W, Chen S, Zhang P, Cui L, Zhou L, Yang K, Li X. Analysis of KangDuo-SR-1500 and KangDuo-SR-2000 robotic partial nephrectomy from an operative and ergonomic perspective: a prospective controlled study in porcine models. J Robot Surg 2024; 18:26. [PMID: 38217779 DOI: 10.1007/s11701-023-01770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/22/2023] [Indexed: 01/15/2024]
Abstract
The objective of this study is to explore the safety and effectiveness of two new models of KangDuo surgical robots for partial nephrectomy in porcine models, and evaluate the ergonomic characteristics from both subjective and objective perspectives. Twelve porcine models were equally divided for KD-SR-1500 (three-arm) and KD-SR-2000 (four-arm). The perioperative outcomes, and physical and mental workload of the surgeon were compared. Physical workload was evaluated with surface electromyography. Mental workload was evaluated with NASA-TLX. All surgeries were performed successfully. There were no differences in perioperative variables (p > 0.05). There were no perioperative complications. The mental workload in both groups was at a low level. KD-SR-2000 showed advantages in physical workload (p < 0.01). KD-SR-1500 and KD-SR-2000 are technically feasible, valid, and safe for RAPN in porcine models. KD-SR-2000 had ergonomic advantages over KD-SR-1500.
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Affiliation(s)
- Liqing Xu
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xinfei Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Shubo Fan
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Zhihua Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Wei Zuo
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Silu Chen
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Peng Zhang
- Department of Urology, Emergency General Hospital, Beijing, 100028, China
| | - Liang Cui
- Department of Urology, School of Clinical Medicine, Civil Aviation General Hospital, Peking University Aerospace, Beijing, 100080, China
| | - Liqun Zhou
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Kunlin Yang
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Xuesong Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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Togami S, Higashi T, Tokudome A, Fukuda M, Mizuno M, Yanazume S, Kobayashi H. The first report of surgery for gynecological diseases using the hinotori™ surgical robot system. Jpn J Clin Oncol 2023; 53:1034-1037. [PMID: 37595992 DOI: 10.1093/jjco/hyad105] [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: 02/27/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023] Open
Abstract
OBJECTIVE This study aimed to report the first surgery for gynecological diseases using a new robotic platform, the hinotori™, and validate its feasibility in clinical settings. METHODS The world's first robot-assisted total hysterectomy for a gynecological ailment was carried out at Kagoshima University Hospital in December 2022 utilizing the hinotori™ surgical robot system. Eleven other patients then underwent comparable procedures. The surgical team was certified to execute the procedure and had undergone official hinotori™ training. RESULTS Preoperative diagnoses indicated five cases of endometrial cancer, four cases of uterine myoma and one case each of atypical endometrial hyperplasia, uterine adenosarcoma and high-grade cervical intraepithelial neoplasia. Median age and body mass index were 51 (range: 38-70) years and 26.9 (range: 17.3-33.3) kg/m2, respectively. Median roll-in, cockpit and operation times were 15 (range: 10-18), 161 (range: 110-225) and 214 (range: 154-287) min, respectively. The median blood loss was 22 (range: 7-83) mL and conversion to laparotomy was not allowed. Only one patient had postoperative pelvic region infection. The median length of hospital stay was 6 (range: 4-10) days. CONCLUSION Based on our experience with presented 12 cases, robotic surgery with the hinotori™ is a feasible technique of minimally invasive surgery for gynecological diseases.
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Affiliation(s)
- Shinichi Togami
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Takuro Higashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Akio Tokudome
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mika Fukuda
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mika Mizuno
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shintaro Yanazume
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Zeng Q, Chen C, Zhang N, Yu J, Yan D, Xu C, Liu D, Zhang Q, Zhang X. Robot-assisted thoracoscopic surgery for mediastinal tumours in children: a single-centre retrospective study of 149 patients. Eur J Cardiothorac Surg 2023; 64:ezad362. [PMID: 37897669 DOI: 10.1093/ejcts/ezad362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/28/2023] [Accepted: 10/27/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES The purpose of this retrospective study was to summarize our experience in performing robot-assisted thoracoscopic surgery (RATS) for mediastinal tumours in children to investigate its safety and feasibility. METHODS This retrospective study involved 149 patients with mediastinal tumours who were hospitalized in the Department of Thoracic Surgery of Beijing Children's Hospital, Capital Medical University, and underwent RATS for tumour resection from March 2021 to November 2022. Information on patient age, weight, tumour size, surgical incision selection, operative time, intraoperative bleeding, intraoperative complications, length of hospital stay, rate of conversion to thoracotomy and follow-up conditions were summarized. RESULTS All 149 surgeries were successfully completed with no cases of mortality. There were 77 male and 72 female patients, with a mean age of 5.9 years (range: 6 months-16 years, 8 months) and a mean weight of 23.6 kg (8.0-72.0 kg). The mean maximum tumour diameter was 5.5 cm (2.0-12.0 cm), the mean operative time was 106.7 min (25.0-260.0 min), the mean intraoperative bleeding volume was 11.3 ml (1.0-400.0 ml) and the mean hospital stay was 7.2 days (4.0-14.0 days). All patients recovered well with no cases of tumour recurrence or mortality during the postoperative follow-up period (3-23 months). CONCLUSIONS RATS is safe and feasible to apply in children with mediastinal tumours who are >6 months of age and weigh more than 8 kg in terms of short-term outcomes, but longer-term follow-up is needed to fully evaluate the benefits. For cases that are associated with greater surgical difficulty and risk, a comprehensive surgical plan should be fully prepared in advance of surgery.
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Affiliation(s)
- Qi Zeng
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Chenghao Chen
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Na Zhang
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Jie Yu
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Dong Yan
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Changqi Xu
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Dingyi Liu
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Qian Zhang
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
| | - Xu Zhang
- Department of Thoracic Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Thoracic Surgery, National Clinical Research Center for Respiratory Disease, Ministry of Science and Technology, Beijing, China
- Department of Paediatric Surgery, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
- Department of Thoracic Surgery, Beijing Engineering Research Center of Paediatric Surgery, Beijing, China
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11
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Yoon YK, Park KH, Shim DW, Han SH, Lee JW, Jung M. Robotic-assisted foot and ankle surgery: a review of the present status and the future. Biomed Eng Lett 2023; 13:571-577. [PMID: 37872981 PMCID: PMC10590355 DOI: 10.1007/s13534-023-00328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023] Open
Abstract
The surgical application of robotics has increased significantly since its first application in 1985 for a brain biopsy acquisition. Robotic-assisted surgery has been one of the viable options in various surgical areas, and also in orthopaedic surgery. Robotic-assisted orthopaedic surgery has gained popularity as a mean of improving accuracy, reducing complications and achieving better patient satisfaction. Numerous clinical research studies have demonstrated advantages of robotic-assisted orthopaedic surgery, however, most of that researches were about the total knee arthroplasty, total hip arthroplasty and spine surgery. The application of robotic technology in foot and ankle surgery is in a very nascent stage. Furthermore, there has been little research on intraoperative use of robotics in foot and ankle surgery in literature. A review of previous preclinical studies in foot and ankle robotics and clinical research studies in various fields of robot-assisted orthopaedic surgery shows that its potential application and benefits over conventional techniques, such as total ankle arthroplasty, minimally invasive surgery for foot and ankle trauma or other corrective procedure, and intraoperative biomechanical testing. More studies on practical application of robotic technology to surgical procedure in the field of foot and ankle surgery are needed to confirm its clinical usefulness and cost effectiveness.
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Affiliation(s)
- Yeo Kwon Yoon
- Department of Orthopaedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Kwang Hwan Park
- Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Woo Shim
- Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Hwan Han
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Woo Lee
- Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Min Jung
- Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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12
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Panico G, Mastrovito S, Campagna G, Monterossi G, Costantini B, Gioè A, Oliva R, Ferraro C, Ercoli A, Fanfani F, Scambia G. Robotic docking time with the Hugo™ RAS system in gynecologic surgery: a procedure independent learning curve using the cumulative summation analysis (CUSUM). J Robot Surg 2023; 17:2547-2554. [PMID: 37542580 PMCID: PMC10492716 DOI: 10.1007/s11701-023-01693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/30/2023] [Indexed: 08/07/2023]
Abstract
Robot-assisted surgery has been proven to offer improvements in term of surgical learning curve and feasibility of minimally invasive surgery, but has often been criticized for its longer operative times compared to conventional laparoscopy. Additional times can be split into time required for system set-up, robotic arms docking and calibration of robotic instruments; secondly, surgeon's learning curve. One of the newest systems recently launched on the market is the Hugo™ RAS (MEDTRONIC Inc, United States). As some of the earliest adopters of the Hugo™ RAS system technology, we present our data on robotic docking learning curve for the first 192 gynecologic robotic cases performed at our institution. Our data indicates that robotic set-up and docking with the new Hugo™ RAS robotic surgical system can be performed time-effectively and that the specific robotic docking learning curve is comparable to preexisting data for other platforms. This preliminary insights into this recently released system may be worthwhile for other centers which may soon adopt this new technology and may need some relevant information on topics such as OR times. Further studies are necessary to assess the different features of the Hugo™ RAS considering other technical and surgical aspects, to fully become familiar with this novel technology.
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Affiliation(s)
- Giovanni Panico
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy
| | - Sara Mastrovito
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy
| | - Giuseppe Campagna
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy.
| | - Giorgia Monterossi
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Oncologica, 00168, Rome, Italy
| | - Barbara Costantini
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Oncologica, 00168, Rome, Italy
| | - Alessandro Gioè
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Oncologica, 00168, Rome, Italy
| | - Riccardo Oliva
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Ginecologia Oncologica, 00168, Rome, Italy
- IRCAD, Research Institute Against Digestive Cancer, 1, Place de l'Hôpital, 67091, Strasbourg, France
| | - Chiara Ferraro
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy
| | - Alfredo Ercoli
- PID Ginecologia Oncologica e Chirurgia Ginecologica Miniinvasiva, Università Degli Studi di Messina, Policlinico G.Martino, 98124, Messina, Italy
| | - Francesco Fanfani
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy
| | - Giovanni Scambia
- Dipartimento di Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC Chirurgia Ginecologica, 00168, Rome, Italy
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13
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Goodsell KE, Park JO. Robotic hepatectomy: current evidence and future directions. Minerva Surg 2023; 78:525-536. [PMID: 36946128 DOI: 10.23736/s2724-5691.23.09858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Minimally invasive hepatectomy continues to gain popularity and acceptance for treatment of benign and malignant liver disease. Robotic hepatectomy offers potential advantages over open and conventional laparoscopic approaches. Review of the literature on robotic hepatectomy was performed. Search terms included "robotic hepatectomy" and "minimally invasive hepatectomy." Search was further customized to include articles related to robotic surgical technology. Across many parameters in liver surgery, robotic liver resection appears to have comparable outcomes with respect to laparoscopic resection. The benefits over open resection are largely related to less morbidity and faster recovery times. There is evidence that the robotic approach may have a shorter learning curve and enable more difficult resections to be performed minimally invasively. The robotic platform may have the potential to achieve superior margin status or parenchymal sparing resection in oncologic resections, but numerous obstacles remain. The robotic platform has not been applied to liver surgery to the same extent as either laparoscopic or open surgery. Robotic surgical technology will need to continue developing to deliver on its potential advantages.
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Affiliation(s)
| | - James O Park
- Department of Surgery, University of Washington, Seattle, WA, USA
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14
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Motoyama D, Matsushita Y, Watanabe H, Tamura K, Otsuka A, Fujisawa M, Miyake H. Perioperative outcomes of robot-assisted partial nephrectomy using hinotori versus da Vinci surgical robot system: a propensity score-matched analysis. J Robot Surg 2023; 17:2435-2440. [PMID: 37462888 DOI: 10.1007/s11701-023-01614-x] [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: 03/26/2023] [Accepted: 05/13/2023] [Indexed: 09/10/2023]
Abstract
The purpose of this study was to evaluate perioperative outcomes of robot-assisted partial nephrectomy (RAPN) using hinotori, a recently developed robot-assisted surgical platform, by comparing them with those using da Vinci. This study included 303 and 40 consecutive patients who underwent RAPN using da Vinci and hinotori, respectively. To adjust potential baseline parameters between da Vinci and hinotori groups, 1:2 propensity score-matching was performed, and perioperative outcomes in these two groups were comprehensively evaluated. Propensity score-matched analysis generated two groups, consisting of 74 and 37 patients undergoing RAPN using da Vinci and hinotori, respectively, and no significant differences in major baseline parameters were noted between the two groups. RAPN could be completed without conversion to nephrectomy or open surgery in all patients. There were no significant differences in major perioperative outcomes between da Vinci and hinotori groups, including the operative time, time using the robotic system and warm ischemia time. No patient in either group was diagnosed with a positive surgical margin or experienced perioperative complications, corresponding to Clavien-Dindo 3 ≤ . There were no significant differences in the achievements of trifecta and margin, ischemia and complications outcomes between the two groups, and changes in the estimated glomerular filtration rate 1 and 28 days after RAPN were also similar between them. In conclusion, these findings showed that the hinotori platform could facilitate similar perioperative outcomes in patients undergoing RAPN in comparison with the existing robotic system, da Vinci.
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Affiliation(s)
- Daisuke Motoyama
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
- Department of Developed Studies for Advanced Robotic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Yuto Matsushita
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Hiromitsu Watanabe
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Keita Tamura
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Atsushi Otsuka
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, 431-3192, Japan.
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15
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Cacciatore L, Costantini M, Tedesco F, Prata F, Machiella F, Iannuzzi A, Ragusa A, Deanesi N, Qaddourah YR, Brassetti A, Anceschi U, Bove AM, Testa A, Simone G, Scarpa RM, Esperto F, Papalia R. Robotic Medtronic Hugo™ RAS System Is Now Reality: Introduction to a New Simulation Platform for Training Residents. SENSORS (BASEL, SWITZERLAND) 2023; 23:7348. [PMID: 37687810 PMCID: PMC10490585 DOI: 10.3390/s23177348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023]
Abstract
The use of robotic surgery (RS) in urology has grown exponentially in the last decade, but RS training has lagged behind. The launch of new robotic platforms has paved the way for the creation of innovative robotics training systems. The aim of our study is to test the new training system from Hugo™ RAS System-Medtronic. Between July 2020 and September 2022, a total of 44 residents from urology, gynaecology and general surgery at our institution participated in advanced robotic simulation training using the Hugo™ RAS simulator. Information about sex, age, year of residency, hours spent playing video games, laparoscopic or robotic exposure and interest in robotics (90.9% declared an interest in robotics) was collected. The training program involved three robotic exercises, and the residents performed these exercises under the guidance of a robotics tutor. The residents' performance was assessed based on five parameters: timing, range of motion, panoramic view, conflict of instruments and exercise completion. Their performance was evaluated according to an objective Hugo system form and a subjective assessment by the tutor. After completing the training, the residents completed a Likert scale questionnaire to gauge their overall satisfaction. The rate of the residents' improvement in almost all parameters of the three exercises between the first and the last attempts was statistically significant (p < 0.02), indicating significant progress in the residents' robotic surgical skills during the training. The mean overall satisfaction score ± standard deviation (SD) was 9.4 ± 1.2, signifying a high level of satisfaction among the residents with the training program. In conclusion, these findings suggest that the training program utilizing the Hugo™ RAS System is effective in enhancing robotic surgical skills among residents and holds promise for the development of standardized robotics training programs in various surgical specialties.
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Affiliation(s)
- Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Manuela Costantini
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Francesco Prata
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Fabio Machiella
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Andrea Iannuzzi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Alberto Ragusa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Noemi Deanesi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Yussef Rashed Qaddourah
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Aldo Brassetti
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Umberto Anceschi
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Alfredo M. Bove
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Antonio Testa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Giuseppe Simone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (L.C.); (F.T.)
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16
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Pai SN, Jeyaraman M, Jeyaraman N, Nallakumarasamy A, Yadav S. In the Hands of a Robot, From the Operating Room to the Courtroom: The Medicolegal Considerations of Robotic Surgery. Cureus 2023; 15:e43634. [PMID: 37719624 PMCID: PMC10504870 DOI: 10.7759/cureus.43634] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
Robotic surgery has rapidly evolved as a groundbreaking field in medicine, revolutionizing surgical practices across various specialties. Despite its numerous benefits, the adoption of robotic surgery faces significant medicolegal challenges. This article delves into the underexplored legal implications of robotic surgery and identifies three distinct medicolegal problems. First, the lack of standardized training and credentialing for robotic surgery poses potential risks to patient safety and surgeon competence. Second, informed consent processes require additional considerations to ensure patients are fully aware of the technology's capabilities and potential risks. Finally, the issue of legal liability becomes complex due to the involvement of multiple stakeholders in the functioning of robotic systems. The article highlights the need for comprehensive guidelines, regulations, and training programs to navigate the medicolegal aspects of robotic surgery effectively, thereby unlocking its full potential for the future..
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Affiliation(s)
- Satvik N Pai
- Orthopaedic Surgery, Hospital for Orthopedics, Sports Medicine, Arthritis, and Trauma (HOSMAT) Hospital, Bangalore, IND
| | - Madhan Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | - Naveen Jeyaraman
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | - Arulkumar Nallakumarasamy
- Orthopaedics, ACS Medical College and Hospital, Dr. MGR Educational and Research Institute, Chennai, IND
| | - Sankalp Yadav
- Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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17
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Pisla D, Crisan N, Gherman B, Andras I, Tucan P, Radu C, Pusca A, Vaida C, Al Hajjar N. Safety Issues in the Development of an Innovative Medical Parallel Robot Used in Renal Single-Incision Laparoscopic Surgery. J Clin Med 2023; 12:4617. [PMID: 37510731 PMCID: PMC10380956 DOI: 10.3390/jcm12144617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Robotic-assisted single-incision laparoscopic surgery (SILS) is becoming an increasingly widespread field worldwide due to the benefits it brings to both the patient and the surgeon. The goal of this study is to develop a secure robotic solution for SILS, focusing specifically on urology, by identifying and addressing various safety concerns from an early design stage. Starting with the medical tasks and protocols, the technical specifications of the robotic system as well as potential; hazards have been identified. By employing competitive engineering design methods such as Analytic Hierarchy Process (AHP), Risk assessment, and Failure Mode and Effects Analysis (FMEA), a safe design solution is proposed. A set of experiments is conducted to validate the proposed concept, and the results strongly support the development of the experimental model. The Finite Element Analysis (FEA) method is applied to validate the mechanical architecture within a set of simulations, demonstrating the compliance of the robotic system with the proposed technical specifications and its capability to safely perform SILS procedures.
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Affiliation(s)
- Doina Pisla
- Research Center for Industrial Robots Simulation and Testing-CESTER, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Nicolae Crisan
- Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdan Gherman
- Research Center for Industrial Robots Simulation and Testing-CESTER, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Iulia Andras
- Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Paul Tucan
- Research Center for Industrial Robots Simulation and Testing-CESTER, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Corina Radu
- Department of Internal Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Alexandru Pusca
- Research Center for Industrial Robots Simulation and Testing-CESTER, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Calin Vaida
- Research Center for Industrial Robots Simulation and Testing-CESTER, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
| | - Nadim Al Hajjar
- Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
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18
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Esperto F, Cacciatore L, Tedesco F, Brassetti A, Testa A, Raso G, Iannuzzi A, Papalia R, Scarpa RM. Video Consensus and Radical Prostatectomy: The Way to Chase the Future? J Pers Med 2023; 13:1013. [PMID: 37374002 DOI: 10.3390/jpm13061013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/16/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In the age of information, new platforms are consulted by patients to acquire consciousness about medical treatments. The aim of this study was to assess the level of understanding and feasibility of video consensus (VC) administration in patients scheduled for radical prostatectomy (RP), comparing it with standard informed consensus (SIC). According to the European Association of Urology Patient Information, we set up a video content for RP that was translated in Italian and implemented with information about possible perioperative and postoperative complications, days of hospitalization etc. From 2021 to 2022, all patients undergoing RP at our institution were prospectively included in this study. Patients received an SIC and after that, a VC about RP. After two consensuses were administered, patients received a preformed Likert 10 scale and STAI questionnaires. On the RP dataset, 276 patients were selected and 552 questionnaires for both SIC and VC were evaluated. Out of these, the median age was 62 years (IQR 60-65). Patients reported a higher overall satisfaction for VC (8.8/10) compared to the traditional informed consent (6.9/10). Therefore, VC may play a role in the future of surgery, improving the consciousness and satisfaction of patients and reducing preoperative anxiety.
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Affiliation(s)
- Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Aldo Brassetti
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, 00128 Rome, Italy
| | - Antonio Testa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Gianluigi Raso
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Andrea Iannuzzi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
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19
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Tsakos E, Xydias EM, Ziogas AC, Sorrentino F, Nappi L, Vlachos N, Daniilidis A. Multi-Port Robotic-Assisted Laparoscopic Myomectomy: A Systematic Review and Meta-Analysis of Comparative Clinical and Fertility Outcomes. J Clin Med 2023; 12:4134. [PMID: 37373827 DOI: 10.3390/jcm12124134] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Uterine fibroids are the most frequently diagnosed gynaecological tumours, and they often require surgical treatment (conventional laparoscopic myomectomy-CLM). The introduction and evolution of robotic-assisted laparoscopic myomectomy (RALM) in the early 2000s has expanded the range of minimally invasive options for the majority of cases. This study aims to compare RALM with CLM and abdominal myomectomy (AM). METHODS AND MATERIALS Fifty-three eligible studies adhered to the pre-established inclusion criteria and were subsequently evaluated for risk of bias and statistical heterogeneity. RESULTS The available comparative studies were compared using surgical outcomes, namely blood loss, complication rate, transfusion rate, operation duration, conversion to laparotomy, and length of hospitalisation. RALM was significantly superior to AM in all assessed parameters other than operation duration. RALM and CLM performed similarly in most parameters; however, RALM was associated with reduced intra-operative bleeding in patients with small fibroids and had lower rates of conversion to laparotomy, proving RALM as a safer overall approach. CONCLUSION The robotic approach for surgical treatment of uterine fibroids is a safe, effective, and viable approach, which is constantly being improved and may soon acquire widespread adoption and prove to be superior to CLM in certain patient subgroups.
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Affiliation(s)
| | - Emmanouil M Xydias
- EmbryoClinic IVF, 55133 Thessaloniki, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Apostolos C Ziogas
- Faculty of Medicine, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, 71121 Foggia, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynaecology, University of Foggia, 71121 Foggia, Italy
| | - Nikolaos Vlachos
- 2nd Department of Obstetrics and Gynaecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Angelos Daniilidis
- 1st University Department of Obstetrics and Gynecology, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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20
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Abstract
Objective: The da Vinci single-port (SP) platform represents the latest innovation in minimally invasive urologic surgery, and the adoption of this technology by urologists is increasing. In this article, we briefly describe the evolution of minimally invasive and single-site surgery, and offer a comprehensive review of the current literature on the SP platform. Materials and Methods: For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until August 15, 2022. The published literature to date within SP robotic surgery in urology will be discussed. Evidence Synthesis: There are relatively few high-quality studies on the SP system, but there are multiple case series describing unique indications and surgical approaches with the SP robot, demonstrating safety and feasibility in the hands of experienced robotic surgeons. There also are an increasing number of prospective, larger cohort studies comparing outcomes between SP and multiport (MP) approaches that show benefits of the SP system regarding improved cosmesis, postoperative pain control, and decreased length of stay. Conclusions: Multiple prospective studies have shown benefits regarding cost and pain control for SP platform procedures compared to the traditional MP robotic approach. While its high cost and learning curve represent barriers to adoption, the SP platform represents a critical development in minimally invasive surgery. As this technology is further implemented at more institutions, long-term, high-quality data should accrue that will demonstrate its true value.
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Affiliation(s)
- Tuan Thanh Nguyen
- Department of Urology, University of California Irvine, Orange, California, USA
- University of Medicine and Pharmacy at Ho Chi Minh City, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Jacob Basilius
- Department of Urology, University of California Irvine, Orange, California, USA
| | - Sohrab Naushad Ali
- Department of Urology, University of California Irvine, Orange, California, USA
| | - Ryan W Dobbs
- Department of Urology, Cook County Health & Hospitals System, Chicago, Illinois, USA
| | - David I Lee
- Department of Urology, University of California Irvine, Orange, California, USA
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21
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Esperto F, Cacciatore L, Tedesco F, Testa A, Callè P, Ragusa A, Deanesi N, Minore A, Prata F, Brassetti A, Papalia R, Scarpa RM. Impact of Robotic Technologies on Prostate Cancer Patients' Choice for Radical Treatment. J Pers Med 2023; 13:jpm13050794. [PMID: 37240964 DOI: 10.3390/jpm13050794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Prostate cancer (PCa) surgery has a strong impact on men's social and sexual lives. For this reason, many patients ask for robotic surgery. To assess the rate of lost patients due to the lack of a robotic platform (RPl) at our center, we retrospectively selected 577 patients who underwent prostate biopsy between 2020 and 2021 who were eligible for radical prostatectomy (RP) (ISUP ≥ 2; age ≤ 70 yr). Patients eligible for surgery who decided to be operated received a phone call interview asking the reason for their choice. Overall, 230 patients (31.7%) underwent laparoscopic-assisted radical prostatectomy (LaRP) at our center, while 494 patients (68.3%) were not treated in our hospital. Finally, 347 patients were included: 87 patients (25.1%) underwent radiotherapy; 59 patients (17%) were already under another urologist's care; 113 patients (32.5%) underwent robotic surgery elsewhere; and 88 patients (25.4%) followed the suggestion of friends or relatives based on their surgical experience. Despite no surgical technique for RP having shown superiority in terms of oncological or functional outcomes, patients eligible for PCa treatment decided to be operated on elsewhere because of the lack of an RPl. Our results show how the presence of an RPl may increase the case volume of RP by 49% at our center.
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Affiliation(s)
- Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Antonio Testa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Pasquale Callè
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Alberto Ragusa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Noemi Deanesi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Antonio Minore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesco Prata
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Aldo Brassetti
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, 00128 Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
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22
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Artificial Intelligence in Surgical Learning. SURGERIES 2023. [DOI: 10.3390/surgeries4010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
(1) Background: Artificial Intelligence (AI) is transforming healthcare on all levels. While AI shows immense potential, the clinical implementation is lagging. We present a concise review of AI in surgical learning; (2) Methods: A non-systematic review of AI in surgical learning of the literature in English is provided; (3) Results: AI shows utility for all components of surgical competence within surgical learning. AI presents with great potential within robotic surgery specifically (4) Conclusions: Technology will evolve in ways currently unimaginable, presenting us with novel applications of AI and derivatives thereof. Surgeons must be open to new modes of learning to be able to implement all evidence-based applications of AI in the future. Systematic analyses of AI in surgical learning are needed.
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23
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Peteinaris A, Kallidonis P, Tsaturyan A, Pagonis K, Faitatziadis S, Gkeka K, Vagionis A, Natsos A, Obaidat M, Anaplioti E, Tatanis V, Vrettos T, Liatsikos E. The feasibility of robot-assisted radical cystectomy: an experimental study. World J Urol 2023; 41:477-482. [PMID: 36577927 DOI: 10.1007/s00345-022-04266-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/04/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To investigate the feasibility of the avatera system for performing robot-assisted radical cystectomy (RARC) followed by intracorporeal reconstruction of ileal neobladder. METHODS Six anesthetized female pigs were used to perform RARC and formation of the intracorporeal orthotopic ileal neobladder. Three surgeons with different level of expertise in the use of robotic systems performed RARC after a short instructional lecture and a 2-h hands-on training. The urinary diversion phase was performed only by the experienced surgeon. The successful completion of the procedure, operative time for demolitive and reconstructive phases, intraoperative blood loss and malfunction of the robotic system were evaluated. RESULTS An improvement of the operative time was observed for each surgeon. The experienced surgeon, the fellow and the resident improved their time by 11, 15, and 22 min, respectively, between the first and the second RARC performed. The most significant time difference was demonstrated by the resident, who had no previous experience in using robotic systems. The time difference between the first and the last orthotopic ileal neobladder creation for the experienced surgeon was 51 min. CONCLUSION The feasibility of avatera system for performing complex surgical procedure such as RARC with intracorporeal neobladder formation was demonstrated by this experimental study. No major bleeding or severe malfunctions were observed during the procedures. Significant improvement in operative time was demonstrated with the increasing experience from 1st to 6th case.
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Affiliation(s)
- Angelis Peteinaris
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Panagiotis Kallidonis
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Arman Tsaturyan
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Konstantinos Pagonis
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Solon Faitatziadis
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Kristiana Gkeka
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Athanasios Vagionis
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Anastasios Natsos
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Mohammed Obaidat
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Eirini Anaplioti
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Vasileios Tatanis
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece
| | - Theofanis Vrettos
- Department of Anesthesiology and ICU, University Hospital of Patras, Patras, Greece
| | - Evangelos Liatsikos
- Department of Urology, University Hospital of Patras, University of Patras Medical School, Rio, 26500, Patras, Greece. .,Department of Urology, Medical University of Vienna, Vienna, Austria.
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24
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Shen LT, Tou J. Application and prospects of robotic surgery in children: a scoping review. WORLD JOURNAL OF PEDIATRIC SURGERY 2022; 5:e000482. [PMID: 36474741 PMCID: PMC9717356 DOI: 10.1136/wjps-2022-000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/28/2022] [Indexed: 01/25/2023] Open
Abstract
As an innovative minimally invasive surgical technology, robot-assisted surgery (RAS) has greatly improved the accuracy and safety of surgery through the advantages of three-dimensional magnification, tremor filtering, precision and flexibility, and has been carried out by an increasing number of surgeries. In recent years, robots have been gradually applied to children, bringing new ideas and challenges to pediatric surgeons. This review will describe the advantages and limitations of robotic surgery in children, summarize its application in pediatric surgery, and provide an outlook. It is believed that clinicians should actively carry out RAS under the premise of rigorously ensuring surgical indications and strive to improve the efficacy of surgical treatment for children.
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Affiliation(s)
- Lei Ting Shen
- Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinfa Tou
- Neonatal Surgery, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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25
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Bramhe S, Pathak SS. Robotic Surgery: A Narrative Review. Cureus 2022; 14:e29179. [PMID: 36258968 PMCID: PMC9573327 DOI: 10.7759/cureus.29179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
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26
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Cepolina F, Razzoli RP. An introductory review of robotically assisted surgical systems. Int J Med Robot 2022; 18:e2409. [PMID: 35476899 PMCID: PMC9540802 DOI: 10.1002/rcs.2409] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 12/28/2022]
Abstract
Purpose The scope of the work is to present the state of the art of robotically assisted surgical systems and to give a general idea about how technology can help today and tomorrow robotic surgery. The road to innovation passes through research and on field trials; for this reason, not only commercial surgery robots, but also innovative prototype robots, proposed by the Academic world, are presented. Design/methodology/approach Following a short introduction, robotically assisted surgery systems are introduced discussing their architectures and main peculiarities. A further section is dedicated to the key enabling technologies that will make possible to improve current systems and that will lead to a new generation of surgical robotic systems able to meet the patient's needs and facilitate the surgeon's task. Finally, brief concluding comments are given. Findings The idea of using robots for surgery was born many years ago and in a short time a market demand was created. Today the market is very dynamic, and several new products are updated and created for the execution of both traditional and new procedures. The article provides a guide for the reader who has an interest in this area. Originality/value This paper provides an insight into the commercial robotic surgical systems and a look on research prototypes from academic and industrial worlds.
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Affiliation(s)
- Francesco Cepolina
- Department of Mechanical Engineering, Energy, Production, Transport and Mathematical Models (DIME) University of Genoa Genova Italy
| | - Roberto P. Razzoli
- Department of Mechanical Engineering, Energy, Production, Transport and Mathematical Models (DIME) University of Genoa Genova Italy
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27
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Teoh AYB. Will robots take over our jobs as endoscopists? Gastrointest Endosc 2022; 96:148-149. [PMID: 35545471 DOI: 10.1016/j.gie.2022.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Anthony Yuen Bun Teoh
- Department of Surgery, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR
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28
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Feasibility and optimal setting of robot-assisted partial nephrectomy with the novel “hugo” robotic system: a pre-clinical study. UROLOGY VIDEO JOURNAL 2022. [DOI: 10.1016/j.urolvj.2022.100164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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