1
|
Abokhozima A, Zidan MH, Abo Elmagd A, Alokl M, Altabbaa H, Al Sayed M, Selim A. Lymphatic Chyle Duct Injury and Identification During Laparoscopic Sleeve Gastrectomy Preventing Postoperative Chylous Ascites. Obes Surg 2024; 34:1995-2000. [PMID: 38589758 PMCID: PMC11031454 DOI: 10.1007/s11695-024-07215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/10/2024]
Abstract
We present a case of intraoperative detection of an iatrogenic chyle duct injury during laparoscopic sleeve gastrectomy. The chyle duct injury was identified and managed by ligature, preventing postoperative chylous ascites.
Collapse
Affiliation(s)
- Ahmed Abokhozima
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
- Ekbal Hospital, 10 Hassan Amin Street, Alexandria, Egypt
| | - Mohamed H Zidan
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt.
- Alexandria Main University Hospital, Al Mothaf, Al Mesallah Sharq, Al Attarin, Alexandria, 5372066, Egypt.
- Ekbal Hospital, 10 Hassan Amin Street, Alexandria, Egypt.
| | - Ahmed Abo Elmagd
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
- Alexandria Main University Hospital, Al Mothaf, Al Mesallah Sharq, Al Attarin, Alexandria, 5372066, Egypt
- Ekbal Hospital, 10 Hassan Amin Street, Alexandria, Egypt
| | - Mohammed Alokl
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
- Ekbal Hospital, 10 Hassan Amin Street, Alexandria, Egypt
| | - Hashem Altabbaa
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
| | - Mohamed Al Sayed
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
- Alexandria Main University Hospital, Al Mothaf, Al Mesallah Sharq, Al Attarin, Alexandria, 5372066, Egypt
| | - Aliaa Selim
- Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Alexandria, Egypt
- Ekbal Hospital, 10 Hassan Amin Street, Alexandria, Egypt
| |
Collapse
|
2
|
Loverro M, Bizzarri N, Capomacchia FM, Watrowski R, Querleu D, Gioè A, Naldini A, Santullo F, Foschi N, Fagotti A, Scambia G, Fanfani F. Indocyanine green fluorescence applied to gynecologic oncology: beyond sentinel lymph node. Int J Surg 2024; 110:01279778-990000000-01185. [PMID: 38489558 PMCID: PMC11175818 DOI: 10.1097/js9.0000000000001318] [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: 09/16/2023] [Accepted: 02/26/2024] [Indexed: 03/17/2024]
Abstract
Indocyanine green (ICG), a well-known molecule employed in medicine for over five decades, has emerged as a versatile dye widely embraced across various surgical disciplines. In gynecologic oncology, its prevalent use revolves around the detection of sentinel lymph nodes. However, the true potential of ICG extends beyond this singular application, owing to its pragmatic utility, cost-effectiveness, and safety profile. Furthermore, ICG has been introduced in the theranostic landscape, marking a significant juncture in the evolution of its clinical utility. This narrative review aims to describe the expanding horizons of ICG fluorescence in gynecologic oncology, beyond the sentinel lymph node biopsy. The manifold applications reported within this manuscript include: 1) lymphography; 2) angiography; 3) nerve visualization; 4) ICG-driven resections; and 5) theranostic. The extensive exploration across these numerous applications, some of which are still in the pre-clinical phase, serves as a hypothesis generator, aiming to stimulate the development of clinical studies capable of expanding the use of this drug in our field, enhancing the care of gynecological cancer patients.
Collapse
Affiliation(s)
- Matteo Loverro
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
| | - Nicolò Bizzarri
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
| | | | - Rafał Watrowski
- Department of Gynecology and Obsterics, Helios Hospital Müllheim, Teaching Hospital of the University of Freiburg, 79379 Müllheim
- Faculty of Medicine, Medical Center - University of Freiburg, 79106 Freiburg, Germany
| | - Denis Querleu
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
| | - Alessandro Gioè
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
| | - Angelica Naldini
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
| | - Francesco Santullo
- Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli
| | - Nazario Foschi
- Urology Division, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Anna Fagotti
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
- Università Cattolica del Sacro Cuore
| | - Giovanni Scambia
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
- Università Cattolica del Sacro Cuore
| | - Francesco Fanfani
- UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS
- Università Cattolica del Sacro Cuore
| |
Collapse
|
3
|
Mokhtari L, Hosseinzadeh F, Nourazarian A. Biochemical implications of robotic surgery: a new frontier in the operating room. J Robot Surg 2024; 18:91. [PMID: 38401027 DOI: 10.1007/s11701-024-01861-6] [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: 11/23/2023] [Accepted: 02/01/2024] [Indexed: 02/26/2024]
Abstract
Robotic surgery represents a milestone in surgical procedures, offering advantages such as less invasive methods, elimination of tremors, scaled motion, and 3D visualization. This in-depth analysis explores the complex biochemical effects of robotic methods. The use of pneumoperitoneum and steep Trendelenburg positioning can decrease pulmonary compliance and splanchnic perfusion while increasing hypercarbia. However, robotic surgery reduces surgical stress and inflammation by minimizing tissue trauma. This contributes to faster recovery but may limit immune function. Robotic procedures also limit ischemia-reperfusion injury and oxidative damage compared to open surgery. They also help preserve native antioxidant defenses and coagulation. In a clinical setting, robotic procedures reduce blood loss, pain, complications, and length of stay compared to traditional procedures. However, risks remain, including device failure, the need for conversion to open surgery and increased costs. On the oncology side, there is still debate about margins, recurrence, and long-term survival. The advent of advanced technologies, such as intraoperative biosensors, localized drug delivery systems, and the incorporation of artificial intelligence, may further improve the efficiency of robotic surgery. However, ethical dilemmas regarding patient consent, privacy, access, and regulation of this disruptive innovation need to be addressed. Overall, this review sheds light on the complex biochemical implications of robotic surgery and highlights areas that require additional mechanistic investigation. It presents a comprehensive approach to responsibly maximize the potential of robotic surgery to improve patient outcomes, integrating technical skill with careful consideration of physiological and ethical issues.
Collapse
Affiliation(s)
- Leila Mokhtari
- Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | | | - Alireza Nourazarian
- Department of Basic Medical Sciences, Khoy University of Medical Sciences, Khoy, Iran.
| |
Collapse
|
4
|
Fenn MG, Koliyadan SV, Machado L, Sheik S, Riyami NA. Protracted Chemical Peritonitis Following Laparoscopy for Dermoid Cyst: A management dilemma. Sultan Qaboos Univ Med J 2024; 24:123-126. [PMID: 38434467 PMCID: PMC10906760 DOI: 10.18295/squmj.3.2023.019] [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: 11/16/2022] [Revised: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 03/31/2023] Open
Abstract
Dermoid cysts are common benign ovarian tumours arising from totipotent germ cells. We report a rare case of chemical peritonitis and prolonged fever following laparoscopic salpingo-oophorectomy for torsion of a large ovarian dermoid and discuss the management of this patient with prolonged hospital stay, antibiotics and anti-inflammatory use, repeated drainage of the collection as well as re-laparotomy. The occurrence of this rare condition can be extremely distressing for the patient and treating surgeon alike, as the recommendations for management are limited. The management of chemical peritonitis may require one or more surgical procedures along with prolonged anti-inflammatory therapy.
Collapse
Affiliation(s)
- Miriam G. Fenn
- Department of Obstetrics & Gynecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Sreedharan V. Koliyadan
- Department of Surgery, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Lovina Machado
- Department of Obstetrics & Gynecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Shahila Sheik
- Department of Surgery, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | - Nihal Al Riyami
- Department of Obstetrics & Gynecology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
5
|
Abi Antoun M, Etrusco A, Chiantera V, Laganà AS, Feghali E, Khazzaka A, Stabile G, Della Corte L, Dellino M, Sleiman Z. Outcomes of conventional and advanced energy devices in laparoscopic surgery: a systematic review. MINIM INVASIV THER 2024; 33:1-12. [PMID: 38164811 DOI: 10.1080/13645706.2023.2274396] [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: 04/21/2023] [Accepted: 10/04/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Hemostasis is an important step in all surgical procedures. Mechanical methods of hemostasis have been gradually abandoned in favor of electrosurgery. The aim of this systematic review was to evaluate the effectiveness of electrosurgical instruments utilized in minimally invasive gynecological procedures. MATERIAL AND METHODS We performed a systematic review, including randomized controlled trials, prospective and retrospective studies, comparing the outcomes of different energy devices (EDs) used in laparoscopic gynecologic surgeries. We extracted data about blood loss (BL), mean operative time, post-operative pain, hospital stay and complications associated with each electrosurgical device. RESULTS We included 30 studies reporting comparative outcomes concerning conventional (bipolar and monopolar) and innovative EDs (Harmonic scalpel, LigaSure, Plasma kinetic gyrus, Thunderbeat, EnSeal, Marseal, Caiman and ALAN). New EDs were found to be more efficient in complex surgeries due to less intraoperative BL and shorter operative time. No significant decrease in hospital stay, post-operative pain or complications was found with the use of new energy instruments. CONCLUSIONS Although new electrosurgical devices seem an appealing and safer option, there is still insufficient evidence for one vessel-sealing technology to be considered superior to another. Therefore, monopolar and conventional bipolar (CB) are still widely used in laparoscopic gynecology.
Collapse
Affiliation(s)
- Melissa Abi Antoun
- Obstetrics and gynecology department, Saint Joseph University, Beirut, Lebanon
| | - Andrea Etrusco
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute - IRCCS - Fondazione "G. Pascale", Naples, Italy
| | - Antonio Simone Laganà
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Edwin Feghali
- Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| | - Aline Khazzaka
- Surgical Research Lab, Saint Joseph University, Beirut, Lebanon
| | - Guglielmo Stabile
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Zaki Sleiman
- Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
| |
Collapse
|
6
|
Capozzi VA, De Finis A, Scarpelli E, Gallinelli A, Monfardini L, Cianci S, Gulino FA, Rotondella I, Celora GM, Martignon G, Ghi T, Berretta R. Infectious Complications in Laparoscopic Gynecologic Oncology Surgery within an ERAS-Compliant Setting. J Pers Med 2024; 14:147. [PMID: 38392581 PMCID: PMC10890568 DOI: 10.3390/jpm14020147] [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: 12/30/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Minimally Invasive Surgery (MIS) represents a safe and feasible option for the surgical treatment of gynecologic malignancies, offering benefits, including reduced blood loss, lower complications, and faster recovery, without compromising oncological outcomes in selected patients. MIS is widely accepted in early-stage gynecologic malignancies, including endometrial cancer, cervical tumors measuring 2 cm or less, and early-stage ovarian cancer, considering the risk of surgical spillage. Despite its advantages, MIS does not rule out the possibility of adverse events such as postoperative infections. This retrospective study on 260 patients undergoing laparoscopic surgery at Parma University Hospital for gynecologic malignancies explores the incidence and risk factors of postoperative infectious complications. The Clavien-Dindo classification was used to rank postoperative surgical complications occurring 30 days after surgery and Enhanced Recovery After Surgery (ERAS) recommendations put into practice. In our population, 15 (5.8%) patients developed infectious complications, predominantly urinary tract infections (9, 3.5%). Longer surgical procedures were independently associated with higher postoperative infection risk (p = 0.045). Furthermore, C1 radical hysterectomy correlated significantly with infectious complications (p = 0.001, OR 3.977, 95% CI 1.370-11.544). In conclusion, compared to prior research, our study reported a lower rate of infectious complications occurrence and highlights the importance of adopting infection prevention measures.
Collapse
Affiliation(s)
- Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Alessandra De Finis
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Elisa Scarpelli
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Asya Gallinelli
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Luciano Monfardini
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Stefano Cianci
- Unit of Gynecology and Obstetric, Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, 98125 Messina, Italy
| | - Ferdinando Antonio Gulino
- Unit of Gynecology and Obstetrics, Department of Human Pathology of Adults and Developmental Age, University Hospital "G. Martino", 98100 Messina, Italy
| | - Isabella Rotondella
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | | | - Giulia Martignon
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Tullio Ghi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Roberto Berretta
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| |
Collapse
|
7
|
Jain Y, Lanjewar R, Shinde RK. Revolutionising Breast Surgery: A Comprehensive Review of Robotic Innovations in Breast Surgery and Reconstruction. Cureus 2024; 16:e52695. [PMID: 38384645 PMCID: PMC10879655 DOI: 10.7759/cureus.52695] [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: 10/13/2023] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
Robotic innovations in breast surgery have ushered in a new era of precision, safety, and patient-centred care. This comprehensive review explores the multifaceted realm of robotic breast surgery, from preoperative planning to postoperative outcomes, learning curves for surgeons, and the implications for healthcare policies. We examine the ethical considerations, cost-effectiveness, and future directions, including integrating artificial intelligence and telesurgery. Key findings reveal that robotic systems provide improved surgical precision, reduced complications, and enhanced patient satisfaction. Ethical concerns encompass informed consent, resource allocation, and equitable access. The future of breast surgery lies in continued research and development, ensuring that robotics becomes a standard of care accessible to all patients. This technology is reshaping breast surgery and offering new possibilities for minimally invasive, patient-centred care, ultimately redefining the standards of care in this critical field of medicine.
Collapse
Affiliation(s)
- Yashraj Jain
- Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjana Lanjewar
- Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Raju K Shinde
- Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
8
|
Patel N, Chaudhari K, Jyotsna G, Joshi JS. Surgical Frontiers: A Comparative Review of Robotics Versus Laparoscopy in Gynecological Interventions. Cureus 2023; 15:e49752. [PMID: 38161931 PMCID: PMC10757673 DOI: 10.7759/cureus.49752] [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] [Received: 11/14/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
This review comprehensively examines the current state and future directions of gynecological surgery, focusing on the comparative analysis of laparoscopy and robotic surgery. The overview highlights the evolution of these surgical techniques, emphasizing their impact on patient outcomes, procedural efficiency, and safety profiles. The analysis encompasses critical factors such as cost-effectiveness, learning curves, and implications for postoperative recovery. The future of gynecological surgery is envisioned through emerging technologies, including augmented reality, single-incision laparoscopy, and artificial intelligence. The coexistence of laparoscopy and robotics is explored, acknowledging their respective strengths and roles in shaping women's healthcare. In conclusion, the dynamic nature of the field is underscored, emphasizing the need for a patient-centered and adaptable approach. Collaboration between healthcare professionals, engineers, and researchers is pivotal in unlocking these innovations' full potential, ensuring continued advancements in gynecological surgery for improved outcomes and enhanced patient care.
Collapse
Affiliation(s)
- Nainita Patel
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kamlesh Chaudhari
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Garapati Jyotsna
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jalormy S Joshi
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
9
|
Park J, Bak S, Song JY, Chung YJ, Yuki G, Lee SJ, Mun J, Kim MR. Robotic surgery in Gynecology: the present and the future. Obstet Gynecol Sci 2023; 66:518-528. [PMID: 37465847 PMCID: PMC10663391 DOI: 10.5468/ogs.23132] [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: 05/02/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
Since its introduction, laparoscopic surgery has been often preferred over open surgery in obstetrics and gynecology due to its advantages, such as less bleeding, lower incidence of adhesions, reduced postoperative pain, short hospital stay, and quick return to daily life. However, in the case of complex surgeries, laparoscopy presented some limitations. Nonetheless, since the 1980s, medical robots have been introduced to overcome the technical limitations of laparoscopy and start a new age for minimally invasive surgery. In this review, we explore the indications and advantages and disadvantages of robotic surgery in the field of gynecology, and try to assess the recent trend of robotic surgery.
Collapse
Affiliation(s)
- JungYoon Park
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - SeongEun Bak
- Department of Obstetrics and Gynecology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jae-Yen Song
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Youn-Jee Chung
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Gen Yuki
- Department of Obstetrics and Gynecology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Su Jeong Lee
- Department of Obstetrics and Gynecology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jisu Mun
- Department of Obstetrics and Gynecology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Mee-Ran Kim
- Department of Obstetrics and Gynecology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| |
Collapse
|
10
|
Watrowski R, Kostov S, Sparić R. Editorial: Changing backgrounds and groundbreaking changes: Gynecological surgery in the third decade of the 21st century. Front Surg 2022; 9:1060503. [DOI: 10.3389/fsurg.2022.1060503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
|
11
|
Naujokat H, Spille J, Bergholz R, Wieker H, Weitkamp J, Wiltfang J. Robot‐assisted scaffold implantation and two‐stage flap raising of the greater omentum for reconstruction of the facial skeleton: Description of a novel technique. Int J Med Robot 2022; 18:e2429. [DOI: 10.1002/rcs.2429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/02/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Johannes Spille
- Department of Oral and Maxillofacial Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Robert Bergholz
- Department of General Visceral Thoracic, Transplant and Pediatric Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Henning Wieker
- Department of Oral and Maxillofacial Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Jan‐Tobias Weitkamp
- Department of Oral and Maxillofacial Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery University Hospital of Schleswig‐Holstein Campus Kiel Kiel Germany
| |
Collapse
|
12
|
Assessment of the Versius Robotic Surgical System in Minimal Access Surgery: A Systematic Review. J Clin Med 2022; 11:jcm11133754. [PMID: 35807035 PMCID: PMC9267445 DOI: 10.3390/jcm11133754] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Despite the superiority of minimal access surgery (MAS) over open surgery, MAS is difficult to perform and has a demanding learning curve. Robot-assisted surgery is an advanced form of MAS. The Versius® surgical robot system was developed with the aim of overcoming some of the challenges associated with existing surgical robots. The present study was designed to investigate the feasibility, clinical safety, and effectiveness of the Versius system in MAS. Materials and Methods: A comprehensive search was carried out in the Medline, Web of Science Core Collection (Indexes = SCI-EXPANDED, SSCI, A & HCI Timespan), and Scopus databases for articles published until February 2022. The keywords used were Versius robot, visceral, colorectal, gynecology, and urologic surgeries. Articles on the use of the Versius robot in minimal access surgery (MAS) were included in the review. Results: Seventeen articles were reviewed for the study. The investigation comprised a total of 328 patients who had been operated on with this robot system, of which 48.3%, 14.2%, and 37.5% underwent colorectal, visceral, and gynecological procedures, respectively. Postoperative and major complications within 30 days varied from 7.4% to 39%. No major complications and no readmissions or reoperations were reported in visceral and gynecological surgeries. Readmission and reoperation rates in colorectal surgeries were 0–9%. Some procedures required conversion to conventional laparoscopic surgery (CLS) or open surgery, and all procedures were completed successfully. Based on the studies reviewed in the present report, we conclude that the Versius robot can be used safely and effectively in MAS. Conclusions: A review of the published literature revealed that the Versius system is safe and effective in minimal access surgery. However, the data should be viewed with caution until randomized controlled trials (RCTs) have been performed. Studies on the use of this robotic system in oncological surgery must include survival as one of the addressed outcomes.
Collapse
|
13
|
Vitale SG, Watrowski R, Barra F, D’Alterio MN, Carugno J, Sathyapalan T, Kahramanoglu I, Reyes-Muñoz E, Lin LT, Urman B, Ferrero S, Angioni S. Abnormal Uterine Bleeding in Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality. Diagnostics (Basel) 2022; 12:diagnostics12051176. [PMID: 35626331 PMCID: PMC9140476 DOI: 10.3390/diagnostics12051176] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Abnormal uterine bleeding (AUB) is a frequent symptom in perimenopausal women. It is defined as uterine bleeding in which the duration, frequency, or amount of bleeding is considered excessive and negatively affects the woman’s quality of life (QoL) and psychological well-being. In cases of structural uterine pathology, hysterectomy (usually performed via a minimally invasive approach) offers definitive symptom relief and is associated with long-lasting improvement of QoL and sexuality. However, over the past 30 years, uterus-preserving treatments have been introduced as alternatives to hysterectomy. Hysteroscopic polypectomy, myomectomy, or endometrial resection/endometrial ablation are minimally invasive techniques that can be used as an alternative to hysterectomy to treat AUB due to benign conditions. Although associated with high patient satisfaction and short-term improvement in their QoL, hysteroscopic treatments do not eliminate the risk of AUB recurrence or the need for further intervention. Therefore, considering the impact of different treatment options on QoL and sexuality during preoperative shared decision making could help identify the most appropriate and personalized treatment options for perimenopausal women suffering from AUB.
Collapse
Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy
- Correspondence: (S.G.V.); (R.W.)
| | - Rafał Watrowski
- Faculty of Medicine (Associate), University of Freiburg, 79106 Freiburg, Germany
- Correspondence: (S.G.V.); (R.W.)
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, University of Genova, 16132 Genoa, Italy; (F.B.); (S.F.)
| | - Maurizio Nicola D’Alterio
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (M.N.D.); (S.A.)
| | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Sciences Department, University of Miami, Miami, FL 33146, USA;
| | - Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Kingston upon Hull HU6 7RX, UK;
| | - Ilker Kahramanoglu
- Department of Gynecologic Oncology, Emsey Hospital, 34912 Istanbul, Turkey;
| | - Enrique Reyes-Muñoz
- Department of Gynecological and Perinatal Endocrinology, Instituto Nacional de Perinatología, Mexico City 11000, Mexico;
| | - Li-Te Lin
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung City 81362, Taiwan;
- Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei 11265, Taiwan
- Department of Biological Science, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung City 80424, Taiwan
| | - Bulent Urman
- Centre for Reproductive Endocrinology and Infertility, American Hospital, 34365 Istanbul, Turkey;
- Department of Obstetrics and Gynecology, Reproductive Endocrinology, Infertility Centre Istanbul, Koc University, 34450 Istanbul, Turkey
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, University of Genova, 16132 Genoa, Italy; (F.B.); (S.F.)
| | - Stefano Angioni
- Division of Gynecology and Obstetrics, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (M.N.D.); (S.A.)
| |
Collapse
|