The term “robot” was concepted in the beginning of last century, coming originally from the Czech word “robota”, meaning “labor”. More recently, computer assistance and robotics based in the telepresence and virtual reality concept have been applied to surgical procedures. The application of robots in surgery dates approximately 35 years, experiencing significant growth in the last two decades fueled by the advent of advanced technologies. Despite its recent and brief status in surgery history, robotic technology has already proven its enhanced visualization, superior dexterity and precision during minimally invasive procedures. Currently, the worldwide diffused and predominant robot system used in surgery is Da Vinci by Intuitive Surgical, however robotic surgery evolution is far from over, with multiple potential competitors on the horizon pushing forward its paradigms. We aim to describe the history and evolution of robotic surgery in the last years as well as present its future perspectives.
Background:Diastasis of the rectus abdominis muscles (DMRA) is frequent and may be
associated with abdominal wall hernias. For patients with redudant skin,
dermolipectomy and plication of the diastasis is the most commonly used
procedure. However, there is a significant group of patients who do not
require skin resection or do not want large incisions. Aim:To describe a “new” technique (subcutaneous onlay laparoscopic approach -
SCOLA) for the correction of ventral hernias combined with the DMRA
plication and to report the initial results of a case series. Method:SCOLA was applied in 48 patients to correct ventral hernia concomitant to
plication of DMRA by pre-aponeurotic endoscopic technique. Results:The mean operative time was 93.5 min. There were no intra-operative
complications and no conversion. Seroma was the most frequent complication
(n=13, 27%). Only one (2%) had surgical wound infection. After a median
follow-up of eight months (2-19), only one (2%) patient presented recurrence
of DMRA and one (2%) subcutaneous tissue retraction/fibrosis. Forty-five
(93.7%) patients reported being satisfied with outcome. Conclusion:The SCOLA technique is a safe, reproducible and effective alternative for
patients with abdominal wall hernia associated with DMRA.
RESUMO A infecção pelo coronavírus determinante da doença COVID-19, também conhecida como SARS-COV2 foi classificada nos últimos meses como pandemia. Essa é potencialmente fatal, representando enorme problema de saúde mundial. A disseminação, após provável origem zoonótica na cidade de Wuhan, China, resultou em colapso do sistema de saúde de diversos países, alguns com enorme impacto social e número grande de mortes descritas na Itália e Espanha. Medidas extremas intra e extra-hospitalares têm sido implementadas a fim de conter a transmissão e disseminação da COVID-19. No âmbito cirúrgico, enorme quantidade de procedimentos considerados não essenciais ou eletivos foram prorrogados ou suspensos até resolução da pandemia. No entanto, cirurgias de urgência e oncológicas não permitem que o paciente espere. Nesta publicação, sugerimos e ensinamos adaptação a ser feita com materiais de uso corriqueiro em laparoscopias para evitar a contaminação ou a disseminação entre as equipes assistenciais e os pacientes.
RESUMO As hérnias inguinais são um problema frequente e o seu reparo representa a cirurgia mais comumente realizada por cirurgiões gerais. Nos últimos anos, novos princípios, produtos e técnicas têm mudado a rotina dos cirurgiões que precisam reciclar conhecimentos e aperfeiçoar novas habilidades. Além disso, antigos conceitos sobre indicação cirúrgica e riscos de complicações vêm sendo reavaliados. Visando criar um guia de orientações sobre o manejo das hérnias inguinais em pacientes adultos, a Sociedade Brasileira de Hérnias reuniu um grupo de experts com objetivo de revisar diversos tópicos, como indicação cirúrgica, manejo perioperatório, técnicas cirúrgicas, complicações e orientações pós-operatórias.
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