A meta-analysis of robotic versus laparoscopic colectomy

Chang, Yu Fan; Wang, Jiaxiang; Chang, Dehua

doi:10.1016/j.jss.2015.01.026

Cited by 43 publications

(49 citation statements)

References 49 publications

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“…Robotic systems offer the advantages of: (i) a stable camera platform that is directly controlled by the surgeon; (ii) 3D stereoscopic vision with 10× magnification; and (iii) instruments with 7 degrees of movement, assisted by tremor‐filtering and motion‐scaling . These features potentially translate to better surgical outcomes in terms of preservation of neurological function, earlier return of bowel function, greater rates of negative resection margin, reduced fatigue of the surgeon, and lower conversion rates …”

Section: Discussionmentioning

confidence: 99%

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Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Ngu

Sim

Yusof

et al. 2016

Robotics Computer Surgery

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Section: Discussionmentioning

confidence: 99%

“…in 2002 . Since then, various authors have attempted to expound on the advantages of robotic surgery . Unfortunately, these benefits have to date been limited by issues such as prolonged docking time, operative duration, technical difficulties in multi‐quadrant access, and cost.…”

Section: Introductionmentioning

confidence: 99%

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Ngu

Sim

Yusof

et al. 2016

Robotics Computer Surgery

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“…Multiple factors, including surgical technique, may affect LN yield in resections for colon cancer . To date, studies comparing robotic, laparoscopic and open colectomies have reported conflicting results regarding LN yield . As the paradigm for oncological resections shifts towards increasing LN yield, it is important to assess the role of surgical technique in optimizing LN retrieval.…”

Section: Introductionmentioning

confidence: 99%

Lymph node yield in right colectomy for cancer: a comparison of open, laparoscopic and robotic approaches

et al. 2017

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Aim Studies have demonstrated a relationship between lymph node (LN) yield and survival after colectomy for cancer. The impact of surgical technique on lymph node yield has not been well explored. Method This is a retrospective study of right colectomies (RC) for cancer at a single institution from 2012–2014. Exclusion criteria were previous colectomy, emergent and palliative operations. All data were collected by chart review. Primary outcomes were LN yield and the lymph node to length of surgical specimen (LN-LSS) ratio. Multivariable mixed models were created with surgeon and pathologist as random effects. Sensitivity analyses were performed to exclude stage IV cancers and to analyze groups on an “as-treated” basis. Results We identified 181 open (O-RC), 163 laparoscopic (L-RC) and 119 robotic (R-RC) cases. Open RC was more commonly performed in females with metastatic disease. Mean LN yield was 28, 29, and 34 in O-RC, L-RC, and R-RC, respectively; mean LN-LSS ratios were 0.83, 0.91 and 1.0. The R-RC approach produced a higher LN yield compared to other approaches (p < 0.01), and a higher LN-LSS ratio compared to O-RC (p < 0.01). These findings were unchanged in sensitivity analyses. Conclusion Robotic RC improves LN yield and LN-LSS ratio, which may reflect a better mesocolic excision. The effect of these findings on survival requires further investigation.

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“…19 Of the 24 studies included in the meta-analysis by Zhang et al, 17 were retrospective, and only the two by Jiménez-Rodríguez et al and Park et al were randomized trials. [20][21][22] All seven articles in the 2014 publication by Xu et al were included in a 2015 publication by Chang et al, and some of these articles also contributed to half of the meta-analysis by Zarak et al 11,12,[22][23][24][25][26] Between 2014 and 2016, three different journals separately published meta-analyses on robotic versus laparoscopic rectal cancer surgery -all included the same eight studies and 1229 patients. [27][28][29] Two of these publications were authored by the same group.…”

mentioning

confidence: 99%

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Ngu¹,

Tsang²,

Koh³

2017

RSRR

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Abstract:The Xi is the latest da Vinci surgical system approved for use in colorectal surgery. With its novel overhead architecture, slimmer boom-mounted arms, extended instrument reach, guided targeting, and integrated auxiliary technology, the Xi manages to address several limitations of earlier models. The versatility of this new system allows it to be implemented in a wide range of colorectal procedures -from complex multiquadrant colectomies to challenging mesorectal dissections in the pelvis. While commonly criticized for its cost and prolonged operative time, robotic colorectal surgery holds the potential for enhanced ergonomics, superior precision, and a reduction in the learning curve involved in training an expert surgeon. This review appraises the existing literature on robotic colorectal surgery while elaborating how the improved capabilities of the Xi serve to usher in a new era of minimally invasive colorectal surgery.

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A meta-analysis of robotic versus laparoscopic colectomy

Cited by 43 publications

References 49 publications

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Insight into the da Vinci® Xi – technical notes for single‐docking left‐sided colorectal procedures

Lymph node yield in right colectomy for cancer: a comparison of open, laparoscopic and robotic approaches

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

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