A Three-Arm (Laparoscopic, Hand-Assisted, and Robotic) Matched-Case Analysis of Intraoperative and Postoperative Outcomes in Minimally Invasive Colorectal Surgery

Patel, Chirag B.; Ragupathi, Madhu; Ramos-Valadez, Diego I.; Haas, Eric M.

doi:10.1007/dcr.0b013e3181fec377

Cited by 67 publications

(44 citation statements)

References 19 publications

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“…It has to be critically pointed out that the preoperative robotic system preparation time was always significantly longer, thereby prolonging the use of the operating theater [62]. The same observation was reported by Patel et al [63] upon comparing RALS, CL, and HALS, with similar short clinical results in all groups. The mortality rate was analyzed by Keller et al [52]; no differences were found and the study concluded that CL, RALS, and SILS enable high-quality colorectal surgery [52].…”

Section: Advanced Clinically Approved Laparoscopic Techniquessupporting

confidence: 65%

Minimally Invasive Surgery for the Treatment of Colorectal Cancer

Karcz

Braun

2016

Visc Med

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Background: Reduction in operative trauma along with an improvement in endoscopic access has undoubtedly occupied surgical minds for at least the past 3 decades. It is not at all surprising that minimally invasive colon surgery has come a long way since the first laparoscopic appendectomy by Semm in 1981. It is common knowledge that the recent developments in video and robotic technologies have significantly furthered advancements in laparoscopic and minimally invasive surgery. This has led to the overall acceptance of the treatment of benign colorectal pathology via the endoscopic route. Malignant disease, however, is still primarily treated by conventional approaches. Methods and Results: This review article is based on a literature search pertaining to advances in minimally invasive colorectal surgery for the treatment of malignant pathology, as well as on personal experience in the field over the same period of time. Our search was limited to level I and II clinical papers only, according to the evidence-based medicine guidelines. We attempted to present our unbiased view on the subject relying only on the evidence available. Conclusion: Focusing on advances in colorectal minimally invasive surgery, it has to be stated that there are still a number of unanswered questions regarding the surgical management of malignant diseases with this approach. These questions do not only relate to the area of boundaries set for the use of minimally invasive techniques in this field but also to the exact modality best suited to the treatment of every particular case whilst maintaining state-of-the-art oncological principles.

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Section: Advanced Clinically Approved Laparoscopic Techniquessupporting

confidence: 65%

Minimally Invasive Surgery for the Treatment of Colorectal Cancer

Karcz

Braun

2016

Visc Med

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“…A meta-analysis of 32 studies examining robotic-assisted rectal surgery demonstrated a wide range of operative times for robotic proctectomy from 192-385 min and 158-197 min for laparoscopic proctectomy [57]. Patel et al [58] compared robotic colectomy to standard laparoscopy and hand-assisted laparoscopy and found that the operative time for the robotic approach was 237 ± 56.8 min. This was significantly longer than both standard laparoscopy (181 ± 52.5 min) and hand-assisted laparoscopic colectomy (158 ± 51.0 min).…”

Section: Discussionmentioning

confidence: 98%

A comparison of laparoscopic and robotic colorectal surgery outcomes using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database

et al. 2015

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As the robotic platform continues to grow in colorectal surgery and as technical upgrades continue to advance, comparison of outcomes requires continuous reevaluation. This study demonstrated that robotic operations have longer operative times, decreased hospital length of stay, and decreased rates of conversion to open in the pelvis. These findings warrant continued evaluation of the role of minimally invasive technical upgrades in colorectal surgery.

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“…Completeness of TME Positive circumferential margin Harvested lymph nodes laTME, % taTME, % p laTME, % taTME, % p taTME/roTME : laTME p Shorter LOS, less pain, and lower demand for analgesics result in faster convalescence after roTME. Several authors consider less tissue trauma in RS due to subtle retraction by robotic arms and fine dissection as a main reason for less pain and shorter LOS [22,54]. Overall, this underlines the safety and feasibility of colorectal RS.…”

Section: Resultsmentioning

confidence: 76%

Lower Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures

et al. 2018

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Introduction: For a long time, the comprehensive application of minimally invasive techniques in lower gastrointestinal (GI) surgery was substantially impaired by inherent anatomical and technical complexities. Recently, several new techniques such as robotic operating platforms and transanal total mesorectal excision (taTME) have revolutionized the minimally invasive approach. This review aims to depict the current state of the art and evaluates the advantages and drawbacks in regard to perioperative outcome and quality of oncological resection. Methods: A systematic literature search was performed using the search terms ‘colorectal cancer', ‘rectal cancer', ‘minimally invasive surgery', ‘laparoscopic surgery', and ‘robotic' to identify relevant studies reporting on robotic surgery (RS) either alone or in comparison to laparoscopic surgery (LS). Publications on taTME were analyzed separately. Results: 69 studies reporting on RS with a total of 20,872 patients, and 17 articles on taTME including 881 patients, were identified. Conclusion: Both RS and taTME can facilitate a minimally invasive approach for lower GI surgery in an increasing number of patients. Furthermore, combining both techniques might become an auspicious approach in selected patients; further prospective and randomized trials are needed to verify its benefits over conventional laTME.

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A Three-Arm (Laparoscopic, Hand-Assisted, and Robotic) Matched-Case Analysis of Intraoperative and Postoperative Outcomes in Minimally Invasive Colorectal Surgery

Cited by 67 publications

References 19 publications

Minimally Invasive Surgery for the Treatment of Colorectal Cancer

Minimally Invasive Surgery for the Treatment of Colorectal Cancer

A comparison of laparoscopic and robotic colorectal surgery outcomes using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database

Lower Gastrointestinal Surgery: Robotic Surgery versus Laparoscopic Procedures

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