da Vinci® single‐site platform: anthropometrical, docking and suturing considerations for hysterectomy in the cadaver model

Escobar, Pedro F.; Knight, J.; Rao, Subramanyeshwar; Weinberg, Lori

doi:10.1002/rcs.448

Cited by 32 publications

(13 citation statements)

References 12 publications

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“…However, in addition to these advantages, robotic single-site surgery is not significantly superior to conventional single site laparoscopy in terms of early surgical outcomes. In our experience, both techniques are feasible and safe, as previously reported [3,20,21,22,23]; however, single-site surgery still requires innovations such as wristed/articulated instruments to have better surgical outcomes.…”

Section: Discussionsupporting

confidence: 49%

Single Incision Trans-Umbilical Total Hysterectomy: Robotic or Laparoscopic?

Akdemir¹,

Yıldırım

Zeybek³

et al. 2015

Gynecol Obstet Invest

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Objective: The aim of this study was to compare the early surgical outcomes in patients who underwent total hysterectomy with laparoendoscopic single-site surgery (LESS-TH) versus robotic single-site total hysterectomy (RSS-TH). Methods: Twenty-four patients who underwent RSS-TH and thirty-four patients who underwent LESS-TH were retrospectively evaluated. Patient characteristics, operation time, intraoperative data (conversions, complications, estimated blood loss, etc.) and postoperative pain scores were compared. Results: The total operation time was significantly longer in the robotic surgery group, with a time of 98.5 vs. 86 min (p = 0.013), while vaginal closure time was significantly higher in the laparoscopic surgery group (p = 0.011). Intraoperative outcomes and postoperative pain scores were similar in the two groups. Conclusion: RSS-TH helps surgeons to overcome the technical disadvantages of LESS-TH, particularly vaginal cuff closure, ergonomics and instrument crowding and clashing. Early surgical outcomes are comparable in the two groups, and both techniques are safe and feasible.

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Section: Discussionsupporting

confidence: 49%

Single Incision Trans-Umbilical Total Hysterectomy: Robotic or Laparoscopic?

Akdemir¹,

Yıldırım

Zeybek³

et al. 2015

Gynecol Obstet Invest

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“…In addition to the 3D visualization, positioning of the surgeon on the robot console and the precise dissection of the anatomical structures result in a more accurate operation, with no collision of forceps [10]. The initial studies demonstrated that this technique is also safe and effective, and can help resolve the technical limitations found in laparoscopy [11,12].…”

Section: Introductionmentioning

confidence: 99%

Robotic Single-Site Hysterectomy versus Robot-Assisted Multiport Hysterectomy in Benign Gynecologic Diseases: A Retrospective Comparison of Clinical and Surgical Outcomes

Park

Lee

et al. 2018

Soonchunhyang Med Sci

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Objective: The purpose of this study was to compare clinical and surgical outcomes of robotic single-site hysterectomy (RSSH) and robot-assisted multiport hysterectomy (RH) in benign disease. Methods: We retrospectively reviewed the medical records of 38 women who underwent RSSH (N= 12) or RH (N= 26) for the treatment of benign uterine disease between June 2015 and November 2017. Results: There were no intergroup differences in parity, comorbidities, and number of previous abdominal surgery. Mean age was older (49.5± 5.05 years vs. 44.4± 3.54 years, P= 0.001) and mean body mass index was higher (27.4± 2.47 kg/m 2 vs. 25.3± 3.12 kg/ m 2 , P = 0.045) in RSSH group than RH group. Surgical outcomes, including operative time (165.0 minutes vs. 159.2 minutes, P= 0.727), estimated blood loss (115.8± 33.15 mL vs. 108.1± 56.42 mL, P= 0.662), uterus weight (445.9± 157.21 g vs. 374.5± 197.91 g, P= 0.291), postoperative hospital stay (5.4± 0.51 days vs. 5.8± 1.20 days, P= 0.289), postoperative hemoglobin change in day 1 (1.8 ± 0.89 g/dL vs. 1.4 ± 1.53 g/dL, P = 0.431) and day 3 (2.1 ± 1.32 g/dL vs. 1.7 ± 1.83 g/dL, P = 0.601), and perioperative complications did not significantly differ between two groups. The use of additional analgesics after 6 hours, 24 hours, and 48 hours, and mean NRS score after 6 hours, 24 hours, and 48 hours were not significantly different between two groups. Conclusion: RSSH might be an effective and safe alternative to RH, even if in older and/or obese women with large uteri.

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“…However, certain types of surgery that require multiple sutures and knots are nevertheless thought to be challenging in terms of single-port laparoscopic surgery. 8 9 LSC for POP is a good example of this type of technically difficult surgery. However, the difficulty of applying multiple sutures can be overcome by using the newly introduced Single-Site® Wristed Needle Driver.…”

Section: Discussionmentioning

confidence: 99%

Robotic Single-Site® Sacrocolpopexy: First Report and Technique Using the Single-Site® Wristed Needle Driver

Lee

2016

Yonsei Med J

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The recently introduced da Vinci Single-Site® platform offers cosmetic benefits when compared with standard Multi-Site® robotic surgery. The innovative endowristed technology has increased the use of the da Vinci Single-Site® platform. The newly introduced Single-Site® Wristed Needle Driver has made it feasible to perform various surgeries that require multiple laparoscopic sutures and knot tying. Laparoscopic sacrocolpopexy is also a type of technically difficult surgery requiring multiple sutures, and there have been no reports of it being performed using the da Vinci Single-Site® platform. Thus, to the best of our knowledge, this is the first report of robotic single-site (RSS) sacrocolpopexy, and I found this procedure to be feasible and safe. All RSS procedures were completed successfully. The mean operative time was 122.17±22.54 minutes, and the mean blood loss was 66.67±45.02 mL. No operative or major postoperative complications occurred. Additional studies should be performed to assess the benefits of RSS sacrocolpopexy. I present the first six cases of da Vinci Single-Site® surgery in urogynecology and provide a detailed description of the technique.

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da Vinci® single‐site platform: anthropometrical, docking and suturing considerations for hysterectomy in the cadaver model

Abstract: Further work is needed in the development and advancement of single-site robotic platforms, articulated instrumentation, and optics.

Cited by 32 publications

References 12 publications

Single Incision Trans-Umbilical Total Hysterectomy: Robotic or Laparoscopic?

Single Incision Trans-Umbilical Total Hysterectomy: Robotic or Laparoscopic?

Robotic Single-Site Hysterectomy versus Robot-Assisted Multiport Hysterectomy in Benign Gynecologic Diseases: A Retrospective Comparison of Clinical and Surgical Outcomes

Robotic Single-Site® Sacrocolpopexy: First Report and Technique Using the Single-Site® Wristed Needle Driver

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