Diverticular Disease Complicated With Colovesical Fistula: Laparoscopic Versus Robotic Management

Maciel, Victor; Lujan, Henry; Plasencia, Gustavo; Zeichen, Marianna; Mata, Wilmer; Jorge, Irving; Lee, Dustin; Viamonte, Manuel; Hartmann, Rene F.

doi:10.9738/intsurg-d-13-00201.1

Cited by 48 publications

(75 citation statements)

References 28 publications

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“…Benefits of robotic technique in terms of lower rate of conversion were reported in previous case series. Maciel et al reported no conversions in 20 robotic cases performed with the Si platform. Colorectal operations performed with the Si platform usually require laparoscopic assistance.…”

Section: Discussioncontrasting

confidence: 64%

“…Generally, long operating time was reported as a disadvantage of robotic surgery . Previous reports comparing laparoscopy and robotics in the treatment of sigmoid diverticulitis have shown longer operative time associated with robotic surgery . However, duration of surgery was similar in totally laparoscopic and totally robotic resections in our study despite our totally robotic group had higher BMI.…”

Section: Discussionmentioning

confidence: 99%

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Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Bilgin

Bas

Benlice

et al. 2020

Robotics Computer Surgery

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Background: Introduction of the da Vinci Xi system has facilitated the use of robotics in colorectal surgery. Nevertheless, data on the outcomes of robotic surgery for the treatment of colonic diverticulitis have remained scarce. Methods: Patient demographics, clinical characteristics, and perioperative outcomes of the patients undergoing totally robotic with the da Vinci Xi system or laparoscopic surgery for left-sided colonic diverticulitis (LCD) were compared. Results: Laparoscopic and robotic groups included 22 and 20 patients, respectively. There were no significant differences between the two groups in terms of patient demographics, clinical characteristics, operative time, and postoperative complications. There were three conversions in the laparoscopy group and no conversion in the robotic group (P = 0.23). Conversion to open surgery was associated with postoperative morbidity (P = 0.02). Conclusion: Robotic surgery is an applicable alternative for the treatment of LCD. Robotic approach may potentially lower the risk of operative morbidity by reducing the requirement of conversion. K E Y W O R D S colectomy, laparoscopic surgery, left sided colonic diverticulitis, robotic surgery

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Bilgin

Bas

Benlice

et al. 2020

Robotics Computer Surgery

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“…This strategy has enabled us to minimise the consequences of an anastomotic dehiscence while reducing stoma related complications. Recently published studies describe the efficacy of laparoscopic and robotic assisted repair of CVF (10,11). However, these require expertise and…”

Section: Segmental Resection and Local Repair Are The Main Modalitiesmentioning

confidence: 99%

Diagnosis and management of colovesical fistulae

et al. 2019

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IntroductionColovesical fistulae (CVF) are the relatively uncommon presentation in colorectal surgical practice. However, the rarity of the disease gives rise to problems in diagnosis and treatment as adequately powered data is lacking in published literature. Furthermore, the aetiology of CVF in Asia differs from the West which plays an important role in patient management. MethodsThe records of all the patients with CVF managed in the Gastrointestinal and Urological surgical units of a tertiary care centre over a nine-year period were collected and analysed. Follow-up data have been collected prospectively to assess the outcome. ResultsA total of 11 patients (M: F=9:2) with a median age of 59 years were studied. Faecaluria, pneumaturia and recurrent urinary tract infections were the commonest presenting symptoms. The diagnosis was based on clinical evaluation. Cystoscopy, colonoscopy and CECT were utilized to identify the underlying pathology, complications and for staging. Commonest benign pathology was diverticular disease (n=7), followed by tuberculosis (n=1). Adenocarcinoma of the sigmoid colon and squamous cell Carcinoma of the bladder were reported in three patients. Majority of patients (n=9) were managed successfully by open-left colonic resection with or without temporary ileostomy and bladder repair, while inoperable patients were managed with a stoma. ConclusionCVF is a relatively uncommon condition in our setup and mostly related to isolated diverticular disease of the sigmoid colon. Diagnosis of CVF can be made with accuracy by proper clinical assessment. Cystoscopy and LGIE are essential components of the diagnostic workup of a patient with suspected CVF. During surgery, segmental resection of the colon is favoured than local repair.

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“…The remarkable observation of this series was the fact that the robotic group did not experience any conversions to open surgeries, or any ureteral injuries. The same was not true of the laparoscopic arm [29]. Along the lines of benign disease, rectal prolapse, and robotic rectopexy have been studied and compared to the laparoscopic approach, with the conclusion that both methods to deal with it are effective, although more data are needed to establish any superiority of the robotic technique, such as a randomized controlled trial.…”

Section: Colorectal Surgery: the Subspecialty That Paved The Waymentioning

confidence: 99%

The Surgical Robot: Applications and Advantages in General Surgery

Barrera¹

2018

Surgical Robotics

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The field of General Surgery with its multiple sub-specialties has experienced the progression of minimally invasive procedures performed with the robotic technology since the last decade. The robotic applications are extensive and have contributed to the enrichment of the surgical sub-specialties based on advantages such as increased surgeon control and autonomy, superior instrument dexterity and tissue handling, improved three-dimensional visualization, wristed articulation, all of this despite the lack of haptic feedback. The sub-specialties of Colorectal, Hepatobiliary and Pancreatic, Gastric Oncologic, Bariatric, Foregut, Pediatric, Endocrine, and Hernia Surgery, in addition to General Surgery as the principal specialty, have produced several high-quality randomized controlled trials, meta-analyses, prospective and retrospective series which have established, in many instances, superior results to those of laparoscopy, and at least non-inferior outcomes over the years. From the first pioneer single-surgeon experiences around the world to the most recent large trials, including the first Robotic General Surgery case series in an American community hospital not classified as a tertiary referral center, patients continue to benefit from this technology as surgeons engage in overcoming their learning curve and training their teams, involving their hospital administrators and working with the industry to perfect their techniques for the sake of their patients.

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Diverticular Disease Complicated With Colovesical Fistula: Laparoscopic Versus Robotic Management

Cited by 48 publications

References 28 publications

Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Totally laparoscopic and totally robotic surgery in patients with left‐sided colonic diverticulitis

Diagnosis and management of colovesical fistulae

The Surgical Robot: Applications and Advantages in General Surgery

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