Efficacy of the Da Vinci Surgical System in Abdominal Surgery Compared With That of Laparoscopy

Maeso, Sergio; Reza, M. M.; Mayol, Julio; Blasco, Juan Antonio; Guerra, Mercedes; Andradas, Elena; Plana, María Nieves

doi:10.1097/sla.0b013e3181e6239e

Cited by 359 publications

(222 citation statements)

References 44 publications

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“…Interestingly, in the Chicago group's study 10, the cold ischemia time was 47 min longer in the robotic group than the open surgery group. Based on our experience and the results of large meta‐analyses and series, the use of robotic assistance is likely responsible for an increase in operative time, as compared to open or laparoscopic surgery 17, 18, 19, 20, 21. We thus believe that a longer anastomosis time and uncontrolled kidney rewarming are valid concerns in robot‐assisted kidney transplantation.…”

Section: Discussionmentioning

confidence: 95%

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

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Robot‐assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra‐abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra‐abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p‐values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia–reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot‐assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra‐abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia–reperfusion injuries.

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Section: Discussionmentioning

confidence: 95%

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Meier

Piller

Hagen

et al. 2018

American Journal of Transplantation

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“…Multiple studies have demonstrated that the outcomes of RC are similar to LC with regards to initial hospitalization as well as 30-day complications related to the index procedure (30). While there is some evidence that RC is safe with satisfactory patient outcomes at 3-year follow-up (31), there is limited reporting of long term outcomes.…”

Section: Outcomes Of Robotic Cholecystectomy: Safety and Patient Satimentioning

confidence: 97%

The emerging role for robotics in cholecystectomy: the dawn of a new era?

Zaman¹,

Singh²

2018

Hepatobiliary Surg. Nutr.

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Though laparoscopic cholecystectomy (LC) was highly criticized in its early stages, it quickly grew to become a new standard of care and has revolutionized the field of general surgery. Now emerging robotic technology is making its way into the minimally invasive arena. Robotic cholecystectomy (RC) is often disparaged as a costly technology that can lead to increased operative times with outcomes that are quite similar to LC. However, this perspective is skewed as many existing studies were performed in the early phase of learning for this procedure. RC can be performed in a cost-effective manner as the volume of robotic procedures increases. In addition, improved visualization and capability to perform fluorescence cholangiography can improve the safety profile of cholecystectomy to a level that has not yet been achieved with conventional laparoscopy. Advanced simulation technology for robotic surgery, and newer singlesite robotic platforms have the potential to further revolutionize this technology and lead to improved patient satisfaction. In this review, we will present current data, trends, and controversies in robotic-assisted cholecystectomy.

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“…[5] Both laparoscopic and robotic-assisted esophageal myotomy are comparable in terms of feasibility, safety, and longterm symptomatic relief. [24,25] However, robotic surgery is superior in terms of mucosal perforation. In a comparative study of 121 myotomies in adults, there were no cases of mucosal perforation in the robotic myotomy group, but mucosal perforation occurred in 16% of patients in the laparoscopic group.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted Heller’s myotomy for achalasia in children

Altokhais

Mandora

Alqahtani

et al. 2016

Computer Assisted Surgery

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Background: Achalasia is rare in children. Surgical options include open, laparoscopic and robotic approaches. However, Heller's myotomy remains the treatment of choice. This report describes our experience with robot-assisted Heller's myotomy in children and presents a review of the literature. Methods: Included in this study are children who underwent robot-assisted Heller's myotomy for esophageal achalasia via the Da Vinci surgical system between 2004 and 2015 at King Saud University Medical City, Riyadh, Saudi Arabia. The medical records of these patients were reviewed for demographic data, presenting symptoms, diagnostic modalities, operative procedures, complications, outcomes and follow-ups. Results: Six patients were identified. The age of the patients at surgery ranged between 2 and 12 years (mean 7.1 years). The most common presenting symptoms were dysphagia, vomiting and nocturnal cough. Contrast swallow and upper gastrointestinal endoscopy established a diagnosis of esophageal achalasia in all of the patients. Four patients underwent esophageal dilatation 2-5 times before the definitive procedure. All patients underwent successful robot-assisted Heller's myotomy with concomitant partial posterior fundoplication. The postoperative course was uneventful. Five patients had a complete resolution of the symptoms and one patient improved. The follow-up assessments have been consistent and have ranged from 0.5 to 11 years (mean 4.4 years). Conclusion: Robotic-assisted Heller's myotomy for esophageal achalasia in children is safe and effective and is a suitable alternative to open and laparoscopic approaches.

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Efficacy of the Da Vinci Surgical System in Abdominal Surgery Compared With That of Laparoscopy

Cited by 359 publications

References 44 publications

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

Intra-Abdominal Cooling System Limits Ischemia–Reperfusion Injury During Robot-Assisted Renal Transplantation

The emerging role for robotics in cholecystectomy: the dawn of a new era?

Robot-assisted Heller’s myotomy for achalasia in children

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