Enhancing the hole in patients with hernia: Does single-site surgery make any sense?

Bosi, Henrique Rasia; Cavazzola, Leandro Totti

doi:10.1007/s10029-020-02289-1

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…36 In contrast, the incidence of incisional hernias is higher in LESS procedures, [37][38][39][40] raising questions about the real benefit of this technique. 41 However, Marks et al found no relationship between the incidence of incisional hernias in surgeries with a single portal and age, BMI, sex, smoking history, surgical time, size of the incision or way of closing the aponeurosis. 42 This study concludes that the method is safe, but that the aesthetic effect still overlaps the hernia rate.…”

Section: Discussionmentioning

confidence: 99%

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Does single‐site robotic surgery makes sense for gallbladder surgery?

Bosi

Rombaldi

Zaniratti

et al. 2022

Robotics Computer Surgery

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Background Cholecystectomy is one of the most performed surgeries. Several techniques were created, generating less pain, better aesthetic results and faster return to activities. Robotic surgery through a single portal combined the advantages of single‐incision surgery with the principles of conventional laparoscopy, making it a safe and feasible procedure. However, due to the high costs, this technology is hardly available in practice, especially in the public health system. The objective is to evaluate the safety of robotic cholecystectomy using the da Vinci Single‐Site © Surgical Platform (DVSSP) in a tertiary public hospital, and to assess alternatives that can reduce the costs, influencing the final real value of the procedure. Methods Prospective and descriptive study evaluating robotic cholecystectomies using the DVSSP technology performed at Hospital de Clínicas de Porto Alegre from May 2017 to November 2018. Results A total of 37 cholecystectomies were performed. The average time of surgery was 82.62 min, and no intraoperative complications were observed. There was a need for conversion to conventional laparoscopy in two surgeries (5.4%). The average cost of the robotic procedure was U$ 1146.23 and the amount passed on to the institution by the Brazilian Unified Health System was on average U$ 212.59 (p < 0.05). Postoperative outcomes were satisfactory, with an incisional hernia index of 8.1%. Conclusion Although robotic surgery in this setting is a safe and feasible alternative, the high cost of the procedure prevents its dissemination on a large scale. New alternatives are needed to reduce the value and to allow greater accessibility.

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Section: Discussionmentioning

confidence: 99%

“…This favourable cosmetic result can be one of the main points to leverage this approach 36 . In contrast, the incidence of incisional hernias is higher in LESS procedures, 37–40 raising questions about the real benefit of this technique 41 . However, Marks et al.…”

Section: Discussionmentioning

confidence: 99%

Does single‐site robotic surgery makes sense for gallbladder surgery?

Bosi

Rombaldi

Zaniratti

et al. 2022

Robotics Computer Surgery

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“…Later on, based on the Da Vinci Single-Site platform, Bosi et al 125 described their experience of the first SIRAS TAPP bilateral inguinal hernia repair in Brazil in 2016, while Cestari et al 126 demonstrated the first SIRAS TEP inguinal hernia repair in 2017. Meanwhile, there were voices against SIRAS inguinal hernia repair due to concerns about the unnecessary large incision for single-site trocar that was very likely to develop incisional hernia, and the prolonged and complicated procedure for such simple operation 127 . A retrospective study by Cuccurullo et al 128 of 44 cases of SIRAS TAPP in 32 patients between Feburary 2016 and July 2018 reported no recurrence and PIH at 12-month follow-up, and only one case of temporary postoperative pain of 4 months, but the small sample size was a major limitation.…”

Section: The Research Status Of Sirasmentioning

confidence: 99%

Clinical status and future prospects of single-incision robotic assisted surgery (SIRAS): A review

Cheng,

Huang,

Jia

et al. 2023

International Journal of Surgery

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Since the advent of conventional multiport laparoscopic surgery, the prosperity of minimally invasive surgery has been thriving on the advancement of endoscopic techniques. Cosmetic superiority, recovery benefits, and noninferior surgical outcomes weigh single-incision laparoscopic surgery as a promising modality. Although there are surgical challenges posed by steep learning curve and technological difficulties, such as instruments collision, triangulation loss and limited retraction, the establishment of robotic surgical platform as a solution to all is inspiring. Furthermore, with enhanced instrument maneuverability and stability, robotic ergonomic innovations adopt the advantages of single-incision laparoscopic surgery and surmount its recognized barriers by introducing a novel combination, single-incision robotic-assisted surgery. As was gradually diffused in general surgery and other specialties, single-incision robotic-assisted surgery manifests privileges in noninferior clinical outcomes an satisfactory cosmetic effect among strictly selected patients, and has the potential of a preferable surgical option for minimally invasive surgery.

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“…In response to Bosi et al [2], we would like to comment some concerns. Despite in our series no incisional hernia occurred at 1-year follow-up, we agree with the authors who support that the incidence of trocar hernias is directly related to the size of the device used [3,4].…”

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confidence: 99%