Feasibility of transthoracic esophagectomy with a next-generation surgical robot

Puntambekar, Shailesh; Bharambe, Suyog; Pawar, Swapnil; Chitale, Mihir; Panse, Mangesh

doi:10.1038/s41598-022-21323-z

Cited by 6 publications

(6 citation statements)

References 32 publications

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“…Forty-five (43.7%) authors reported the surgical background of the operating surgeon and his previous experience [ 26 , 31 , 33 , 45 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 62 , 64 , 67 , 69 , 76 , 77 , 79 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 94 , 96 , 99 , 102 , 103 , 104 , 105 , 106 , 108 , 109 , 110 ]. A structured training process of the surgical team on the adopted system was reported by 28 (27.2%) authors [ 26 , 40 , 47 , 48 , 49 , 51 , 52 ...…”

Section: Resultsmentioning

confidence: 99%

“…Concerning skill transferability, 26 (25.2%) articles reported a previous experience with a Da Vinci robot [ 26 , 31 , 33 , 45 , 47 , 53 , 54 , 56 , 62 , 67 , 69 , 77 , 79 , 83 , 85 , 87 , 88 , 89 , 90 , 96 , 99 , 103 , 104 , 105 , 106 , 110 ].…”

Section: Resultsmentioning

confidence: 99%

“…Forty-five (43.7%) authors reported the surgical background of the operating surgeon and his previous experience [26,31,33,45,[47][48][49][50][51][52][53][54][55][56][57][58][59]62,64,67,69,76,77,79,[83][84][85][86][87][88][89][90][91][92]94,96,99,[102][103][104][105][106][108][109][110]. A structured training process of the surgical team on the adopted system was reported by 28 (27.2%) authors [26,40,[47][48][49]…”

Section: Trainingmentioning

confidence: 99%

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New Robotic Platforms in General Surgery: What’s the Current Clinical Scenario?

et al. 2023

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Background and Objectives: Robotic surgery has been widely adopted in general surgery worldwide but access to this technology is still limited to a few hospitals. With the recent introduction of new robotic platforms, several studies reported the feasibility of different surgical procedures. The aim of this systematic review is to highlight the current clinical practice with the new robotic platforms in general surgery. Materials and Methods: A grey literature search was performed on the Internet to identify the available robotic systems. A PRISMA compliant systematic review was conducted for all English articles up to 10 February 2023 searching the following databases: MEDLINE, EMBASE, and Cochrane Library. Clinical outcomes, training process, operating surgeon background, cost-analysis, and specific registries were evaluated. Results: A total of 103 studies were included for qualitative synthesis after the full-text screening. Of the fifteen robotic platforms identified, only seven were adopted in a clinical environment. Out of 4053 patients, 2819 were operated on with a new robotic device. Hepatopancreatobiliary surgery specialty performed the majority of procedures, and the most performed procedure was cholecystectomy. Globally, 109 emergency surgeries were reported. Concerning the training process, only 45 papers reported the background of the operating surgeon, and only 28 papers described the training process on the surgical platform. Only one cost-analysis compared a new robot to the existing reference. Two manufacturers promoted a specific registry to collect clinical outcomes. Conclusions: This systematic review highlights the feasibility of most surgical procedures in general surgery using the new robotic platforms. Adoption of these new devices in general surgery is constantly growing with the extension of regulatory approvals. Standardization of the training process and the assessment of skills’ transferability is still lacking. Further studies are required to better understand the real clinical and economical benefit.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Trainingmentioning

confidence: 99%

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New Robotic Platforms in General Surgery: What’s the Current Clinical Scenario?

et al. 2023

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“…Patients in the minimally invasive group underwent thoracolaparoscopy, and patients in the open group underwent conventional open surgery. Surgical manoeuvres were performed as described in previous literature [ 12 , 13 ]. The thoracic part of the operation included freeing the thoracic oesophagus and clearing the paraoesophageal lymph nodes, bilateral paraglottic lymph nodes, subglottic lymph nodes, paratracheal lymph nodes, lower pulmonary ligament lymph nodes, and paradiaphragmatic lymph nodes according to the American Joint Committee on Cancer(AJCC) guidelines.…”

Section: Methodsmentioning

confidence: 99%

Effect of oesophagectomy on lipid profiles in patients with oesophageal cancer combined with hyperlipidaemia: a retrospective study

Yang,

Li,

Huang

et al. 2024

Lipids Health Dis

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Background Surgery is widely regarded as a pivotal therapeutic approach for treating oesophageal cancer, and clinical observations have revealed that many oesophageal cancer patients also present with concomitant hyperlipidaemia. It is surprising that few studies have been performed to determine how blood lipid levels are affected by oesophageal cancer resection. This research was designed to assess the influence of oesophageal cancer resection on lipid profiles among individuals diagnosed with both oesophageal cancer and hyperlipidaemia. Methods A retrospective analysis was carried out on 110 patients with hyperlipidaemia and oesophageal cancer who had undergone oesophagectomy at the 900th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army. Preoperative and postoperative serological data were collected at seven-, thirty-, sixty-day-, and one-year-long intervals. Changes in lipid levels were compared, the remission of various types of hyperlipidaemia was statistically assessed, and Pearson correlation was used to analyse the association between lipid changes and preoperative body weight. The research sought to assess the reduction in body weight and the proportion of body weight lost one year following surgery. Results Noteworthy decreases were observed in total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) levels, with TC decreasing from 6.20 mmol/L to 5.20 mmol/L, TG decreasing from 1.40 mmol/L to 1.20 mmol/L, and LDL decreasing from 4.50 mmol/L to 3.30 mmol/L. Conversely, there was a notable increase in high-density lipoprotein (HDL) levels, which increased from 1.20 mmol/L to 1.40 mmol/L (P < 0.05) compared to the preoperative levels. Notably, the remission rates for mixed hyperlipidaemia (60.9%) and high cholesterol (60.0%) were considerably greater than those for high triglycerides (16.2%). Alterations in TC at one year postoperatively correlated with preoperative weight and weight loss (r = 0.315, -0.216); changes in TG correlated with preoperative weight, percentage of total weight loss (TWL%), and weight reduction (r = -0.295, -0.246, 0.320); and changes in LDL correlated with preoperative weight, TWL%, and weight loss (r = 0.251, 0.186, and -0.207). Changes in non-high-density lipoprotein(non-HDL) were linked to preoperative weight (r = 0.300), and changes in TG/HDL were correlated with preoperative weight and TWL% (r = -0.424, -0.251). Conclusions Oesophagectomy significantly improved lipid profiles in oesophageal cancer patients, potentially leading to a reduction in overall cardiovascular risk.

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“…The Versius Surgical System has undergone in-human clinical trials for robotic-assisted surgery in gynaecology, general surgery and urology 13–17. The system has proved to be safe and effective in these applications and is in clinical use in general surgery, urology, gynaecology and thoracic surgery.…”

Section: Introductionmentioning

confidence: 99%

New robotic platform for transoral robotic surgery: an IDEAL stage 0 study

Arora,

Faulkner,

Paleri

et al. 2024

BMJ Surg Interv Health Technologies

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ObjectivesThis study aims to assess the feasibility to perform transoral robotic surgery (TORS) with a new robotic platform, the Versius Surgical System (CMR Surgical, UK) in a preclinical cadaveric setting in accordance to stage 0 of the IDEAL-D framework.DesignIDEAL stage 0 preclinical assessment of the Versius Robotic System in TORS in human cadavers.SettingAll procedures were performed in a simulated operating theatre environment at a UK surgical training centre.Participants11 consultant head and neck surgeons from the UK, mainland Europe and the USA took part in TORS procedures on six human cadavers.Interventions3 key index procedures were assessed that represent the core surgical workload of TORS: lateral oropharyngectomy, tongue base resection and partial supraglottic laryngectomy.Main outcome measuresThe primary outcome was the successful completion of each surgical procedure. Secondary outcomes included the optimisation of system setup, instrumentation and surgeon-reported outcomes for feasibility of each component procedural step.Results33 cadaveric procedures were performed and 32 were successfully completed. One supraglottic laryngectomy was not fully completed due to issues dividing the epiglottic cartilage with available instrumentation. Surgeon-reported outcomes met the minimal level of feasibility in all procedures and a consensus that it is feasible to perform TORS with Versius was reached. Available instrumentation was not representative of other robotic platforms used in TORS and further instrument optimisation is recommended before wider dissemination.ConclusionsIt is feasible to perform TORS with the Versius Surgical System (CMR Surgical) within a pre-clinical cadaveric setting. Clinical evaluation is needed and appropriate with the system. Further instrument development and optimisation is desirable.

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Feasibility of transthoracic esophagectomy with a next-generation surgical robot

Cited by 6 publications

References 32 publications

New Robotic Platforms in General Surgery: What’s the Current Clinical Scenario?

New Robotic Platforms in General Surgery: What’s the Current Clinical Scenario?

Effect of oesophagectomy on lipid profiles in patients with oesophageal cancer combined with hyperlipidaemia: a retrospective study

New robotic platform for transoral robotic surgery: an IDEAL stage 0 study

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