Intraoperative and postoperative outcomes of robot-assisted cholecystectomy: a systematic review

Shenoy, Rivfka; Mederos, Michael A.; Ye, Linda; Mak, Selene; Begashaw, Meron M.; Booth, Marika; Shekelle, Paul G; Gunnar, William; Maggard-Gibbons, Melinda; Girgis, Mark D.

doi:10.1186/s13643-021-01673-x

Cited by 27 publications

(30 citation statements)

References 51 publications

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“…The longer operating time for robotic VHR compared with open surgery or laparoscopic VHR is consistent with similar findings for inguinal hernia repair and cholecystectomy 41 , 42 . This is likely related to a variety of factors, including robot docking, surgeon and staff efficiency, learning curve, and patient selection.…”

Section: Discussionsupporting

confidence: 81%

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Childers

Virgilio

et al. 2021

BJS Open

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Background Robotic ventral hernia repair (VHR) has seen rapid adoption, but with limited data assessing clinical outcome or cost. This systematic review compared robotic VHR with laparoscopic and open approaches. Methods This systematic review was undertaken in accordance with PRISMA guidelines. PubMed, MEDLINE, Embase, and Cochrane databases were searched for articles with terms relating to ‘robot-assisted’, ‘cost effectiveness’, and ‘ventral hernia’ or ‘incisional hernia’ from 1 January 2010 to 10 November 2020. Intraoperative and postoperative outcomes, pain, recurrence, and cost data were extracted for narrative analysis. Results Of 25 studies that met the inclusion criteria, three were RCTs and 22 observational studies. Robotic VHR was associated with a longer duration of operation than open and laparoscopic repairs, but with fewer transfusions, shorter hospital stay, and lower complication rates than open repair. Robotic VHR was more expensive than laparoscopic repair, but not significantly different from open surgery in terms of cost. There were no significant differences in rates of intraoperative complication, conversion to open surgery, surgical-site infection, readmission, mortality, pain, or recurrence between the three approaches. Conclusion Robotic VHR was associated with a longer duration of operation, fewer transfusions, a shorter hospital stay, and fewer complications compared with open surgery. Robotic VHR had higher costs and a longer operating time than laparoscopic repair. Randomized or matched data with standardized reporting, long-term outcomes, and cost-effectiveness analyses are still required to weigh the clinical benefits against the cost of robotic VHR.

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Section: Discussionsupporting

confidence: 81%

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Childers

Virgilio

et al. 2021

BJS Open

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“…Hoffman et al [12] compared 1118 robotic [12]. Finally, in a systematic review of the literature on robotic CCE for benign elective gallbladder disease between 2010 and 2020, Shenoy et al [13] found similar clinical outcomes for laparoscopic and robotic CCEs, without differences in conversion and complication rates, same length of stay and same readmission rates.…”

Section: Discussionmentioning

confidence: 99%

“…Hoffman et al [12] compared 1118 robotic to 298.188 laparoscopic CHEs in the New York state between 2009 and 2017 and found higher complication and bile duct injury rates (1.3 vs. 0.4%) and conversion (4.9 vs. 2.8%) rates for robotic CCE, as well as longer postoperative stay (3 vs. 1 day) and more readmissions (7.3 vs. 4.4%) for those patients [12]. Finally, in a systematic review of the literature on robotic CCE for benign elective gallbladder disease between 2010 and 2020, Shenoy et al [13] found similar clinical outcomes for laparoscopic and robotic CCEs, without differences in conversion and complication rates, same length of stay and same readmission rates.…”

Section: Discussionmentioning

confidence: 99%

Safety and Feasibility of Cholecystectomy with the HugoTM RAS: Proof of Setup Guides and First-In-Human German Experience

Belyaev,

Fahlbusch,

Slobodkin

et al. 2023

Visc Med

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Introduction: The Hugo RAS robotic platform by Medtronic was recently certified for human use in Europe. Several centers have gained initial experience with this system in urology and gynecology. However, few data about its feasibility and safety in general surgery have been published. Methods: The first-in-human surgical procedures with the Hugo RAS in Germany were performed at our hospital in February 2023. We report our early experience with robotic cholecystectomy using this new platform. The primary aim was to test the setup guides of the manufacturer and to evaluate the safety and feasibility of Hugo RAS for this procedure. Results: A modified setup with two 11-mm ports and two 8-mm ports without an assistant port was used in 14 consecutive cases. A 30° or a 0° camera, a bipolar grasper or a Maryland on the left arm, a monopolar scissors on the right arm, and a double-fenestrated grasper on the additional arm were mounted. Clip application and gallbladder extraction were performed by the bedside assistant through the right arm 11-mm port. There were no complications, no adverse events, and no conversions. Arm collisions were reduced through slight corrections in trocar positions. Conclusion: Robotic-assisted cholecystectomy with the Hugo RAS was safe and feasible. The modularity of robotic arms allows individual setup modifications which may be of advantage for patients and surgeons.

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“…To further expand the use of fluorescent imaging technology to tumor detection and focus surgical resection, molecular imaging methods with several contrast agents targeting various cancer biomarkers are currently under development [ 9 ]. Since laparoscopic and robotic surgeries are already being widely used for gallbladder surgery and suitable imaging tools are available, a fluorescent molecular imaging technology can be easily applied to treat gallbladder cancer after its usefulness is proven in preclinical studies [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

EGFR-targeted fluorescent imaging using the da Vinci® Firefly™ camera for gallbladder cancer

2022

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Background Fluorescent imaging may aid with the precise diagnosis and treatment of patients with gallbladder cancer. In this study, we sought to demonstrate whether the da Vinci® surgical system and Firefly™ camera could detect EGFR-targeted fluorescent images in orthotopic mouse models of gallbladder cancer. Methods An orthotopic mouse model of gallbladder cancer was created by injecting NOZ gallbladder cancer cells mixed with Matrigel into the gallbladder. In vivo imaging of subcutaneous and orthotopic gallbladder tumors was performed after the injection of DyLight 650- or 800-conjugated EGFR antibody. Results Western blotting, flow cytometry, and confocal microscopy showed the presence of EGFR in NOZ cells, but not in HEK293 cells. Subcutaneous NOZ cell tumors fluoresced after injection with fluorescent EGFR antibody, but subcutaneous HEK293 tumors did not. Fluorescent EGFR antibody made orthotopic NOZ tumors fluoresce, with an intensity stronger than that in the surrounding normal tissues. Histochemical examination confirmed the location of the tumors inside the gallbladder and adjacent liver parenchyma. Fluorescent signal was also detected in orthotopic gallbladder tumors with Firefly™ camera. Conclusion Our study showed that fluorescent EGFR antibodies and the Firefly camera in the da Vinci system can detect fluorescing gallbladder tumors, which demonstrates their potential use for molecular imaging-based prevision surgery in the near future.

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Intraoperative and postoperative outcomes of robot-assisted cholecystectomy: a systematic review

Cited by 27 publications

References 51 publications

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Safety and Feasibility of Cholecystectomy with the HugoTM RAS: Proof of Setup Guides and First-In-Human German Experience

EGFR-targeted fluorescent imaging using the da Vinci® Firefly™ camera for gallbladder cancer

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