Operating costs, fiscal impact, value analysis and guidance for the routine use of robotic technology in abdominal surgical procedures

Quilici, Philippe J.; Wolberg, Harry; McConnell, Nathaniel

doi:10.1007/s00464-021-08428-8

Cited by 15 publications

(13 citation statements)

References 36 publications

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“…While outside the scope of the current review, robotic surgery has been shown in other disciplines to cost a hospital 1.4 to 2 times as much as the same, nonrobotic procedures. 38,39 However, the ability to perform neurosurgical procedures using these tools may offset the cost burden on hospitals that already have a robotic system set up.…”

Section: Figmentioning

confidence: 99%

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Pangal

Coté

Ruzevick

et al. 2022

Neurosurgical Focus

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OBJECTIVE The utility of robotic instrumentation is expanding in neurosurgery. Despite this, successful examples of robotic implementation for endoscopic endonasal or skull base neurosurgery remain limited. Therefore, the authors performed a systematic review of the literature to identify all articles that used robotic systems to access the sella or anterior, middle, or posterior cranial fossae. METHODS A systematic review of MEDLINE and PubMed in accordance with PRISMA guidelines performed for articles published between January 1, 1990, and August 1, 2021, was conducted to identify all robotic systems (autonomous, semiautonomous, or surgeon-controlled) used for skull base neurosurgical procedures. Cadaveric and human clinical studies were included. Studies with exclusively otorhinolaryngological applications or using robotic microscopes were excluded. RESULTS A total of 561 studies were identified from the initial search, of which 22 were included following full-text review. Transoral robotic surgery (TORS) using the da Vinci Surgical System was the most widely reported system (4 studies) utilized for skull base and pituitary fossa procedures; additionally, it has been reported for resection of sellar masses in 4 patients. Seven cadaveric studies used the da Vinci Surgical System to access the skull base using alternative, non–TORS approaches (e.g., transnasal, transmaxillary, and supraorbital). Five cadaveric studies investigated alternative systems to access the skull base. Six studies investigated the use of robotic endoscope holders. Advantages to robotic applications in skull base neurosurgery included improved lighting and 3D visualization, replication of more traditional gesture-based movements, and the ability for dexterous movements ordinarily constrained by small operative corridors. Limitations included the size and angulation capacity of the robot, lack of drilling components preventing fully robotic procedures, and cost. Robotic endoscope holders may have been particularly advantageous when the use of a surgical assistant or second surgeon was limited. CONCLUSIONS Robotic skull base neurosurgery has been growing in popularity and feasibility, but significant limitations remain. While robotic systems seem to have allowed for greater maneuverability and 3D visualization, their size and lack of neurosurgery-specific tools have continued to prevent widespread adoption into current practice. The next generation of robotic technologies should prioritize overcoming these limitations.

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Section: Figmentioning

confidence: 99%

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Pangal

Coté

Ruzevick

et al. 2022

Neurosurgical Focus

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“…Appendicitis is one of the classic indications for surgery. Appendicitis is inflammation of the appendix, usually caused by blockage of the lumen of the appendix, and when left untreated can lead to serious conditions like peritonitis [1][2][3]. Among the most common surgical procedures performed in the United States annually, appendectomy is at the top of the list with more than 300,000 operations performed each year [1].…”

Section: Introductionmentioning

confidence: 99%

“…Among the most common surgical procedures performed in the United States annually, appendectomy is at the top of the list with more than 300,000 operations performed each year [1]. While a laparoscopic approach is still the most common form of operative management, roboticassisted surgery is a growing method of removing the appendix [2]. In cases of acute appendicitis, prompt removal can prevent more serious complications including but not limited to infection, abscess, peritonitis, and bowel obstruction [2].…”

Section: Introductionmentioning

confidence: 99%

“…While a laparoscopic approach is still the most common form of operative management, roboticassisted surgery is a growing method of removing the appendix [2]. In cases of acute appendicitis, prompt removal can prevent more serious complications including but not limited to infection, abscess, peritonitis, and bowel obstruction [2]. Clinical evaluation and management are the mainstays of diagnosis, though imaging can be of assistance.…”

Section: Introductionmentioning

confidence: 99%

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A Tooth Decaying in the Appendix: An Unusual Cause of Appendicitis

Brennan¹,

Young²,

Packer³

2022

Cureus

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Appendicitis is a very common indication for surgery, although in recent years uncomplicated cases have often been managed with antibiotics. In this case, we discuss a patient who presented to the emergency department with a case of seemingly uncomplicated acute appendicitis. Physical exam, history, and imaging indicated that this was due to an ingested foreign body, specifically a dental crown, that had impacted the appendix. In cases of ingested foreign bodies, antibiotics are not an appropriate treatment for appendicitis and all cases should be treated surgically if the patient will tolerate surgery. A thorough history and physical exam, as well as imaging when indicated, can assist in the assessment of such patients.

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“…Robotic-assisted techniques generally incur increased cost and resource utilization compared to laparoscopy and open techniques. 1 Finding the right balance of benefit to patients, attention to costs, and appropriateness of use remains elusive. Kudsi et al 2 aimed to address this information gap by analyzing their single institution experience of robotic-assisted VHR over 7 years.…”

mentioning

confidence: 99%