Placement of robotic single-site surgery with the tumor-free technique for early cervical cancer using the da Vinci Xi platform

Su, Meng-Chan; Zheng, Ying; Yang, Fan; Liu, Yanyan

doi:10.1016/j.asjsur.2022.09.049

Cited by 3 publications

(2 citation statements)

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“…Additionally, it has a more pronounced impact on lowering the physical and psychological distress experienced by patients (8). Over the past ten years, numerous studies have shown that robotic surgery is effective and safe for treating gynecological malignancies (15)(16)(17). There is an increasing level of excitement surrounding the use of minimally invasive techniques for treating cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of robotic radical hysterectomy in cervical cancer compared with laparoscopic radical hysterectomy: a meta-analysis

Dai,

Qin,

Yang

et al. 2024

Front. Oncol.

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IntroductionRobotic radical hysterectomy (RRH) is a newly developed minimally invasive surgery that has been suggested as a substitute for laparoscopic radical hysterectomy (LRH). This meta-analysis aims to assess the clinical efficacy and safety of robot-assisted radical hysterectomy (RRH) for cervical cancer.Materials and methodsA systematic search was conducted in four databases (Medline, Embase, Web of Science, and CENTRAL) for studies comparing the utilization of RRH and LRH in the treatment of cervical cancer. The search included articles published from the inception of the databases up until July 18, 2023. Meta-analyses were conducted to assess several surgical outcomes, including operation time, estimated blood loss, length of hospital stay, pelvic lymph nodes, positive surgical margin, total complications, one-year recurrence rate, one-year mortality, and one-year disease-free survival rate.ResultsSix studies were included for meta-analysis. In total, 234 patients were in the RRH group and 174 patients were in the LRH group. RRH had significantly longer operative time (MD=14.23,95% CI:5.27~23.20, P=0.002),shorter hospital stay (MD= -1.10,95% CI:-1.43~0.76, P <0.00001),more dissected pelvic lymph nodes(MD=0.89,95%CI:0.18~1.60, P =0.01) and less blood loss(WMD = -27.78,95%CI:-58.69 ~ -3.14, P=0.08, I2 = 80%) compared with LRH. No significant difference was observed between two groups regarding positive surgical margin (OR = 0.59, 95% CI 0.18~2.76, P=0.61), over complications (OR = 0.77, 95% CI, 0.46-1.28, P=0.31), one-year recurrence rate (OR = 0.19, 95% CI 0.03-1.15, P=0.13), one-year mortality rate (OR = 0.19, 95% CI 0.03-1.15, P=0.07) and disease-free survival at one year (OR = 1.92, 95% CI 0.32-11.50, P=0.48).ConclusionRRH is an increasingly popular surgical method known for its high level of security and efficiency. It has many benefits in comparison to LRH, such as decreased blood loss, a higher quantity of dissected pelvic lymph nodes, and a shorter duration of hospitalization. Further multicenter, randomized controlled trials with extended follow-up durations are necessary to conclusively determine the safety and efficacy of RRH, as no significant differences were observed in terms of positive surgical margin, postoperative complications, 1-year recurrence, 1-year mortality, and 1-year disease-free survival.Systematic Review RegistrationPROSPERO, identifier CRD42023446653

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of robotic radical hysterectomy in cervical cancer compared with laparoscopic radical hysterectomy: a meta-analysis

Dai,

Qin,

Yang

et al. 2024

Front. Oncol.

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“…Minimally invasive surgery can result in better treatment outcomes, faster recovery times, shorter hospital stays, and reduced physical and psychological trauma (19). Recently, a growing number of studies have reported the efficiency and safety of da Vinci robots for the treatment of benign and malignant gynecological tumors (20)(21)(22). Due to subjective factors such as the patient's subjective choice of surgical method, difficultly in ensuring the informed consent of patients and their families with randomized surgical methods and difficulty in achieving double-blinding of the wound type after surgery, it is difficult to randomize surgical methods.…”

Section: Discussionmentioning

confidence: 99%

Application of robotic surgery and traditional laparoscopic surgery in lymph node dissection for gynecological cancer: A meta‑analysis

Chen

Wei

et al. 2023

Oncol Lett

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Since the advantages of robotic surgery and laparoscopic surgery in the number of lymph node resections are not well understood, this meta-analysis used evidence-based medicine to assess the difference in the number of lymph nodes retrieved in gynecological cancer between the two surgical methods to guide clinical treatment. In the present meta-analysis, the Pubmed, Embase, Cochrane, China National Knowledge Infrastructure and Wanfang libraries were searched for articles that were published from the time of the database's inception to January 2021, including cohort studies and randomized controlled trials, where the observation group underwent robotic surgery to treat gynecological cancers and the control group underwent laparoscopic surgery to treat gynecological cancers, including cervical and ovarian cancers and endometrial cancers. Duplicate publications, studies with no full text, incomplete information or where the authors were unable to perform data extraction, animal experiments, reviews and systematic reviews were excluded. STATA 15.1 was used to analyze the data. Robotic surgery resulted in a significant increase in the number of lymph nodes retrieved from the pelvis [standard mean difference (SMD)=0.24; 95% CI, 0.04-0.45; P=0.007] and para-aortic (SMD=0.41; 95% CI, 0.13-0.69; P=0.004) regions compared with the number retrieved by laparoscopic surgery. Furthermore, there was no significant difference in operating time between robotic and laparoscopic surgery, despite the use of different instruments (SMD=0.12; 95% CI, -0.35-0.58; P=0.616). The amount of blood lost during robotic surgery was significantly less compared with that lost during laparoscopic surgery [SMD=-0.40; 95% CI, -0.58-(-0.22); P<0.001]. The present study evaluated cancer recurrence and death in further detail, and no statistically significant difference was demonstrated between robotic surgery and laparoscopic surgery in terms of recurrence rate [odds ratio (OR)=0.59; 95% CI, 0.21-1.65; P=0.318] and mortality rate (OR=0.31; 95% CI, 0.08-1.30; P=0.109). The present study demonstrated that robotic surgery was able to retrieve more pelvic and para-aortic lymph nodes than traditional laparoscopic surgery, which was consistent with previous reports. With regards to blood loss, The difference in operation time between the two surgical methods was not statistically significant, whereas the estimated blood loss of robotic surgery was significantly lower than that of traditional laparoscopic surgery. There was no statistically significant difference in the recurrence rate and mortality rate of the two surgical modality.

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Prospect of Robot Assisted Maxilla-Mandibula-Complex Reposition in Orthognathic Surgery

Liu

Wang

et al. 2022

2022 IEEE International Conference on Robotics and Biomimetics (ROBIO)

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Placement of robotic single-site surgery with the tumor-free technique for early cervical cancer using the da Vinci Xi platform

Cited by 3 publications

References 5 publications

Efficacy and safety of robotic radical hysterectomy in cervical cancer compared with laparoscopic radical hysterectomy: a meta-analysis

Efficacy and safety of robotic radical hysterectomy in cervical cancer compared with laparoscopic radical hysterectomy: a meta-analysis

Application of robotic surgery and traditional laparoscopic surgery in lymph node dissection for gynecological cancer: A meta‑analysis

Prospect of Robot Assisted Maxilla-Mandibula-Complex Reposition in Orthognathic Surgery

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