Potential Applications of the da Vinci Minimally Invasive Surgical Robotic System in Otolaryngology

McLeod, Ian K.; Mair, Eric A.; Melder, Patrick C.

doi:10.1177/014556130508400810

Cited by 64 publications

(43 citation statements)

References 21 publications

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“…Robotic technique is now an alternative for handsewn GJ creation [2,3,9,10,12] that oVers several advantages to the bariatric surgeon. The most important advantage is that the added degrees of freedom of the needle driver allow for precise, ambidextrous forehand and backhand suture placement [17]. The angles encountered in the creation of the laparoscopic GJ are sometimes awkward and can make the anastomosis technique challenging.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass

Snyder¹,

Wilson²,

Scarborough³

et al. 2008

J Robotic Surg

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Robotic-assisted surgery has been described for many general surgery procedures, including gastric bypass. This is a comparative study looking at the short-term outcomes and technical differences between laparoscopic Roux-en-Y gastric bypass (LRNY) and robotic-assisted Roux-en-Y gastric bypass (RARNY). Our database was reviewed for all Roux-en-Y gastric bypass procedures performed over the last 5 years. Operative times, length of stay, and all complications listed for the 90 days postoperatively were recorded and statistically analyzed. A total of 356 LRNY and 249 RARNY were performed. The average body mass index (BMI), age, and sex were similar between groups. On average, the RARNY took 17 min longer than the LRNY, this difference being significant (p < 0.01). Average length of stay for the two groups was similar (~3 days). There were a total of 51 complications in the standard laparoscopic group (14%), of which 14 (3.9%) were major complications. In the robotic group, there were 35 (14%) complications, of which 9 (3.6%) were major complications. The only significant difference in complication rate was for anastomotic leak at the gastrojejunostomy: there were no leaks in the robotic series, and six (1.7%) in the standard laparoscopic series (p = 0.04). Length of stay and overall complication rates were similar for RARNY and LRNY. There was no mortality in either group, and the complication rate was lower than literature standards. While the RARNY took longer, there was a significantly lower gastrointestinal leak rate in this group.

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Section: Discussionmentioning

confidence: 99%

“…Robotic surgery is slow in coming to the forefront of surgical therapy; nonetheless, it is Wnding its place in urology [6,8,14,23], gynecology [22], microsurgery [18,19], oral surgery [17], and general surgery [1, [4][5][6][7]11]. In addition, it is becoming more common in bariatric surgery [2,3,9,10,12].…”

Section: Introductionmentioning

confidence: 99%

Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass

Snyder¹,

Wilson²,

Scarborough³

et al. 2008

J Robotic Surg

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“…19,20 Moreover application of the Da Vinci system in otolaryngology has been reported in animal models and quite recently in human. 8,21,22 Meanwhile, several studies have shown the feasibility and safety of robot-assisted antireflux surgery both in adult patients and children. 5,6,[23][24][25][26][27] Only three prospective randomized studies (randomized controlled trials [RCT]) have compared robot-assisted with standard laparoscopic fundoplication so far (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Gastroesophageal Reflux Disease and Upside-down Stomach Using the Da Vinci® Robotic System. A Prospective Study

Hartmann¹,

Jacobi²,

Menenakos³

et al. 2008

Journal of Gastrointestinal Surgery

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So far, the impact of telematic surgical approach in Gastroesophageal Reflux Disease (GERD) is still obscure. In this prospective study, we analyzed the Da Vinci Intuitive Surgical robotic system for antireflux surgery. In April 2003, we set up a pilot study to evaluate the efficacy of laparoscopic telerobotic surgery using the three-arm Da Vinci system. Optimal trocar positions, operating and setup times, conversion rate, intraoperative complications, and perioperative morbidity, as well as mortality rate, were analyzed. The median age was 53 years (range 25-74) in 118 patients (52 female/66 male). In 17 patients, an upside-down stomach- and in 101 GERD was surgical indication. The median operating time has been reduced from 105 min to 91 min after 40 procedures and setup time from 24.5 min to 10.4 min after 10 procedures. The system is safe and it seems to be superior to traditional laparoscopy during dissection in the esophageal hiatus region. This compensates long setup- and operating times. Disadvantages are the high costs, the time to master the setup/system and the necessity of exact trocar positioning.

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“…More than twenty studies on TORS in animals, cadavers, human subjects and various head and neck cancer sites have been published since 2005 [1][2][3][4]. A Pubmed search revealed several prospective studies based on series of at least 20 patients in the United States [5][6][7][8][9][10][11][12][13] and Australia [14] but only one European series [15] has been published in the literature.…”

Section: Introductionmentioning

confidence: 99%

Transoral robotic surgery for head and neck carcinomas

Hans

Badoual

Gorphe

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study was prospectively to assess the feasibility and safety of transoral robotic surgery (TORS) in head and neck carcinomas and to report our learning curve and 2-year outcomes. Patients with oropharyngeal, hypopharyngeal and laryngeal tumors treated with TORS were prospectively included. We evaluated: the feasibility of TORS, robotic set-up time, transoral robotic surgery time, blood loss, surgical margins, tracheotomy, feeding tube, time to oral feeding and surgery-related complications. Twenty-three patients were treated for 25 carcinomas. Twenty-two patients underwent successful robotic resection for 24 carcinomas (96%). One patient required conversion to open surgery due to massive bleeding. The mean robotic set-up time was 25 min (range: 15-100 min) and mean TORS operating time was 70 min (range: 20-150 min). Positive margin of resection was observed in one patient (classified pT3) out of the 24 cancers and was managed by postoperative chemoradiation. No tracheotomy was performed. Three patients required prolonged intubation for a mean of 22 h. Two patients required a temporary gastrostomy (for 2 and 3.5 months, respectively). All other patients resumed oral feeding between the first and third postoperative day. The mean hospital stay was 6.4 days (range: 4-19 days). No postoperative complication occurred. Mean follow-up was 20 months (median: 19, range: 14-26). No death and no case of local or metastatic failure were observed. TORS is feasible and safe for the resection of selected head and neck carcinomas. The occurrence of intraoperative bleeding emphasizes the need for surgeons to be skilled in both transoral and open approaches.

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Potential Applications of the da Vinci Minimally Invasive Surgical Robotic System in Otolaryngology

Cited by 64 publications

References 21 publications

Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass

Lowering gastrointestinal leak rates: a comparative analysis of robotic and laparoscopic gastric bypass

Surgical Treatment of Gastroesophageal Reflux Disease and Upside-down Stomach Using the Da Vinci® Robotic System. A Prospective Study

Transoral robotic surgery for head and neck carcinomas

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