Robot-assisted laparoscopic surgery of the colon and rectum

Antoniou, Stavros A.; Antoniou, George Α.; Koch, Oliver; Pointner, Rudolph; Granderath, Frank A.

doi:10.1007/s00464-011-1867-y

Cited by 125 publications

(75 citation statements)

References 65 publications

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“…Baik et al and Tayfun et al reported nil conversion rates for robotic low anterior resection. Stavioros A and Sami Al Asari reported 0.4 and 6 % conversion rates [9,[15][16][17]. Fig.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

Somashekhar

Ashwin²,

Rajashekhar

et al. 2013

Indian J Surg

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Rectal cancer is one of the common cancers in India. Surgical management is the mainstay of initial treatment for majority of patients. Minimally invasive surgery has gained acceptance for the surgical treatment of rectal cancer because, compared with laparotomy, it is associated with fewer complications, shorter hospitalization, and faster recovery. The aim of this study is to evaluate the safety, feasibility, technique, and outcomes (postoperative, oncological, and functional) of robotic-assisted rectal surgery in comparison with open surgery in the Indian population. A prospective randomized study was undertaken from August 2011 to December 2012. Fifty patients who presented with rectal carcinoma were randomized to either robotic arm (RA) or open arm (OA) group. Both groups were matched for clinical stage and operation type. Technique and feasibility of roboticassisted surgery in terms of operating time, estimated blood loss, margins status, total number of lymph nodes retrieved, hospital stay, conversion to open procedure, complications, and functional outcomes were analyzed. The mean operative time was significantly longer in the RA than in the OA group (310 vs 246 min, P <0.001) but was significantly reduced in the latter part of the robotic-assisted patients compared with the initial patients. The mean estimated blood loss was significantly less in the RA compared with the OA group (165.14 vs 406.04 ml, P <0.001). None of the patients had margin positivity. The mean distal resection margin was significantly longer in the RA than in the OA group (3.6 vs 2.4 cm, P < 0.001). A total of 100 % of patients in the RA group had complete mesorectal excision while two patients in the OA group had incomplete mesorectal excision. The average number of retrieved lymph nodes was adequate for accurate staging. The number of lymph nodes removed by robotic method is slightly higher than the open method (16.88 vs 15.20) but with no statistical significance. Conversion rate was nil. The mean hospital stay was significantly shorter in the RA group (7.52 vs 13.24 days, P <0.001). Postoperative and functional outcomes were comparable between the two groups. Roboticassisted surgery is an emerging technique in our country. Robotic-assisted rectal cancer surgery is safe with low conversion rates and acceptable morbidity and is oncologically feasible.

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“…Baik et al and Tayfun et al reported nil conversion rates for robotic low anterior resection. Stavioros A and Sami Al Asari reported 0.4 and 6 % conversion rates [9,[15][16][17]. Fig.…”

Section: Discussionmentioning

confidence: 99%

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

Somashekhar

Ashwin²,

Rajashekhar

et al. 2013

Indian J Surg

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“…The theory, promoted by Intuitive Surgical, that the increased precision and control RAS offers the surgeon will result in improved patient outcomes was reiterated in many papers. In robot-assisted colorectal surgery, rates of conversion to open surgery are generally found to be low, providing support for this theory [144][145][146] (although, with such studies being non-randomised and authored by RAS enthusiasts, this could be due to case selection). Another motivation was the ergonomic benefits that the robot is anticipated to offer to the surgeon.…”

Section: Issues Of Implementationmentioning

confidence: 99%

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/04. The contractual start date was in September 2013. The final report began editorial review in September 2016 and was accepted for publication in February 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department...

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“…All involved cases were successfully completed using the robotic platform, with no conversion to laparotomy. In an overall review of current literature on robotic colon resection, Antoniou et al 7 3,4 Our case series represents one of first case series reporting the feasibly of successfully performing minimally invasive colonic resection and reanastomosis through the robotic platform in 3 patients with ovarian remnant syndrome and 1 case with secondary cytoreductive surgery for ovarian carcinoma without conversion to open laparotomy. The mean blood loss was 162.5 mL, and the mean length of hospital stay was 6.5 days until having flatus and a bowel movement.…”

Section: Discussionmentioning

confidence: 92%

Robotic Colonic Resection and Reanastomosis in Gynecologic Surgery: Report of 4 Cases

Mahdi

Woessner

Gonzalez-Ramos

et al. 2015

CRSLS

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Introduction: Colonic resection in gynecologic surgery, most commonly in the field of gynecologic oncology, is traditionally performed through open laparotomy. Most cases are performed during cancer debulking in either primary or recurrent settings. Other less common indications include resection of ovarian remnants or endometriotic lesions densely adherent to the large bowel, commonly the rectosigmoid colon.

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Robot-assisted laparoscopic surgery of the colon and rectum

Abstract: Robotic applications in colorectal surgery are feasible with low conversion rates and favorable morbidity. Further studies are required to evaluate its oncologic and patient-oriented outcomes.

Cited by 125 publications

References 65 publications

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

Prospective Randomized Study Comparing Robotic-Assisted Surgery with Traditional Laparotomy for Rectal Cancer—Indian Study

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Robotic Colonic Resection and Reanastomosis in Gynecologic Surgery: Report of 4 Cases

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