Robotic gastrointestinal surgery

Felder, Seth; Ramanathan, R. K.; Russo, Ashley; Jiménez-Rodríguez, Rosa M; Hogg, Melissa E.; Zureikat, Amer H.; Strong, Vivian E.; Zeh, Herbert J.; Weiser, Martin R.

doi:10.1067/j.cpsurg.2018.07.001

Cited by 19 publications

(9 citation statements)

References 217 publications

(229 reference statements)

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“…The perceived additional cost associated with robotic surgery is a common argument against adopting the technology. Although the robot itself, the consumables and maintenance are a considerable financial investment, there are numerous examples, where robotic surgery has proven to be cost effective in high volume centres [58, 59] or even cost saving [60, 61], be it within certain, realistic, anticipated complication levels. Although the financial comparison between LAG and OG has not been formally assessed (although expected as part of the LOGICA trial), the cost of RAG was compared to LAG in a multicentre prospective match cohort study and found to be around $5000 higher ($13432 vs $8090) [17].…”

Section: Long-term Outcomesmentioning

confidence: 99%

Robotic-assisted gastrectomy for gastric cancer: a European perspective

2019

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Gastrectomy is the mainstay treatment for gastric cancer. To reduce the associated patient burden, minimally invasive gastrectomy was introduced in almost 30 years ago. The increase in the availability of surgical robotic systems led to the first robotic-assisted gastrectomy to be performed in 2002 in Japan. Robotic gastrectomy however, particularly in Europe, has not yet gained significant traction. Most reports to date are from Asia, predominantly containing observational studies. These cohorts are commonly different in the tumour stage, location (particularly with regards to gastroesophageal junctional tumours) and patient BMI compared to those encountered in Europe. To date, no randomised clinical trials have been performed comparing robotic gastrectomy to either laparoscopic or open equivalent. Cohort studies show that robotic gastrectomy is equal oncological outcomes in terms of survival and lymph node yield. Operative times in the robotic group are consistently longer compared to laparoscopic or open gastrectomy, although evidence is emerging that resectional surgical time is equal. The only reproducibly significant difference in favour of robot-assisted gastrectomy is a reduction in intraoperative blood loss and some studies show a reduction in the risk of pancreatic fistula formation.

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Section: Long-term Outcomesmentioning

confidence: 99%

Robotic-assisted gastrectomy for gastric cancer: a European perspective

2019

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“…MIS is most often technically complex and adverse surgical events remain a major issue as they are associated with morbidity and mortality, impaired recovery, prolonged hospital stay, reduced quality of life and increased costs [ 39 , 40 ]. The interface between surgeon and patient, that is always present in MIS, facilitates the possible application of supporting surgical algorithms in the future.…”

Section: Discussionmentioning

confidence: 99%

Computer-aided anatomy recognition in intrathoracic and -abdominal surgery: a systematic review

et al. 2022

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Background Minimally invasive surgery is complex and associated with substantial learning curves. Computer-aided anatomy recognition, such as artificial intelligence-based algorithms, may improve anatomical orientation, prevent tissue injury, and improve learning curves. The study objective was to provide a comprehensive overview of current literature on the accuracy of anatomy recognition algorithms in intrathoracic and -abdominal surgery. Methods This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Pubmed, Embase, and IEEE Xplore were searched for original studies up until January 2022 on computer-aided anatomy recognition, without requiring intraoperative imaging or calibration equipment. Extracted features included surgical procedure, study population and design, algorithm type, pre-training methods, pre- and post-processing methods, data augmentation, anatomy annotation, training data, testing data, model validation strategy, goal of the algorithm, target anatomical structure, accuracy, and inference time. Results After full-text screening, 23 out of 7124 articles were included. Included studies showed a wide diversity, with six possible recognition tasks in 15 different surgical procedures, and 14 different accuracy measures used. Risk of bias in the included studies was high, especially regarding patient selection and annotation of the reference standard. Dice and intersection over union (IoU) scores of the algorithms ranged from 0.50 to 0.98 and from 74 to 98%, respectively, for various anatomy recognition tasks. High-accuracy algorithms were typically trained using larger datasets annotated by expert surgeons and focused on less-complex anatomy. Some of the high-accuracy algorithms were developed using pre-training and data augmentation. Conclusions The accuracy of included anatomy recognition algorithms varied substantially, ranging from moderate to good. Solid comparison between algorithms was complicated by the wide variety of applied methodology, target anatomical structures, and reported accuracy measures. Computer-aided intraoperative anatomy recognition is an upcoming research discipline, but still at its infancy. Larger datasets and methodological guidelines are required to improve accuracy and clinical applicability in future research. Trial registration: PROSPERO registration number: CRD42021264226

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“…However, in this case, the final product was further purified via column chromatography (neutral Al 2 O 3 , dicloromethane). All the structures of the chemical compounds were verified by 1 H-NMR and 13 C-NMR (Bruker 400 MHz spectrometer at 300 K, Figure S6-S9, Supporting Information). To prepare the doped samples, the appropriate amount of bifunctional SP monomer was dissolved in 1.2 mL of DCM in a glass vial together with the prepolymer (PDMS or Dragonskin20), and stirred vigorously for 1 h. All the weight fractions (prepolymer/curing agent weight ratio 2.5:1, 5:1, 10:1, 15:1, 1:1) were designed in order to replicate sample with SP weight percentages of 1.0%, 1.5%, 2.0%, 4.0%, and 5.0%.…”

Section: Methodsmentioning

confidence: 99%

“…Additional arms mount exchangeable surgical tools. [ 13 ] To augment the safety and the functionality of conventional laparoscopic tools, there is a need for efficient interfaces, sensory feedback strategies, adaptable design, and novel computational approaches. [ 14–16 ] Surgical graspers provide a remarkable example: their rigid jaws, because of the miniature scale imposed by laparoscopic insertion ports (usually 5–15 mm in diameter), induce high stress concentration on the grasped tissue closer to their edges, [ 17,18 ] with high potential for tissue damage.…”

Section: Introductionmentioning

confidence: 99%

Toward Mechanochromic Soft Material‐Based Visual Feedback for Electronics‐Free Surgical Effectors

et al. 2021

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A chromogenically reversible, mechanochromic pressure sensor is integrated into a mininvasive surgical grasper compatible with the da Vinci robotic surgical system. The sensorized effector, also featuring two soft‐material jaws, encompasses a mechanochromic polymeric inset doped with functionalized spiropyran (SP) molecule, designed to activate mechanochromism at a chosen pressure and providing a reversible color change. Considering such tools are systematically in the visual field of the operator during surgery, color change of the mechanochromic effector can help avoid tissue damage. No electronics is required to control the devised visual feedback. SP‐doping of polydimethylsiloxane (2.5:1 prepolymer/curing agent weight ratio) permits to modulate the mechanochromic activation pressure, with lower values around 1.17 MPa for a 2% wt. SP concentration, leading to a shorter chromogenic recovery time of 150 s at room temperature (25 °C) under green light illumination. Nearly three‐times shorter recovery time is observed at body temperature (37 °C). To the best of knowledge, this study provides the first demonstration of mechanochromic materials in surgery, in particular to sensorize unpowered surgical effectors, by avoiding dramatic increases in tool complexity due to additional electronics, thus fostering their application. The proposed sensing strategy can be extended to further tools and scopes.

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Robotic gastrointestinal surgery

Cited by 19 publications

References 217 publications

Robotic-assisted gastrectomy for gastric cancer: a European perspective

Robotic-assisted gastrectomy for gastric cancer: a European perspective

Computer-aided anatomy recognition in intrathoracic and -abdominal surgery: a systematic review

Toward Mechanochromic Soft Material‐Based Visual Feedback for Electronics‐Free Surgical Effectors

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