Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the open approach

Kirks, Russell C.; Lorimer, Patrick D.; Fruscione, Mike; Cochran, Allyson; Baker, E.; Iannitti, David A.; Vrochides, Dionisios; Martinie, John B.

doi:10.1002/rcs.1832

Cited by 11 publications

(8 citation statements)

References 30 publications

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“…Robotic surgery has become increasingly popular for abdominal surgery in recent years due to its potential for improved outcomes and decreased costs. [10][11][12] However, studies have shown that the additional costs associated with robotic instrumentation may not be offset by reduced complications or shorter hospital stays. [13][14][15][16] Additionally, the cost of robotic instruments must be taken into consideration when evaluating its use in clinical practice as they can only be used 10 times before they must be discarded.…”

Section: Robotics In Abdominal Surgerymentioning

confidence: 99%

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Robotic Surgery and Hospital Reimbursement

et al. 2023

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The field of plastic surgery remains at the forefront of technological and surgical innovation. However, the promising applications of robotics in plastic surgery must be thoughtfully balanced with hospital finances and reimbursements. Robotic systems have been studied extensively across multiple surgical disciplines and across diverse health care systems. The results show that there may be equal or better patient outcomes than alternatives. In an era where fiscal responsibility in health care is a top priority, thoughtful budgeting and spending must be considered and revisited frequently to attain sustainable organizational models that ensure appropriate use of robotic technology.

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Section: Robotics In Abdominal Surgerymentioning

confidence: 99%

“…Therefore, it is important that hospitals consider all aspects when deciding whether or not to invest in robotics technology including patient safety outcomes versus financial implications before making any decisions about implementing new technologies into their practices. 12,[16][17][18]…”

Section: Robotics In Abdominal Surgerymentioning

confidence: 99%

Robotic Surgery and Hospital Reimbursement

et al. 2023

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“…8,12 We then began to expand the indication for robotics to include operations for chronic pancreatitis such as lateral pancreaticojejunostomy and pancreatic necrosectomy with cystgastrostomy. [13][14][15] The procedure for drainage of pancreatic fluid collections evolved to include robotic cyst-jejunostomy and transmesenteric pancreatic debridement for pancreatic necrosis that may not be accessible through the stomach. We later incorporated a technique for internal drainage of persistent pancreatic fistulae by performing robotic fistula-jejunostomy after a fibrous tract had been matured.…”

Section: Our Initial E Xperien Ce Building a Roboti C Hpb Prog R Ammentioning

confidence: 99%

“…After gaining experience with robotic left pancreatectomy, we were able to report outcomes comparable to laparoscopic left pancreatectomy 8,12 . We then began to expand the indication for robotics to include operations for chronic pancreatitis such as lateral pancreaticojejunostomy and pancreatic necrosectomy with cyst‐gastrostomy 13–15 . The procedure for drainage of pancreatic fluid collections evolved to include robotic cyst‐jejunostomy and transmesenteric pancreatic debridement for pancreatic necrosis that may not be accessible through the stomach.…”

Section: Our Initial Experience Building a Robotic Hpb Programmentioning

confidence: 99%

Current progress in robotic hepatobiliary and pancreatic surgery at a high‐volume center

McCarron,

Vrochides,

Martinie

2023

Annals of Gastroent Surgery

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There has been steady growth in the adoption of robotic HPB procedures world‐wide over the past 20 years, but most of this increase has occurred only recently. Not surprisingly, the vast majority of robotics has been in the United States, with very few, select centers of adoption in Italy, South Korea, and Brazil, to name a few. We began our robotic HPB program in 2008, well before almost all other centers in the world, with the most notable exception of Giullianotti and colleagues. Our program began gradually, with smaller cases carefully selected to optimize the strengths of the original robotic platform and included complex biliary and pancreatic resections. We performed the first reported series of choledochojejunostomy for benign biliary strictures and first series of completion cholecystectomies. We began performing robotic distal pancreatectomies and longitudinal pancreaticojejunostomies, reporting our early experience for each of these procedures. Over time we progressed to robotic pancreaticoduodenectomies. Initially, these were performed with planned conversions until we were able to optimize efficiency. Now we have performed over 200 robotic whipples, reaching a 100% robotic completion rate by 2020. Finally, we have added robotic major hepatectomies, including resections for hilar cholangiocarcinoma to our repertoire. Since the program began, we have performed over 1600 robotic HPB cases. Outcomes from our program have shown superior lymph node harvest, lower DGE rates, shorter hospitalizations, and fewer rehab admissions with similar overall complications to open and laparoscopic procedures, signifying that over time a robotic HPB program is not only feasible but advantageous as well.

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“…Currently, robotic surgery is performed in different surgical specialties including gynecological 1 , pancreatic 2 , bariatric 3 , colon surgery 4 , etc. Essentially, robots can replicate the movements of a surgeon with high precision, reducing any type of errors.…”

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confidence: 99%

Advanced Robotic Technology Is the Future of Surgery

Sebastian¹

2017

RFMH

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EDITORIALCurrently, we live in a new era of minimally invasive surgery. Operations are more like video games than traditional open surgeries. The old-fashioned expression that "a good surgery requires a large incision" has been completely abandoned in countries where medical technology and research are well structured. Within the modern minimally invasive surgeries over the last 30 years, laparoscopic surgery is the most well established and recognized approach. However, with development of advanced technologies and intense research, robotic surgery has emerged in the last decade as an attractive alternative to laparoscopic surgery.Nowadays, robotic technology plays an important role in our daily life beginning with its use in industries until its adaptation for the medical field. The history of robots begins in science fiction books and movies, where sometimes the robots were seen as an independent and even with some complicities with humans, as in the movie of George Lucas, "Star Wars" where robots were friends with humans, but in other cases with conflict, as in movie "Terminator" that robots were enemies against the human race. Furthermore, in today's industry there are many applications of robots. On the other hand, in medicine, this technology has been introduced successfully even though it is still difficult to think that a robot can perform surgery independently without human monitoring.Robotic technology in surgery initially was introduced in areas where a high level of precision and fine movements are required such as in Neurosurgery or when repeated actions are needed as in Urology. Currently, robotic surgery is performed in different surgical specialties including gynecological 1 , pancreatic 2 , bariatric 3 , colon surgery 4 , etc. Essentially, robots can replicate the movements of a surgeon with high precision, reducing any type of errors. Robotic surgery has many advantages over the wellestablished laparoscopic surgery. One of the major disadvantages of laparoscopic surgery includes the mismatch between the vision space and instruments, vision is usually 2D in laparoscopic surgery causing the surgeon to lose the prospect of depth, as well as the limitation of rotational movements and imperfect coordination of the eye and hand since the camera is controlled by an assistant.However, in robotic surgery, these limitations have been exceeded. First, there is a 3D high resolution visualization. Second, hand movements are coordinated perfectly by the camera; essentially, visual fields follow simultaneously to the hand movements without need of an assistant to manipulate the camera as in laparoscopic surgery. Third, robots reduce the tremor of the human hand, improving precision and operational dexterity and with new endo-wrist technology, surgeons using the robot can suture with more rotational degrees. Finally, haptic feedback which is touch feedback (kinesthetic (force) and cutaneous (tactile) feedback) has improved significantly with new technology systems with multimodal haptic feedback programs 5 .

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Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the open approach

Cited by 11 publications

References 30 publications

Robotic Surgery and Hospital Reimbursement

Robotic Surgery and Hospital Reimbursement

Current progress in robotic hepatobiliary and pancreatic surgery at a high‐volume center

Advanced Robotic Technology Is the Future of Surgery

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