Robotic Surgery and Functional Esophageal Disorders: A Systematic Review and Meta-Analysis

D’Amore, Anna; Manigrasso, Michele; Anoldo, Pietro; Chini, Alessia; Maione, Francesco; Pesce, Marcella; Sarnelli, Giovanni; Palma, Giovanni Domenico De; Vertaldi, Sara

doi:10.3390/jpm13020231

Cited by 3 publications

(2 citation statements)

References 37 publications

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“…Robotic fundoplication is considered feasible and safe, based on currently available literature [ 32 , 33 ], and robotic fundoplication is now fully embedded in our hospital. In the future we aim to utilise standardised learning pathways, such as the proctored pathway presented here, and implement them in larger training programs.…”

Section: Discussionmentioning

confidence: 99%

Proctored adoption of robotic hiatus hernia surgery: outcomes and learning curves in a high-volume UK centre

et al. 2023

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Background The adoption of new surgical technologies is inevitably accompanied by a learning curve. With the increasing adoption of robotic techniques in benign foregut surgery, it is imperative to define optimal learning pathways, to ensure a clinically safe introduction of such a technique. The aim of this study was to assess the learning curve for robotic hiatal hernia repair with a pre-defined adoption process and proctoring. Methods The learning curve was assessed in four surgeons in a high-volume tertiary referral centre, performing over a 100 hiatal hernia repairs annually. The robotic adoption process included simulation-based training and a multi-day wet lab-based course, followed by robotic operations proctored by robotic upper GI experts. CUSUM analysis was performed to assess changes in operating time in sequential cases. Results Each surgeon (A, B, C and D) performed between 22 and 32 cases, including a total of 109 patients. Overall, 40 cases were identified as ‘complex’ (36.7%), including 16 revisional cases (16/109, 14.7%). With CUSUM analysis inflection points for operating time were seen after 7 (surgeon B) to 15 cases (surgeon B). Conclusion The learning curve for robotic laparoscopic fundoplication may be as little as 7–15 cases in the setting of a clearly organized learning pathway with proctoring. By integrating these organized learning pathways learning curves may be shortened, ensuring patient safety, preventing detrimental outcomes due to longer learning curves, and accelerating adoption and integration of novel surgical techniques.

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Section: Discussionmentioning

confidence: 99%

Proctored adoption of robotic hiatus hernia surgery: outcomes and learning curves in a high-volume UK centre

et al. 2023

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“…If the results of robotic surgery, in oncological terms, are encouraging, the same can be said for gastrointestinal functional disorders. Even if, on the one hand, robotic surgery proved to be non-inferior to laparoscopic surgery in the treatment of functional esophageal disorders [ 3 ], on the other hand, it showed better postoperative outcomes in the treatment of pelvic floor disorders, such as lower complication rates and shorter lengths of hospital stay [ 4 ].…”

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confidence: 99%

Robotic Gastrointestinal Surgery: State of the Art and Future Perspectives

Milone

Bianchi

2023

JPM

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Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results

May-Miller,

Markar,

Blencowe

et al. 2024

annals

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Introduction The uptake of upper gastrointestinal (GI) robotic surgery in the United Kingdom (UK), and Europe more widely, is expanding rapidly. This study aims to present a current snapshot of the practice and opinions of the upper GI community with reference to robotic surgery, with an emphasis on tertiary cancer (oesophagogastric) resection centres. Methods An electronic survey was circulated to the UK upper GI surgical community via national mailing lists, social media and at an open-invitation conference on robotic upper GI surgery in January 2023. The survey included questions on surgeons' current practice or planned adoption (if any) of robotics at individual and unit level, and their opinions on robotic upper GI surgery in general. Priority ranking and Likert-scale response options were used. Results In total, 81 respondents from 43 hospitals were included. Thirty-four resectional centres responded, including 30 of 31 (97%) recognised upper GI cancer centres in England. Respondents reported performing robotic surgery in 21 of 34 (61.8%) resectional centres, with a median of 65 procedures per centre performed at the time of the survey (range 0–500, interquartile range 93.75). Every centre without a robotic programme expressed a desire or had active plans to implement one. Respondents ranked surgeon ergonomics as the most important reason for pursuing robotics, followed by improvements in patient outcomes and oncological efficacy. Conclusions Robotic upper GI practice is nascent but rapidly growing in the UK with plans for uptake in almost all tertiary centres. There is growing opinion that this is likely to become the predominant surgical approach in future with benefits to both patients and surgeons. This snapshot offers a point of reference to all stakeholders in upper GI surgery.

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Robotic Surgery and Functional Esophageal Disorders: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 37 publications

Proctored adoption of robotic hiatus hernia surgery: outcomes and learning curves in a high-volume UK centre

Proctored adoption of robotic hiatus hernia surgery: outcomes and learning curves in a high-volume UK centre

Robotic Gastrointestinal Surgery: State of the Art and Future Perspectives

Opinion, uptake and current practice of robot-assisted upper gastrointestinal and oesophagogastric surgery in the UK: AUGIS national survey results

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