Robotic transanal minimally invasive surgery (TAMIS) with the newest robotic surgical platform: a multi-institutional North American experience

Liu, Shanglei; Suzuki, Toshiaki; Murray, Bryce W.; Parry, Lisa; Johnson, Craig S.; Horgan, Santiago; Ramamoorthy, Sonia; Eisenstein, Samuel

doi:10.1007/s00464-018-6329-3

Cited by 38 publications

(57 citation statements)

References 22 publications

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“…A recent observational study has identified that in the United Kingdom a smaller proportion of patients with acute cholecystitis (of any age group) receive emergency cholecystectomy on their index admission compared to the United States (Rate of emergency cholecystectomy in UK 15.7 vs. 52.7% in USA) [ 26 ]. Previous studies from the United Kingdom have recommended that elderly patients with acute cholecystitis should be managed conservatively due to the potentially significant risk of post-operative morbidity in these patients, and interval cholecystectomy be reserved for those with recurrent episodes of cholecystitis [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study

et al. 2018

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BackgroundAcute cholecystitis is a life-threatening emergency in elderly patients. This population-based cohort study aimed to evaluate the commonly used management strategies for elderly patients with acute cholecystitis as well as resulting mortality and re-admission rates.MethodsData from all consecutive elderly patients (≥ 80 years) admitted with acute cholecystitis in England from 1997 to 2012 were captured from the Hospital Episode Statistics database. Influence of management strategies upon mortality was analyzed with adjustment for patient demographics and treatment year.Results47,500 elderly patients were admitted as an emergency with acute cholecystitis. On the index emergency admission the majority of patients (n = 42,620, 89.7%) received conservative treatment, 3539 (7.5%) had cholecystectomy, and 1341 (2.8%) underwent cholecystostomy. In the short term, 30-day mortality was increased in the emergency cholecystectomy group (11.6%) compared to those managed conservatively (9.9%) (p < 0.001). This was offset by the long-term benefits of cholecystectomy with a reduced 1-year mortality [20.8 vs. 27.1% for those managed conservatively (p < 0.001)]. Management with percutaneous cholecystostomy had increased 30-day and 1-year mortality (13.4 and 35.0%, respectively). The annual proportion of cholecystectomies performed laparoscopically increased from 27% in 2006 to 59% in 2012. Within the cholecystectomy group, laparoscopic approach was an independent predictor of reduced 30-day mortality (OR 0.16, 95% CI 0.10–0.25). Following conservative management, there were 16,088 admissions with further cholecystitis. Only 11% of patients initially managed conservatively or with cholecystostomy received subsequent cholecystectomy.ConclusionAcute cholecystitis is associated with significant mortality in elderly patients. Potential benefits of emergency cholecystectomy in selected elderly patients include reduced rate of readmissions and 1-year mortality. Laparoscopic approach for emergency cholecystectomy was associated with an 84% relative risk reduction in 30-day mortality compared to open surgery.Electronic supplementary materialThe online version of this article (10.1007/s00464-018-6092-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study

et al. 2018

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“…Since 2012, several studies reporting the outcomes of R-TAMIS were published, but they included many case reports and small series of patients [2,[35][36][37][38][39][40][41] . The largest series was published by Tommasi et al [40] in 2019 and included overall 58 patients.…”

Section: Robotic Transanal Surgerymentioning

confidence: 99%

“…Some useful data are also provided by the second largest series found about R-TAMIS, published by Liu et al [36] in 2018 and including 34 patients. All cases reported were performed using a Da Vinci Xi technology and a GelPOINT platform.…”

Section: Robotic Transanal Surgerymentioning

confidence: 99%

Robotic transanal surgery: perspectives for application

Genova¹,

Méméo²,

Brunetti³

2020

MIS

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Transanal minimally invasive surgery (TAMIS) is a surgical technique which allows the local excision of rectal benign tumors and early stage cancers measuring up to 4 cm and lying within 6-8 cm from the anal verge. It is performed by means of a disposable transanal platform and conventional laparoscopic instruments, proving to be effective and easily available. Hence, TAMIS soon became a valid alternative to other transanal resective procedures, especially transanal endoscopic microsurgery, and rapidly spread. Moreover, soon after its introduction, TAMIS started to be performed also using robotic technologies, but no clear advantages were found to date. This review is intended to provide a general overview on TAMIS, with a special focus on its association with robotic systems and the perspectives of this approach.

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“…We believe that, at any rate, the significance of the transanal approach will endure, particularly in cases with difficulty via the transabdominal approach, whether open, laparoscopic, or robotic 54) . Recently, transanal use of robotic platforms has been reported to reduce the limitations of the ergonomics of single-port surgery [61][62][63][64] . Furthermore, with the advent of robotic platforms designed for single-port surgery, robotic transanal surgery has been expected to overcome the limitations of single-port surgery 61,62,64) .…”

Section: Future Prospectsmentioning

confidence: 99%

Transanal TME: new standard or fad?

Hasegawa

Yoshida

Morimoto

et al. 2019

J Anus Rectum Colon

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Transanal total mesorectal excision (taTME) has been developed to overcome the difficulty of laparoscopic dissection and transection in the deep pelvis. TaTME has several clinical benefits over laparoscopic surgery, such as better exposure of the distal rectum and direct determination of distal resection margin. Although evidence demonstrating the true benefits of taTME over laparoscopic TME (LapTME) is still insufficient, accumulating data have revealed that, as compared with LapTME, taTME is associated with shorter operative time and a lower conversion rate without jeopardizing other short-term outcomes. However, taTME is a technically demanding procedure with specific complications such as urethral injury, and so sufficient experience of LapTME and step-by-step acquisition of the skills needed for this procedure are requisite. The role of transanal endoscopic surgery is expected to change, along with the recent progress in the treatment of rectal cancer, such as robotic surgery and the watch-and-wait strategy. Optimization of treatment will be needed in the future in terms not only of oncological but also of functional outcomes.

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Robotic transanal minimally invasive surgery (TAMIS) with the newest robotic surgical platform: a multi-institutional North American experience

Abstract: With increased reach and operative range of motion, Robotic TAMIS is a safe and effective method for excising low-risk rectal neoplasia with a wide range of anatomical measurements. Higher BMI is a significant predictor of a longer and likely more challenging operation.

Cited by 38 publications

References 22 publications

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study

Evolution in the management of acute cholecystitis in the elderly: population-based cohort study

Robotic transanal surgery: perspectives for application

Transanal TME: new standard or fad?

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