Robotics in urologic oncology

Jain, Saurabh; Gautam, Gagan

doi:10.4103/0972-9941.147687

Cited by 21 publications

(11 citation statements)

References 44 publications

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“…One such example is the introduction and adoption of robotic surgery within the field of urology (16, 17). Robotic technology was initially met with heavy uncertainty due to several factors, such as exorbitant cost, high degree of technical training, required assistant personnel, and necessity of dedicated operating rooms with bulky equipment (18). Therefore, it was believed that use of robotics would be limited to high-level academic centers, yet now robotic technology and the field of urology are fully integrated with ubiquitous use even amongst small community hospitals…”

Section: Discussionmentioning

confidence: 99%

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance–targeted biopsy

Muthigi

Sidana

George

et al. 2017

Urologic Oncology: Seminars and Original Investigations

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Introduction and Objective Multiparametric MRI (mpMRI) and MR targeted biopsy have a growing role in the screening and evaluation of prostate cancer. We aim to evaluate the current knowledge, attitude, and practice patterns of urologists regarding this new technique. Methods An anonymous online questionnaire was designed to collect information on urologists’ beliefs and use of prostate mpMRI and MR targeted biopsy. The survey was sent to members of the Society of Urologic Oncology (SUO), the Endourological Society (ES), and European Association of Urology (EAU). Multivariate logistic regression analysis was performed to determine predictors for use of prostate MRI and MR targeted biopsy. Results A total of 302 responses were received [ES: 175, EAU: 23, SUO: 104]. The majority of respondents (83.6%) believe MR targeted biopsy to be moderately to extremely beneficial in the evaluation of prostate cancer. 85.7% of responders utilize prostate MR imaging in their practice, and 63.0% utilize MR targeted biopsy. The two most common settings for utilization of MR targeted biopsy include patients with history of prior negative biopsy (96.3%) and monitoring patients on active surveillance (72.5%). In those who do not utilize MR targeted biopsy, the principal reasons were lack of necessary infrastructure (64.1%) and prohibitive costs (48.1%). On multivariate logistic regression analysis, practice in an academic setting (1.86 [1.02–3.40], p = 0.043), and performing > 25 radical prostatectomies per year (2.32 [1.18–4.56], p = 0.015) remained independent predictors for utilizing MR targeted biopsy. Conclusions A majority of respondents to our survey look favorably upon use of prostate MRI and MR targeted biopsy in clinical practice. Over time, reduction in fixed costs and easier access to equipment may lead to further dissemination of this novel and potentially transformative technology.

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Section: Discussionmentioning

confidence: 99%

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance–targeted biopsy

Muthigi

Sidana

George

et al. 2017

Urologic Oncology: Seminars and Original Investigations

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“…[ 11 12 ] RARC was introduced more than a decade ago in India, but there is no significant data available comparing RARC with ORC till date. [ 13 14 ]…”

Section: Discussionmentioning

confidence: 99%

“…However, the randomised trial in Indian setting seems difficult to conduct owing to practice orientation, logistic and financial constraints. [ 13 14 ] The assessment of post-operative bladder functions is another important factor which needs further study. We, in this study, have also not evaluated the financial and psychological impact, which is a significant factor in these patients.…”

Section: Discussionmentioning

confidence: 99%

Is robot-assisted radical cystectomy superior to standard open radical cystectomy? An Indian perspective

et al. 2018

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Introduction:Open radical cystectomy (ORC) has been the standard treatment for muscle-invasive bladder cancer, but this is associated with significant morbidity and mortality. Robot-assisted radical cystectomy (RARC) has been proposed as minimally invasive alternative with improved morbidity and acceptable oncological outcomes, but a large series featuring RARC and their comparison with ORC is still lacking in India despite more than a decade of its inception. We have conducted this study with an objective to see the feasibility of RARC in the Indian context and compare it with contemporary standard.Methods:This is a prospective cohort study conducted at two tertiary cancer institutes. We have evaluated the patients pertaining to operative and early post-operative factors from January 2014 to December 2015. Necessary statistical tests applied to see comparability of the arms and their outcomes.Results:A total of 170 patients underwent surgery for carcinoma bladder (45 ORC while 125 RARC). Intraoperative blood loss (RARC and ORC: 228 and 529 ml) and average transfusion rate were lower with RARC. A trend towards benefit was noted in favour of robotic arm in terms of mean complication rate (RARC and ORC: 54 and 39%).Conclusions:The present study has shown comparable surgical and early post-operative outcomes with clear advantage of robotic approach in terms of intraoperative blood transfusion and lymph node yield. Although the study was non-randomised in nature, it should provide substantial evidence on safety and feasibility of RARC in the Indian context and a reference point of evidence to look ahead.

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“…[ 1 , 2 ] Current guidelines [ 3 – 5 ] recommend coronary artery bypass grafting (CABG) as the criterion standard therapy for LM disease. Although percutaneous coronary intervention (PCI) has been shown to be an effective alternative for treating LM disease, [ 6 – 9 ] there has been an increasing focus on minimally invasive endoscopic surgical techniques [ 10 – 14 ] owing to advantages such as minimal operation wound, shorter hospital stay, faster recovery, and similar or even better clinical outcomes with these techniques compared with traditional surgeries. Robot-assisted CABG (R-CABG) has been proven to be safe and efficient for treating valvular and congenital heart diseases, [ 15 – 18 ] as well as for revascularizing simple and complex CAD.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of left main coronary artery disease patients undergoing three different revascularization approaches

Chen

Shen

et al. 2018

Medicine

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Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013.Of the 472 LM disease patients, 139 received R-CABG, 147 received C-CABG, and 186 received PCI. The need for target vessel revascularization (TVR) was highest in the PCI group. The R-CABG group had significantly lower rates of in-hospital and follow-up all-cause deaths compared with the other 2 groups (1.4% vs. 3.4% and 9.7%, P = .0058; 13.7% vs. 29.3% and 29.6%, P = .0023, respectively). Patients in the R-CABG group had significantly lower rates of intra-aortic balloon pump assistance, and shorter duration of ICU and total hospital stay compared to patients in the C-CABG group. However, revascularization modality, SYNTAX scores, and residual SYNTAX scores were not independent predictors of in-hospital or long-term mortality.In this cohort of LM disease patients treated at a tertiary medical center, PCI is a reasonable choice in patients with less lesion complexity but who are older and have comorbidities. R-CABG is feasible in stable LM disease patients with high SYNTAX scores, and is an effective alternative to C-CABG in LM disease patients with few risk factors. However, revascularization modality per se was not a determinant for long-term mortality in our real-world practice.

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Robotics in urologic oncology

Cited by 21 publications

References 44 publications

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance–targeted biopsy

Current beliefs and practice patterns among urologists regarding prostate magnetic resonance imaging and magnetic resonance–targeted biopsy

Is robot-assisted radical cystectomy superior to standard open radical cystectomy? An Indian perspective

Clinical outcomes of left main coronary artery disease patients undergoing three different revascularization approaches

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