Robotics in urology

McGuinness, Luke A; Prasad, Bhavan

doi:10.1308/rcsann.supp1.38

Cited by 53 publications

(35 citation statements)

References 109 publications

(83 reference statements)

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“…With the advancement of laparoscopic and robotic surgery the complications associated with surgical techniques are in decline. 40 However, complications do occur and can include lymphatic leak, injury to the inferior vena cava or renal segmental artery and delayed wound healing as a result invasive surgical treatment should only be used if conservative of minimally invasive measures fail.…”

Section: Invasivementioning

confidence: 99%

“…Open surgical methods are now possible laparoscopically or robotically, which offer the advantages of reduced morbidity, duration of stay and pain. 40 The process of lympho-venous disconnection was first described in the 1950s. This is still the most frequently performed operation and a modified technique involves only performing medial lymphatic disconnection, reducing operating time, morbidity and excess dissection with good results.…”

Section: Treatmentmentioning

confidence: 99%

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Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

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Chyluria is secondary to the presence of chyle in the urine. The classical appearance on inspection is of milky white urine, which is caused by a fistulous communication between the lymphatic system and the urinary tract. Worldwide, it is most commonly associated with the parasite Wuchereria bancrofti, which is prevalent in Asia, most extensively in India but also China and Taiwan. However, in the United Kingdom, Europe and North America, where the condition is rare, non-parasitic aetiologies predominate. Chyluria is occasionally associated with other urinary tract symptoms including infection, loin pain and haematuria. It may also cause hypoproteinaemia, weight loss and cachexia. Management is based on identifying the aetiology and depends on the severity of the chyluria and presence of associated symptoms. Given its predominate symptom being urinary, cases in the West can fall under the care of the urologist. The aim of this article is to provide an overview and summary of the aetiology, assessment and management of chyluria based on the most up-to-date evidence available. This was achieved through a non-systematic review of world literature.

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Section: Invasivementioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

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“…This has resulted in 74% of all prostatectomies performed in the UK being robotically assisted, a figure which was anticipated to reach 80% by 2020. [ 3 , 4 ] Despite the improvement in many areas of postoperative recovery, robotic surgery still has POI as one of its main complications. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

Serum cytokine levels as markers of paralytic ileus following robotic radical prostatectomy at different pneumoperitoneum pressures

Hampson¹,

Raj²,

Lingamanaicker³

et al. 2021

Current Urology

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Background: To evaluate intraoperative and postoperative cytokines in patients who underwent robotic prostatectomy (RP) at a pressure of 12 or 15 mm Hg, and the risk of postoperative ileus. Materials and methods: We presented the first series evaluating intraoperative and postoperative cytokines in patients undergoing RP at a pressure of 12 or 15 mm Hg by a single surgeon. Changes in cytokine concentrations were shown to correlate with surgical outcomes and pathological states. The study investigated the changes in cytokine concentrations (interferon-γ, tumor necrosis factor-α, interleukin-1β [IL-1β], IL-2, IL-4, IL-6, IL-12, and IL-17) at different pneumoperitoneum pressures and their potential role in the development of postoperative ileus. Results: The data on 10 consecutive patients confirmed that a lower pneumoperitoneum pressure was associated with lower cytokine levels and a lower risk of ileus. There were increased levels of postoperative interferon-γ, tumor necrosis factor-α, IL-12p70, IL-1β, IL-2, IL-4, and IL-17a at 15 mm Hg when compared to 12 mm Hg. Conclusions: The data indicated that lower pressure RP reduced intra-/postoperative cytokine levels confirming our hypothesis. Larger patient numbers are required to further validate this but the implications of this data will benefit not only urological patients but also other speciality patients undergoing minimally invasive surgery.

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“…These are all factors that would undoubtedly contribute heavily when determining the overall benefit and/or superiority of robotic approaches as compared to open or laparoscopic approaches. For example, in robotic radical prostatectomy, superior vision and more intricate operating, facilitated by the robotic platform, has enabled improved nerve-sparing techniques resulting in superior functional outcomes, with no compromise in oncological outcomes 92. Our review also excluded procedures where a significant part of the operation is performed via a robotic approach, but not the relevant anastomosis – for example, in low rectal surgery for cancer.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison Between Robotic and Laparoscopic or Open Anastomoses: A Systematic Review and Meta-Analysis</p>

Kostakis

Sran

Uwechue

et al. 2019

RSRR

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Introduction: Robotic surgery has been increasingly used in fashioning various surgical anastomoses. Our aim was to collect and analyze outcomes related to anastomoses performed using a robotic approach and compare them with those done using laparoscopic or open approaches through meta-analysis. Methods: A systematic review was conducted for articles comparing robotic with laparoscopic and/or open operations (colectomy, low anterior resection, gastrectomy, Roux-en-Y gastric bypass (RYGB), pancreaticoduodenectomy, radical cystectomy, pyeloplasty, radical prostatectomy, renal transplant) published up to June 2019 searching Medline, Scopus, Google Scholar, Clinical Trials and the Cochrane Central Register of Controlled Trials. Studies containing information about outcomes related to hand-sewn anastomoses were included for meta-analysis. Studies with stapled anastomoses or without relevant information about the anastomotic technique were excluded. We also excluded studies in which the anastomoses were performed extracorporeally in laparoscopic or robotic operations. Results: We included 83 studies referring to the aforementioned operations (4 randomized controlled and 79 non-randomized, 10 prospective and 69 retrospective) apart from colectomy and low anterior resection. Anastomoses done using robotic instruments provided similar results to those done using laparoscopic or open approach in regards to anastomotic leak or stricture. However, there were lower rates of stenosis in robotic than in laparoscopic RYGB (p=0.01) and in robotic than in open radical prostatectomy (p<0.00001). Moreover, all anastomoses needed more time to be performed using the robotic rather than the open approach in renal transplant (p≤0.001). Conclusion: Robotic anastomoses provide equal outcomes with laparoscopic and open ones in most operations, with a few notable exceptions.

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Robotics in urology

Abstract: Twenty years after it was introduced, robotic surgery has become more commonplace in urology – we examine its current uses and controversies

Cited by 53 publications

References 109 publications

Chyluria: what does the clinician need to know?

Chyluria: what does the clinician need to know?

Serum cytokine levels as markers of paralytic ileus following robotic radical prostatectomy at different pneumoperitoneum pressures

<p>Comparison Between Robotic and Laparoscopic or Open Anastomoses: A Systematic Review and Meta-Analysis</p>

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