The Role of Robotic Visceral Surgery in Patients with Adhesions: A Systematic Review and Meta-Analysis

Milone, Marco; Manigrasso, Michele; Anoldo, Pietro; D’Amore, Anna; Elmore, Ugo; Giglio, Mariano Cesare; Rompianesi, Gianluca; Vertaldi, Sara; Troisi, Roberto; Francis, Nader; Palma, Giovanni Domenico De

doi:10.3390/jpm12020307

Cited by 13 publications

(10 citation statements)

References 109 publications

(333 reference statements)

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“…Moreover, two conversions from laparoscopy were described by Draaisma et al [ 27 ], and two conversions from the robotic approach were reported by Morino et al and Nakadi et al [ 32 , 34 ]. Although nowadays the risk of conversion to open surgery has decreased due to higher surgeon expertise, it is important to underline that the conversion rate from robotic surgery is lower than that from laparoscopy, according to current literature [ 38 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

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

D’Amore

Manigrasso

Anoldo

et al. 2023

JPM

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The functional disease of the esophago-gastric junction (EGJ) is one of the most common health problems. It often happens that patients suffering from GERD need surgical management. The laparoscopic fundoplication has been considered the gold standard surgical treatment for functional diseases of the EGJ. The aim of our meta-analysis is to investigate functional outcomes after robotic fundoplication compared with conventional laparoscopic fundoplication. A prospective search of online databases was performed by two independent reviewers using the search string “robotic and laparoscopic fundoplication,” including all the articles from 1996 to December 2021. The risk of bias within each study was assessed with the Cochrane ROBINS-I and RoB 2.0 tools. Statistical analysis was performed using Review Manager version 5.4. In addition, sixteen studies were included in the final analysis, involving only four RCTs. The primary endpoints were functional outcomes after laparoscopic (LF) and robotic fundoplication (RF). No significant differences between the two groups were found in 30-day readmission rates (p = 0.73), persistence of symptomatology at follow-up (p = 0.60), recurrence (p = 0.36), and reoperation (p = 0.81). The laparoscopic fundoplication represents the gold standard treatment for the functional disease of the EGJ. According to our results, the robotic approach seems to be safe and feasible as well. Further randomized controlled studies are required to better evaluate the advantages of robotic fundoplication.

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Section: Discussionmentioning

confidence: 99%

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

D’Amore

Manigrasso

Anoldo

et al. 2023

JPM

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“…The analysis of the procedures performed by “expert surgeons” showed a statistically significant difference in favor of robotic surgery (OR 1.48, 95% CI 1.03-2.12, p = 0.03). A reduced conversion rate due to adhesions with the robotic approach was observed in patients undergoing colorectal cancer surgery (OR 2.62, 95% CI 1.20-5.72, p = 0.02) ( 84 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

et al. 2022

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IntroductionThere are standard treatment guidelines for the surgical management of rectal cancer, that are advocated by recognized physician societies. But, owing to disparities in access and affordability of various treatment options, there remains an unmet need for personalizing these international guidelines to Indian settings.MethodsClinical Robotic Surgery Association (CRSA) set up the Indian rectal cancer expert group, with a pre-defined selection criterion and comprised of the leading surgical oncologists and gastrointestinal surgeons managing rectal cancer in India. Following the constitution of the expert Group, members identified three areas of focus and 12 clinical questions. A thorough review of the literature was performed, and the evidence was graded as per the levels of evidence by Oxford Centre for Evidence-Based Medicine. The consensus was built using the modified Delphi methodology of consensus development. A consensus statement was accepted only if ≥75% of the experts were in agreement.ResultsUsing the results of the review of the literature and experts’ opinions; the expert group members drafted and agreed on the final consensus statements, and these were classified as “strong or weak”, based on the GRADE framework.ConclusionThe expert group adapted international guidelines for the surgical management of localized and locally advanced rectal cancer to Indian settings. It will be vital to disseminate these to the wider surgical oncologists and gastrointestinal surgeons’ community in India.

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“…A retrospective study by Park et al 44 reported that previous abdominal surgery did not worsen the perioperative outcomes of either laparoscopic or robotic colorectal surgery. Milone et al 45 examined 70 studies that performed 14,329 minimally invasive procedures (6,472 robotic and 7,857 laparoscopic) in patients with adhesions and reported that the robotic approach was associated with a significantly lower risk of conversion (P = 0.007). In addition, the conversion rate was low in patients who underwent colorectal cancer surgery in the robotic group (P = 0.02).…”

Section: Patients With Abdominal Adhesionsmentioning

confidence: 99%

Current status of robotic surgery for colorectal cancer: A review

Jung

2022

Int J Gastrointest Interv

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The number of robot-assisted colorectal surgeries is increasing because these robotic devices afford surgeon-controlled, high-definition, and threedimensional vision during surgery and have sophisticated, angulated arms with remarkable ergonomics and a great degree of range. Nevertheless, robotic colorectal surgery has been praised and criticized simultaneously because its superiority over laparoscopic surgery in terms of outcomes has not been clearly shown. Despite its numerous advantages, several studies have failed to reveal the supremacy of robotic surgery over laparoscopic surgery regarding oncologic and postoperative outcomes. Additionally, robotic surgery is more expensive and is associated with a longer operative time than laparoscopic surgery. Regardless of research findings, many surgeons perform robotic colorectal surgeries. Therefore, this review will evaluate the benefits and drawbacks of robotic surgery for colorectal cancer through recent studies and reviews. The indications for the robotic approach are increasing. Therefore, further research should be conducted to accurately assess the relevance of robotic surgery for colorectal cancer.

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The Role of Robotic Visceral Surgery in Patients with Adhesions: A Systematic Review and Meta-Analysis

Cited by 13 publications

References 109 publications

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

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

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

Current status of robotic surgery for colorectal cancer: A review

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