Towards Truly “Bespoke” Robotic Surgery: Vessel-Sparing Sigmoidectomy

Hüscher, C; Lazzarin, Gianni

doi:10.1177/15533506221150127

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…However, in our experience, the robot had an obvious advantage over the laparoscope when sewing the anastomotic stoma. During the surgery, the anastomotic wall was shaped by full thickness single-layer continuous suture ( 32 ). Unlike the long rigid laparoscopic instruments, the robot was equipped with wristed instrumentation with seven degrees of freedom (DOFs).…”

Section: Discussionmentioning

confidence: 99%

A novel training program: laparoscopic versus robotic-assisted low anterior resection for rectal cancer can be trained simultaneously

et al. 2023

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BackgroundCurrent expectations are that surgeons should be technically proficient in minimally invasive low anterior resection (LAR)—both laparoscopic and robotic-assisted surgery. However, methods to effectively train surgeons for both approaches are under-explored. We aimed to compare two different training programs for minimally invasive LAR, focusing on the learning curve and perioperative outcomes of two trainee surgeons.MethodsWe reviewed 272 consecutive patients undergoing laparoscopic or robotic LAR by surgeons A and B, who were novices in conducting minimally invasive colorectal surgery. Surgeon A was trained by first operating on 80 cases by laparoscopy and then 56 cases by robotic-assisted surgery. Surgeon B was trained by simultaneously performing 80 cases by laparoscopy and 56 by robotic-assisted surgery. The cumulative sum (CUSUM) method was used to evaluate the learning curves of operative time and surgical failure.ResultsFor laparoscopic surgery, the CUSUM plots showed a longer learning process for surgeon A than surgeon B (47 vs. 32 cases) for operative time, but a similar trend in surgical failure (23 vs. 19 cases). For robotic surgery, the plots of the two surgeons showed similar trends for both operative times (23 vs. 25 cases) and surgical failure (17 vs. 19 cases). Therefore, the learning curves of surgeons A and B were respectively divided into two phases at the 47th and 32nd cases for laparoscopic surgery and at the 23rd and 25th cases for robotic surgery. The clinicopathological outcomes of the two surgeons were similar in each phase of the learning curve for each surgery.ConclusionsFor surgeons with rich experience in open colorectal resections, simultaneous training for laparoscopic and robotic-assisted LAR of rectal cancer is safe, effective, and associated with accelerated learning curves.

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Section: Discussionmentioning

confidence: 99%

A novel training program: laparoscopic versus robotic-assisted low anterior resection for rectal cancer can be trained simultaneously

et al. 2023

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“…A meta-analysis showed that low ligation of the inferior mesenteric artery during radical resection of rectal cancer seemed to be associated with a lower risk of anastomotic leakage and overall morbidity (34). At the same time, "Bespoke " robotic surgery maintains optimal blood flow by preserving blood vessels, thereby reducing the incidence of anastomotic leakage after left hemicolectomy (35). An effective intervention measure that can reduce the incidence will be highly beneficial in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials

Xia

et al. 2023

Front. Oncol.

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BackgroundAnastomotic leakage (AL) is a serious complication of anterior resection for rectal cancer. The use of transanal drainage tubes (TDT) during surgery to prevent AL remains controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy of TDT in reducing AL.MethodsRelevant data and studies published from inception until November 1, 2022, were retrieved from PubMed, Embase, and Cochrane Library databases to compare the incidence of AL after anterior resection for rectal cancer with and without TDT.ResultsThis meta-analysis included 5 RCTs comprising 1385 patients. The results showed that the intraoperative use of TDT could not reduce the incidence of AL after rectal cancer surgery (risk ratio [RR], 0.91; 95% confidence interval [CI], 0.52–1.59; p = 0.75). A subgroup analysis of different degrees of AL revealed that TDT did not reduce the incidence of postoperative grade B AL (RR, 1.18; 95% CI, 0.67–2.09; p = 0.56) but decreased the incidence of grade C AL (RR, 0.28; 95% CI: 0.12–0.64; p = 0.003). Further, TDT did not reduce the incidence of AL in patients with rectal cancer and a stoma (RR, 2.40; 95% CI, 1.01–5.71; p = 0.05).ConclusionTDT were ineffective in reducing the overall incidence of AL, but they might be beneficial in reducing the incidence of grade C AL in patients who underwent anterior resection. However, additional multicenter RCTs with larger sample sizes based on unified control standards and TDT indications are warranted to validate these findings.

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Preserving vascular integrity during totally robotic sigmoidectomy: unleashing the power of vessel-sparing precision

Huscher,

Cobellis,

Lazzarin

2024

Langenbecks Arch Surg

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Towards Truly “Bespoke” Robotic Surgery: Vessel-Sparing Sigmoidectomy

Cited by 3 publications

References 4 publications

A novel training program: laparoscopic versus robotic-assisted low anterior resection for rectal cancer can be trained simultaneously

A novel training program: laparoscopic versus robotic-assisted low anterior resection for rectal cancer can be trained simultaneously

Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials

Preserving vascular integrity during totally robotic sigmoidectomy: unleashing the power of vessel-sparing precision

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