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Journal of Robotic Surgery

Samuel S Kim, Jose Guillen-Rodriguez, Alex G Little
Laparoscopic esophageal myotomy is the standard surgical intervention for achalasia. Compared to standard laparoscopic techniques, use of the robot has theoretical advantages of improved visualization and dexterity. We evaluated the University of Arizona's experience with the two alternatives to compare outcomes. Patients who underwent either laparoscopic or robot-assisted myotomy were identified from a retrospective database from 1/1/2006 to 12/31/2015. Patient demographics, prior treatment, intra-operative complications, operative time, post-operative length of stay and complications, and long-term results were compared between the two groups...
September 14, 2018: Journal of Robotic Surgery
A Pötscher, C Bittermann, F Längle
In this review, we would like to illustrate our experience with the da Vinci® Xi system in case of esophageal surgery. Since the da Vinci® Xi system was installed in our department, it has resulted in a great improvement in cases of minimally invasive surgery. After the successful establishment in the field of colorectal surgery, the next step was surgery of the upper gastrointestinal tract. Due to the features of the robotic system, we can definitely observe the advantages and a positive effect in case of minimal invasive esophagectomy (MIE)...
September 12, 2018: Journal of Robotic Surgery
Sanjay Razdan, Rajesh Raj Bajpai, Shirin Razdan, Marcos A Sanchez
We sought to explore the potency outcomes in two systematically controlled, non-randomized, matched, homogenous patient cohorts, which either underwent intervention (INT) with placement of dehydrated human amniotic membrane (dHAM) around nerve bundles (NVB) during robotic-assisted laparoscopic radical prostatectomy (RALP) or did not (CON). It is hypothesized that dHAM use would lead to better potency outcomes. 1400 eligible informed, consented patients underwent full bilateral nerve-sparing RALP by a single surgeon, wherein 700 patients had dHAM allograft wrapped around the NVB and 700 did not...
September 12, 2018: Journal of Robotic Surgery
D Moran, T Gross, D Gavin, A J Costello
Recent advances in novel functional imaging techniques such as PSMA PET may now offer the ability to identify small volume metastases which may otherwise go undetected. The treatment of these lesions is controversial, particularly in the oligometastatic state. We report the case of an abdominal wall metastasis detected with PSMA imaging which we treated with surgical excision. This resulted in an undetectable PSA 6 weeks post excision.
September 5, 2018: Journal of Robotic Surgery
G H KleinJan, K Sikorska, C M Korne, O R Brouwer, T Buckle, C Tillier, R C M van der Roest, J de Jong, F W B van Leeuwen, H G van der Poel
Robot-assisted radical prostatectomy (RARP) is performed in patients with prostate cancer. Unfortunately, 10-46% of patients may still suffer from limited erectile function (EF) after RARP. This study aimed to develop a prediction model based on the extent of fascia preservation (FP) and postoperative EF after RARP. A previously developed FP score quantizing the extent and regions of nerve-preservation was determined in a cohort of 1241 patients who underwent RARP. The predictive value of the FP score for post-prostatectomy EF (following the international index erectile function (IIEF) score, EF domain) was analyzed...
September 3, 2018: Journal of Robotic Surgery
Courtney A Green, Patricia S O'Sullivan, Ankit Sarin, Hueylan Chern
Without haptic feedback, robotic surgeons rely on visual processing to interpret the operative field. To provide guidance for teaching in this environment, we analyzed intracorporeal actions and behaviors of a robotic surgeon. Six hours of video were captured by the intracorporeal camera during a robot-assisted lower anterior resection. After complete review, authors reduced the video to a consecutive 35 min of highly focused robotic activity and finally, a 2-min clip was subjected to microanalysis. The clip was replayed multiple times (capturing 1, 2, 10, 60 and 120 s intervals) and activities were identified, such as right and left hand motion, tissue handling and camera adjustments recorded using a software program...
September 1, 2018: Journal of Robotic Surgery
Seran Reddy, Divya Jain, Kajal Jain, Komal Gandhi, Ravi Mohan, Mandeep Kang
Robotic surgeries in the extreme Trendelenburg position can lead to changes in the airway dimensions. We conducted a prospective, observational trial to explore the use of ultrasound to quantify these changes in the airway dimensions and identify the factors associated with it. Fifty-two American society of Anaesthesiologists physical status I-II patients between 18 and 70 years of age of either sex scheduled to undergo robot assisted urological procedures in steep Trendelenburg position were enrolled. Anterior soft tissue thickness at the level of hyoid bone and vocal cords, tongue thickness, Malampatti grading and neck circumference were measured at predefined postoperative intervals in the immediate postoperative period, at 2-, 6- and 12-h period postoperatively...
August 31, 2018: Journal of Robotic Surgery
Kellen Choi, Sharon Hill, Nathan Hale, Stephen Phillips, Samuel Deem
Mannitol is routinely used during partial nephrectomies due to its renoprotective properties. With minimally invasive techniques, the need for mannitol has been questioned. Robotic-assisted laparoscopic partial nephrectomy (RALPN) has been shown to decrease warm ischemia time, which may potentially minimize the benefit of mannitol. To date, no prospective, randomized, controlled trials have investigated the use of mannitol in only robotic procedures. We hypothesize that the intraoperative mannitol use during RALPN provides no statistically significant benefit for post-operative renal function outcomes...
August 31, 2018: Journal of Robotic Surgery
Jaya Sai Chavali, Juan Garisto, Riccardo Bertolo, Jose Agudelo, Julien Dagenais, Jihad Kaouk
To describe the surgical management of patients who had radical prostatectomy previously attempted but aborted due to diverse causes. Patients who underwent an "aborted prostatectomy" were extracted from the institutional prostatectomy database. A description of the tailored robotic approach was reported for each case. Tips and tricks for the accomplishment of robotic prostatectomy after aborted prostatectomy were reported. Six clinical cases were analyzed. Three patients had aborted prostatectomy due to complicated dissection hindered by pelvic mesh and bowel adhesions; one prostatectomy was aborted due to anesthesiology/respiratory matters; one for narrow pelvis; one due to abnormal pelvic vascular anatomy...
August 29, 2018: Journal of Robotic Surgery
Santosh Kumar, Abhishek Chandna, Dharmendar Aggarwal, Shantanu Tyagi, Nripesh Sadasukhi
Uretero-pelvic junction obstruction (UPJO) is a common condition, often presenting in adulthood in developing countries. These cases can pose significant problems owing to late presentation and complications such as infection, stones, and impaired renal function. We present the case of a 28-year-old female who presented to us with recurrent symptoms and impaired drainage following a failed open pyeloplasty and robot-assisted ureterocalycostomy for right UPJO. She was managed by robot-assisted boari flap calycovesicostomy, an innovation which helped in salvaging her kidney; ensuring good drainage in the involved kidney...
August 22, 2018: Journal of Robotic Surgery
Giri Krishnan, Jack Mintz, Andrew Foreman, J C Hodge, Suren Krishnan
Transoral robotic surgery (TORS) provides improved access to head and neck subsites resulting in well-validated functional and oncological outcomes, but access to and cost of robotic platforms can limit their use. Evidence suggests TORS is increasingly being adopted globally, but there is a paucity of data on the adoption and diffusion of TORS in Australia and New Zealand. A cross-sectional analysis was performed. An online survey was distributed to otolaryngologists and head and neck surgeons through three different Australian and New Zealand specialty membership databases...
August 20, 2018: Journal of Robotic Surgery
Sahar Salehi, Alireza Daryapeyma, Chikako Suzuki, Ulrika Joneborg, Henrik Falconer
Fistula formation between bowel and blood-vessel is a very rare complication after intraabdominal surgery. We report a case of iliaco-enteric fistula following robot-assisted surgical staging of endometrial cancer. A 71-year-old woman subjected to comprehensive endometrial cancer staging presented with hematochezia 35 days postoperatively. A retroperitoneal right-sided abscess and an iliaco-enteric fistula was confirmed upon imaging. The patient received endovascular repair of the aneurysm in her right common iliac artery and the segments of the small bowel containing the fistula were resected via laparotomy...
August 20, 2018: Journal of Robotic Surgery
Fabrizio Dal Moro, Luca Aiello, Paola Pavarin, Fabio Zattoni
The author would like to correct the errors in the publication of the original article due to multiple small errors in scientific content of article due to author oversight. Errors do not change or invalidate conclusion of article.
August 14, 2018: Journal of Robotic Surgery
Francisco Schlottmann, Jason M Long, Sean Brown, Marco G Patti
Acquisition of robotic surgical skills by surgical residents is usually hindered by time pressure and financial imperatives. Robotic simulation training offers an attractive solution because it allows residents to learn in a safe, controlled, and standardized environment. We aimed to determine the confidence levels of senior surgical residents with the robotic platform, and how those levels were affected by simulation training. Twenty senior residents participated in a simulation course using perfused porcine tissue blocks to perform the following robotic procedures: Nissen fundoplication, Heller myotomy, sleeve gastrectomy, colectomy, and lobectomy...
August 11, 2018: Journal of Robotic Surgery
Daniele Mattevi, L G Luciani, W Mantovani, T Cai, S Chiodini, V Vattovani, M Puglisi, G Malossini
To compare the functional and operative outcomes of robot-assisted partial nephrectomy with selective arterial clamping guided by near infrared fluorescence imaging (NIRF-RAPN) versus a cohort of patients who underwent standard RAPN without selective arterial clamping (S-RAPN). 62 consecutive patients underwent RAPN from January 2016 to May 2017: the last 20 patients underwent NIRF-RAPN. Preoperative and postoperative renal scan at 1 month were performed to evaluate the glomerular filtration rate (GFR) of the operated renal unit and total function...
August 9, 2018: Journal of Robotic Surgery
William Krause, Julio Bird
Robotic-assisted surgical procedures are being increasingly used in general surgery, including in the rural and community setting. Although there is no requirement, general surgery residency programs have begun to incorporate curriculums to train residents in this discipline. As a small rural community program, we recently instituted a voluntary and structured curriculum, and our initial experience is shared here. Our curriculum was voluntary for all general surgical residents for the academic years 2016-2017...
August 7, 2018: Journal of Robotic Surgery
William Krause, Julio Bird
Surgery is an ever evolving discipline, and robotic-assisted procedures are the next generation of surgical techniques. There is currently no requirement for robotic training in surgical residency programs; thus, general surgery programs have incorporated it into their curriculums to varying degrees, including our recently adopted curriculum. As programs adopt new curriculum, it is unknown how applicants in community general surgery view the importance of robotic surgery for future procedures and its overall value in their training...
August 7, 2018: Journal of Robotic Surgery
Richard J Fantus, Andrew Cohen, Christopher B Riedinger, Kristine Kuchta, Chi H Wang, Katharine Yao, Sangtae Park
To evaluate trends in contemporary robotic surgery across multiple organ sites as they relate to robotic prostatectomy volume. We queried the National Cancer Database for patients who underwent surgery from 2010 to 2013 for prostate, kidney, bladder, corpus uteri, uterus, cervix, colon, sigmoid, rectum, lung and bronchus. The trend between volumes of robotic surgery for each organ site was analyzed using the Cochran-Armitage test. Multivariable models were then created to determine independent predictors of robotic surgery within each organ site by calculating the odds ratio with 95% CI...
July 30, 2018: Journal of Robotic Surgery
R Sotelo, L G Medina, F Z Husain, M Khazaeli, K Nikkhou, G E Cacciamani, H Landsberger, M Winter, A Hernandez, A M Kaiser, I Gill
The case is of a 59-year-old male with history of severe ischemic colitis following emergent intervention for a ruptured infrarenal aortic aneurysm who subsequently underwent left hemicolectomy, partial proctectomy, and Hartmann colostomy. The patient later underwent reversal of the Hartmann colostomy with diverting ileostomy. The surgery was complicated by a right ureteral and posterior bladder injury that resulted in a large rectovesical fistula involving the right hemitrigone and right ureteral orifice. An attempt to repair the rectovesical fistula at an outside facility was unsuccessful...
July 30, 2018: Journal of Robotic Surgery
Fabrizio Dal Moro, Luca Aiello, Paola Pavarin, Fabio Zattoni
Several works stress the importance of ultrasound-guided transversus abdominis plane block (TAPb) for post-operative analgesia and its versatility in all types of abdominal surgery, thanks to laparotomy and laparoscopy. The aim of this study was to evaluate the impact of TAPb on intra- and post-operative analgesia in the first 24 h after robot-assisted radical prostatectomy (RARP). TAPb is a new local anesthetic technique which provides analgesia after abdominal surgery. It involves injection of local anesthetic into the plane between the transversus abdominis and the internal oblique muscles...
July 28, 2018: Journal of Robotic Surgery
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