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https://www.readbyqxmd.com/read/29343662/cost-benefit-performance-simulation-of-robot-assisted-thoracic-surgery-as-required-for-financiall-viability-under-the-2016-revised-reimbursement-paradigm-of-the-japanese-national-health-insurance-system
#1
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29312766/robotic-totally-endoscopic-coronary-artery-bypass-for-isolated-ostial-stenosis-of-the-left-coronary-artery
#2
Chia-Cheng Kuo, Chung-Hsi Hsing, Chun-I Chen, Chen-Hui Lee, Bor-Chih Cheng
Isolated ostial stenosis (IOS) is a rare disease that encroaches on aorto-coronary junction of uncertain etiology. All distal coronary vessels present normally. IOS occurs predominantly in premenopausal young women with few risk factors for atherosclerotic disease. Here, we report a 40-year-old woman who had experienced crescendo angina for 4 months. Surgical revascularization was achieved by robotic totally endoscopic coronary artery bypass (TECAB) with left internal thoracic artery (LITA) graft. She resumed her daily tasks without difficulties 1 week after the operation...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29288659/the-learning-curve-for-robotic-mckeown-esophagectomy-in-patients-with-esophageal-cancer
#3
Hanlu Zhang, Longqi Chen, Zihao Wang, Yu Zheng, Yingcai Geng, Fuqiang Wang, Dan Liu, Andong He, Lin Ma, Yong Yuan, Yun Wang
BACKGROUND: Robot-assisted McKeown esophagectomy (RAME) is a promising but technically demanding procedure, so a learning curve should be defined to guide training and allow implementation of this technique. METHODS: This study retrospectively reviewed a prospectively collected data of 72 consecutive patients undergoing RAME by a single surgical team experienced in open and thoracolaparoscopic esophagectomy. The cumulative sum (CUSUM) method was used to analyse the learning curve...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29232300/three-dimensional-printing-of-life-like-models-for-simulation-and-training-of-minimally-invasive-cardiac-surgery
#4
Toshiyuki Yamada, Motohiko Osako, Tomoya Uchimuro, Ryogen Yoon, Toshiaki Morikawa, Maki Sugimoto, Hisao Suda, Hideyuki Shimizu
OBJECTIVE: As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. METHODS: Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29221285/robot-assisted-thoracic-surgery-for-complex-procedures
#5
Shuenn-Wen Kuo, Pei-Ming Huang, Mong-Wei Lin, Ke-Cheng Chen, Jang-Ming Lee
Background: As an option for minimally invasive thoracic surgery, robot-assisted thoracic surgery (RATS) has shown comparable perioperative outcomes to those achieved by traditional video-assisted thoracic surgery (VATS). It is unknown whether RATS might have any potential benefits in more complex thoracic surgical procedures, which usually require open surgery instead of VATS. The current study presents a preliminary result regarding the use of RATS in complex thoracic operations in an attempt to address this unresolved question...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220043/robotic-assisted-thoracic-surgery-a-helpful-tool-or-just-another-expensive-gadget
#6
EDITORIAL
Florian Augustin, Johannes Bodner
No abstract text is available yet for this article.
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29200086/benefits-of-electromagnetic-navigational-bronchoscopy-for-identifying-pulmonary-nodules-for-robotic-resections
#7
Stevan S Pupovac, Alexander Chaudhry, Vijay A Singh
OBJECTIVE: The ability to localize pulmonary nodules via the robotic thoracic technique can be challenging at times. This is most evident when nodules are small and/or ground glass in nature. Information regarding methods available to localize these difficult nodules, while maintaining a minimally invasive robotic approach, is limited. METHODS: We describe a diagnostic and therapeutic method of combining electromagnetic navigational bronchoscopy with a total minimally invasive robotic approach that identifies these difficult-to-localize pulmonary nodules...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29197913/an-alternative-finger-in-robotic-assisted-thoracic-surgery-intraoperative-ultrasound-localization-of-pulmonary-nodules
#8
Zhenyu Zhou, Zhitian Wang, Zhelan Zheng, Jinlin Cao, Chong Zhang, Zhehao He, Wang Lv, Jian Hu
AIM: Robotic-assisted thoracic surgery (RATS) has become a promising treatment for pulmonary neoplasms. During RATS, intraoperative ultrasonography can act as an "alternative finger" to "touch" and locate lesions, especially pulmonary nodules. This study was aimed to investigate the efficacy of intraoperative ultrasonographic localization during da Vinci RATS procedures. MATERIAL AND METHODS: Patients with pulmonary nodules were randomly divided into an Experimental Group and Control Group in which nodules were respectively located using intraoperative ultrasonography or by the surgeon's anatomic knowledge...
November 29, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/29120928/oncologic-considerations-in-the-elderly
#9
Mohamed K Kamel, Jeffrey L Port
PURPOSE OF REVIEW: Elderly patients presenting with thoracic malignancies tend to be largely undertreated because of a presumption that this group will incur a high treatment-associated morbidity and mortality. The current review highlights the current practice and recent updates in the surgical management of thoracic malignancies, mainly lung cancer, in the elderly population. RECENT FINDINGS: Lung resections appears to be relatively safe in the elderly patients presenting with lung cancer...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29089700/total-transthoracic-and-transabdominal-robotic-radical-three-stage-esophagectomy-initial-indian-experience
#10
S P Somashekhar, Rajshekhar C Jaka
This study aims to evaluate the safety and technical feasibility of total robot-assisted three-stage esophagectomy. From July 2011 to June 2014, 35 histologically proven resectable carcinoma esophagus patients underwent robot-assisted transthoracic and transperitoneal three-stage esophagectomy. In the initial ten cases, total docking time, thoracic docking time, total operative time, thoracic-phase operative time, and blood loss were 67.9 ± 13.24, 32.2 ± 9.74, 429.2 ± 57.65, and 96.6 ± 20...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29078684/thymic-minimally-invasive-surgery-state-of-the-art-across-the-world-central-south-america
#11
REVIEW
Ricardo Mingarini Terra
Literature suggests that, for thymectomy in myasthenia or resection of thymic tumors, minimally invasive surgery is equivalent to open surgery with regard to long-term outcomes. However, it could bring some benefits in the immediate results as complication rate or length-of-stay. There are doubts about the worldwide adoption of the method, though. In Latin America, the implementation of video-assisted thoracic surgery (VATS) started in the 1990s, but it progressed slowly. The main barriers were associated costs and training...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078672/robotic-lobectomies-when-and-why
#12
REVIEW
Sara Ricciardi, Giuseppe Cardillo, Carmelina Cristina Zirafa, Federico Davini, Franca Melfi
During the last decade, an abundance of papers has supported minimally invasive pulmonary resections (MIPR) vs. traditional open approach. Both video assisted thoracic surgery (VATS) and robotic thoracic surgery have shown better perioperative outcomes and equivalent oncologic results compared with thoracotomy, confirming the effectiveness of the MIPR. Despite the profound changes and improvements that have taken place throughout the years and the increasing use of robotic system worldwide, the controversy about the application of robotic surgery for lung resections is still open...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078658/minimally-invasive-surgical-procedures-for-thymic-disease-in-asia
#13
REVIEW
Meinoshin Okumura, Yasushi Shintani, Mitsunori Ohta, Yoshihisa Kadota, Masayoshi Inoue, Hiroyuki Shiono
Video-assisted thoracic surgery (VATS) procedures for thymic tumors and myasthenia gravis were introduced in Asia in the middle 1990s in at least two regions, Hong Kong and Japan. To overcome difficulties in obtaining a wide view of the anterior mediastinum, several methods for lifting the sternum or anterior chest wall have been presented, mainly by Japanese surgeons. More recently, single port VATS through a subxiphoid incision was also introduced in Japan. The long-term outcome of a VATS extended thymectomy for myasthenia gravis has been shown to be comparable to that of a trans-sternal extended thymectomy, while the long-term outcome of a VATS thymectomy for thymic epithelial tumors remains to be elucidated...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078642/three-dimensional-video-assisted-thoracic-surgery-for-pulmonary-resections-an-update
#14
REVIEW
Duilio Divisi, Mirko Barone, Roberto Crisci
Video-assisted thoracic surgery (VATS) allows to treat pulmonary and mediastinal diseases although two-dimensional (2D) imaging can make difficult to estimate the morphological and topographical characteristics of a lesion. Some technical aspects have certainly been corrected with the introduction of robot-assisted thoracic surgery (RATS), although not widespread in less economically developed countries. As an emerging imaging system and technique, 3D VATS is an interesting resource for thoracic surgeons and it may be a proper and valid aid in minimally-invasive surgery, but not an alternative or a compromise to the most expensive robotic technology...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078641/robotic-assisted-lobectomy-for-locally-advanced-lung-cancer
#15
REVIEW
Giulia Veronesi, Pierluigi Novellis, Orazio Difrancesco, Mark Dylewski
Some series report the use of video-assisted thoracic surgery (VATS) in patients with locally advanced non-small cell lung cancer (NSCLC) but, few studies describe the use of the robotic approach specifically for locally advanced disease. One potential advantage of the robotic approach over traditional VATS is the increased radicality. While the benefit of the robotic approach over open thoracotomy is directly related to reduced surgical trauma and the improved tolerability in fragile patients that have received induction treatment...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078638/subxiphoid-thymectomy-single-port-dual-port-and-robot-assisted
#16
Takashi Suda
Currently, surgical techniques that are less invasive than conventional median sternotomy are used for thymectomy in the treatment of myasthenia gravis and anterior mediastinal tumors as no sternal incision is required. We reported on a subxiphoid single-port thymectomy using CO2 insufflation, which has the following advantages: (I) the field of view offered by the camera scope inserted from the midline of the body helps confirm the location of the superior pole of the thymus and bilateral phrenic nerves; (II) there is minimal pain and no intercostal neuropathy occurs as intercostal spaces are not traversed; and (III) cosmetic outcomes are excellent...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078624/the-role-of-wet-lab-in-thoracic-surgery
#17
REVIEW
Benedetta Bedetti, Philipp Schnorr, Joachim Schmidt, Marco Scarci
During the last three decades, minimally invasive surgery has become common practice in all kinds of surgical disciplines and, in Thoracic Surgery, the minimally invasive approach is recommended as the treatment of choice for early-stage non-small cell lung cancer. Nevertheless, all over the world a large number of lobectomies is still performed by conventional open thoracotomy and not as video-assisted thoracic surgery (VATS), which shows the need of a proper training for this technique. Development and improvement of surgical skills are not only challenging and time-consuming components of the training curriculum for resident or fellow surgeons, but also for more experienced consultants learning new techniques...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078618/transition-from-video-assisted-thoracic-surgery-to-robotic-pulmonary-surgery
#18
REVIEW
Takashi Suda
The "da Vinci Surgical System" is a robotic surgical system that utilizes multi-jointed robotic arms and a high-resolution three-dimensional video-monitoring system. We report on the state of transition from video-assisted thoracoscopic surgery (VATS) to robotic pulmonary surgery, the surgical outcomes of robotic surgery compared to VATS, and the future of robotic surgery. Surgery utilizing the da Vinci Surgical System requires a console surgeon and assistant who have been certified by Intuitive Surgical, Inc...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078608/new-stapling-devices-in-robotic-surgery
#19
Domenico Galetta, Monica Casiraghi, Alessandro Pardolesi, Alessandro Borri, Lorenzo Spaggiari
Minimally invasive thoracic surgery is rapidly diffusing worldwide. Robotic anatomic pulmonary resection is gaining popularity and acceptance in the thoracic community for the reported feasibility, safety, and good outcomes. The last available robotic system, da Vinci Xi System, added new technical improvements on robotic device allowing best performances in robotic lung resection. We report our initial experience in the use of EndoWrist Stapler during robotic anatomic surgery for lung cancer.
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29078607/robotics-in-general-thoracic-surgery-procedures
#20
REVIEW
M Jawad Latif, Bernard J Park
The use of robotic technology in general thoracic surgical practice continues to expand across various institutions and at this point many major common thoracic surgical procedures have been successfully performed by general thoracic surgeons using the robotic technology. These procedures include lung resections, excision of mediastinal masses, esophagectomy and reconstruction for malignant and benign esophageal pathologies. The success of robotic technology can be attributed to highly magnified 3-D visualization, dexterity afforded by 7 degrees of freedom that allow difficult dissections in narrow fields and the ease of reproducibility once the initial set up and instruments become familiar to the surgeon...
2017: Journal of Visualized Surgery
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