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Robotic surgery complications

Harman S Parhar, Elizabeth Gausden, Jayendrakumar Patel, Eitan Prisman, Donald W Anderson, J Scott Durham, Barret Rush
BACKGROUND: As transoral robotic surgery (TORS) is being increasingly used to treat patients with oropharyngeal squamous cell carcinoma (OPSCC), there is an interest in determining contributors to readmission. METHODS: We conducted this retrospective multivariate analysis modeling 30-day readmission using the Nationwide Readmissions Database (2012-2014). RESULTS: Of 950 patients, 117 (12.3%) were readmitted. Hemorrhage and diet/aspiration accounted for 32...
August 13, 2018: Head & Neck
Jim S Khan, Anjan K Banerjee, Seon-Han Kim, Tim A Rockall, David G Jayne
The relative merits of robotic versus laparoscopic colorectal surgery remain contested. Proponents for robotics maintain better access, efficiency, accurate dissection, handling, visualisation, education and training leads to benefits in functional outcomes, reduced complications, nerve preservation and oncological clearance in appropriately selected patients in specialised centres. Furthermore, technology, experience and skills are likely to improve further with time, making some currently marginal benefits more beneficial...
August 12, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Joshua P Landreneau, Andrew T Strong, John H Rodriguez, Essa M Aleassa, Ali Aminian, Stacy Brethauer, Philip R Schauer, Matthew D Kroh
INTRODUCTION: A subset of patients undergoing laparoscopic sleeve gastrectomy (SG) require eventual conversion to Roux-en-Y gastric bypass (RYGB) due to complications from SG or to enhance weight loss. The aim of this study is to characterize the indications for conversion and perioperative outcomes in a large cohort of these patients at a single institution. METHODS: Patients who underwent revisional surgery to convert SG to RYGB at our institution from January 2008 through January 2017 were retrospectively reviewed...
August 9, 2018: Obesity Surgery
James W F Catto, Pramit Khetrapal, Gareth Ambler, Rachael Sarpong, Muhammad Shamim Khan, Melanie Tan, Andrew Feber, Simon Dixon, Louise Goodwin, Norman R Williams, John McGrath, Edward Rowe, Anthony Koupparis, Chris Brew-Graves, John D Kelly
INTRODUCTION: Bladder cancer (BC) is a common malignancy and one of the most expensive to manage. Radical cystectomy (RC) with pelvic lymphadenectomy is a gold standard treatment for high-risk BC. Reductions in morbidity and mortality from RC may be achieved through robot-assisted RC (RARC). Prospective comparisons between open RC (ORC) and RARC have been limited by sample size, use of extracorporeal reconstruction and use of outcomes important for ORC. Conversely, while RARC is gaining in popularity, there is little evidence to suggest it is superior to ORC...
August 8, 2018: BMJ Open
B Karabulut, I Deveci, M Sürmeli, A Şahin-Yilmaz, Ç Oysu
OBJECTIVE: To compare functional and oncological treatment outcomes among patients with supraglottic laryngeal cancers who underwent transoral robotic supraglottic laryngectomy and open supraglottic laryngectomy. METHODS: A retrospective chart review was conducted of 17 patients treated by transoral robotic supraglottic laryngectomy and 20 patients treated by open supraglottic laryngectomy. RESULTS: No tracheostomy or prolonged intubation was needed in the transoral robotic surgery group...
August 8, 2018: Journal of Laryngology and Otology
Xian-Qiang Wang, Shu-Juan Xu, Zheng Wang, Yuan-Hong Xiao, Jing Xu, Zhen-Dong Wang, Di-Xiang Chen
Our paper describes the key surgical points of pediatric choledochocystectomy performed completely by Da Vinci robotic system. A choledochocystectomy was safely carried out for a girl at our hospital, and without any complication. Then systematic literature review was done to discuss the methods of intestine surgery and intestinal anastomosis, the use of 3rd robotic arm, the surgical safety and advantages comparing open and laparoscopic surgery. We systematically reviewed choledochocystectomy for children performed by robotic surgery...
July 16, 2018: World Journal of Clinical Cases
Giuseppe Simone, Umberto Anceschi, Gabriele Tuderti, Leonardo Misuraca, Antonio Celia, Bernardino De Concilio, Manuela Costantini, Antonio Stigliano, Francesco Minisola, Mariaconsiglia Ferriero, Salvatore Guaglianone, Michele Gallucci
BACKGROUND: In the era of minimally invasive surgery, partial adrenalectomy has certainly been underused. We aimed to report surgical technique and perioperative, pathologic, and early functional outcomes of a two-center robot-assisted partial adrenalectomy (RAPA) series. OBJECTIVE: To detail surgical technique of RAPA for unilateral aldosterone-producing adenoma (UAPA), and to report perioperative and 1-yr functional outcomes. DESIGN, SETTING, AND PARTICIPANTS: Data of 10 consecutive patients who underwent RAPA for UAPA at two centers from June 2014 to April 2017 were prospectively collected and reported...
August 1, 2018: European Urology
A Buia, S Farkas
BACKGROUND: The 3D laparoscopy is currently under intensive discussion. At the moment the majority of newly acquired laparoscopy systems include the 3D technique. New 4K systems, which will be offered in combination with 3D, are complicating the decision-making when buying new laparoscopic systems. The aim of the article is to show the advantages and possible limitations of 3D laparoscopy. Furthermore, the position of 3D laparoscopy in the current video market is evaluated. MATERIAL AND METHODS: This study was based on an up to date literature search in PubMed...
August 3, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Fabrizio Di Benedetto, Paolo Magistri, Roberto Ballarin, Giuseppe Tarantino, Ilenia Bartolini, Lapo Bencini, Luca Moraldi, Mario Annecchiarico, Francesco Guerra, Andrea Coratti
BACKGROUND: Pancreatic neuroendocrine tumors (PanNETs) are relatively rare neoplasms with a low to mild malignant potential. They can be further divided into functioning and nonfunctioning, according to their secretive activity. Surgery is an optimal approach, but the classic open approach is challenging, with some patients having long hospitalization and potentially life-threatening complications. The robotic approach for PanNETs may represent an option to optimize their management. METHODS: We retrospectively reviewed our prospectively maintained databases from 2 high-volume Italian centers for pancreatic surgery...
August 1, 2018: Surgical Innovation
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Junya Kitadani, Shimpei Maruoka, Toshio Shimokawa, Hiroki Yamaue
BACKGROUND: Laparoscopic gastrectomy (LG) has several benefits as a treatment of gastric cancer (GC), including reduced pain, early recovery of intestinal function, and shorter hospital stay. LG still has several drawbacks, however, including limited range of movement, amplification of hand tremors, and inconvenient surgical positioning. Around the peripancreatic area, laparoscopic lymph node dissection, therefore, remains challenging; postoperative pancreatic fistula occurs in around 4-7% of patients undergoing LG...
July 31, 2018: Trials
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
Sohrab Arora, Gerald Heulitt, Mani Menon, Wooju Jeong, Rajesh K Ahlawat, Umberto Capitanio, Daniel A Moon, Kris K Maes, Sudhir Rawal, Alexander Mottrie, Mahendra Bhandari, Craig G Rogers, James R Porter
OBJECTIVES: To evaluate retroperitoneal robot-assisted partial nephrectomy (RAPN) against transperitoneal approach in a multi-institutional prospective database, after accounting for potential selection bias that may affect this comparison. PATIENTS AND METHODS: Post-hoc analysis of the prospective arm of the Vattikuti Collective Quality Initiative database from 2014-2018. Six hundred and ninety consecutive patients underwent RAPN by 22 surgeons at 14 centers in nine countries...
July 24, 2018: Urology
Yonggang Huang, Ping Wang
Direct suture repair with mesh reinforcement is the main surgical procedure in ventral hernia repair. The best place for mesh implantation is retromuscular space which means sublay. The most commonly used techniques are open sublay and laparoscopic IPOM repair. But open sublay repair may cause more trauma to the abdominal wall and result in more infections. Laparoscopic IPOM repair carries an increased risk in bowel injury, mesh-related complications and postoperative pain. Germany surgeon Reinpold developed a new technique defined as "MILOS concept" by combining the advantages of open sublay and laparoscopic IPOM repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Giampaolo Siena, Riccardo Campi, Karel Decaestecker, Volkan Tuğcu, Selcuk Sahin, Antonio Alcaraz, Mireia Musquera, Angelo Territo, Luis Gausa, Caren Randon, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Luis Guirado, Carme Facundo, Nicolas Doumerc, Graziano Vignolini, Alberto Breda, Sergio Serni
BACKGROUND: Kidney transplantation using grafts with multiple vessels (GMVs) is technically demanding and may be associated with increased risk of complications or suboptimal graft function. To date, no studies have reported on robot-assisted kidney transplantation (RAKT) using GMVs. OBJECTIVE: To report our experience with RAKT using GMVs from living donors, focusing on technical feasibility and early postoperative outcomes. DESIGN, SETTING, AND PARTICIPANTS: We reviewed the multi-institutional, prospectively collected European Association of Urology (EAU) Robotic Urology Section (ERUS)-RAKT database to select consecutive patients undergoing RAKT from living donors using GMVs between July 2015 and January 2018...
July 23, 2018: European Urology Focus
Qiyu Yang, Junying Tang, Lin Xiao
RATIONALE: Pelvic exenteration is considered a method to treat central recurrent or persistent gynecologic malignancy after the initial therapy. The postoperative survival rate has been greatly increased by the improvement in the surgical technology and the perioperative management. Yet various complications are still impacting the quality of life. New technologies such as robotic surgery system made it possible to approach radical surgical resection by using a minimally invasive method...
July 2018: Medicine (Baltimore)
Alexandre Amado Elias, Marcelo Roque-de-Oliveira, Josemberg Marins Campos, Walter Takeiti Sasake, Álvaro Antônio Bandeira, Lyz Bezerra Silva, Brenda Ferreira, Renato Massaru Ito, Henrique Yoshio Shirozaki, Fernanda Antico Benetti, Laércio da Silva Paiva, Arthur Belarmino Garrido Júnior
OBJECTIVE: to report a series of cases of robotic bariatric surgery in the treatment of obesity in Brazil. METHODS: we evaluated patients undergoing robotic bariatric surgery at the Garrido Institute and compared them with a group submitted to conventional laparoscopic surgery. RESULTS: we analyzed 45 patients, with a mean age of 39.44 years, of which 34 were female, with an initial mean BMI of 41.26kg/m2. Among the procedures performed, 91...
July 19, 2018: Revista do Colégio Brasileiro de Cirurgiões
Paulo Afonso de Carvalho, João A B A Barbosa, Giuliano B Guglielmetti, Maurício Dener Cordeiro, Bernardo Rocco, William C Nahas, Vipul Patel, Rafael Ferreira Coelho
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy (RARP) presents consistent oncological outcomes for prostate cancer; yet continence and potency results are not uniform. We present a technical modification for RARP which preserves the nerves and vascular structures anterior to the prostate aiming to optimize functional outcomes. OBJECTIVE: To present oncological and functional results of a modified technique for RARP. DESIGN, SETTING, AND PARTICIPANTS: Prospective, noncontrolled case series including 128 consecutive patients undergoing RARP performed by a single surgeon (R...
July 21, 2018: European Urology
G Cochetti, M Del Zingaro, A Boni, D Cocca, M Panciarola, Alessandra Tiezzi, G Gaudio, F Balzarini, P Ursi, E Mearini
Colovesical fistula (CVF) is an abnormal communication between bowel and urinary bladder. Main causes are represented by complicated diverticular disease, colonic and bladder cancer and iatrogenic complications. Diagnosis is often based on patognomonic signs: faecaluria, pneumaturia and recurrent urinary tract infections. Treatment of CVF includes non-surgical and surgical strategy. The non-surgical treatment is reserved to selected patients who are unfit for surgery. Surgery of CVFs is determined by the site of the colonic lesion and patient's comorbidity...
July 2018: Il Giornale di Chirurgia
Jiping Zeng, Andrew John Christiansen, Aydin Pooli, Fang Qiu, Chad A LaGrange
OBJECTIVE: To evaluate the safety and outcomes of robot-assisted radical prostatectomy (RARP) in renal transplant recipients (RTR) based on available literature. METHODS: A literature search was performed using Pubmed, Embase and Web of Science through "robot" AND "prostatectomy" AND "transplant". Three authors separately reviewed the records to select the relevant manuscripts with any discrepancies solved by open discussion. Patient age, PSA, Gleason score, tumor stage were recorded as well as intraoperative and post-operative complications, length of stay (LOS), surgical margin status and disease recurrence if provided...
July 24, 2018: Journal of Endourology
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