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Konstantinos Gioutsos, Gregor J Kocher, Ralph A Schmid
INTRODUCTION: Robot-assisted surgery emerged and evolved in order to increase the surgical precision and due to the need to overcome the drawbacks of conventional minimally invasive surgery. In thoracic surgery the first reported use of a robotic device was in a series of 12 patients with different lung pathologies with the assistance of the DaVinci Robotic Surgical System in 2002. The DaVinci system has been used for various procedures in the field of thoracic surgery since then. While its advantages for the resection of early stage thymoma have been well documented, its role in the treatment of lung cancer and other pathologies is still under investigation...
December 2016: Panminerva Medica
Francesco Montorsi, Giorgio Gandaglia, Nicola Fossati, Nazareno Suardi, Cristian Pultrone, Ruben De Groote, Zach Dovey, Paolo Umari, Andrea Gallina, Alberto Briganti, Alexandre Mottrie
BACKGROUND: Salvage lymph node dissection has been described as a feasible treatment for the management of prostate cancer patients with nodal recurrence after primary treatment. OBJECTIVE: To report perioperative, pathologic, and oncologic outcomes of robot-assisted salvage nodal dissection (RASND) in patients with nodal recurrence after radical prostatectomy (RP). DESIGN, SETTING, AND PARTICIPANTS: We retrospectively evaluated 16 patients affected by nodal recurrence following RP documented by positive positron emission tomography/computed tomography scan...
September 3, 2016: European Urology
M Ashraf, A Souka, R Adelman, S H Forster
The recent results of Protocol T have illustrated the efficacy of aflibercept in the treatment of diabetic macular edema. It also demonstrated that in patients with poor vision (<6/12), aflibercept offers anatomical and visual advantages over ranibizumab and bevacizumab in the first 12 months of treament. At 2 years, the difference between the three drugs decreased with patients with a better baseline VA (69-78) showing a statistically insignificant advantage for ranibizumab compared with aflibercept.These results were achieved using a pro-re nata (PRN) protocol, which was not previously studied in large phase 3 trials, VIVID and VISTA, that chose to compare the 2...
August 26, 2016: Eye
Mashaal Dhir, Deepa Magge, Stephanie Novak, David L Bartlett, Amer H Zureikat
BACKGROUND: Hepatic artery infusion (HAI) chemotherapy is an effective regional therapy for unresectable colorectal liver metastases (U-CRLM).1 (,) 2 One of its limitations is the need for a laparotomy, which can delay the use of systemic therapy.3 Here, we describe a purely robotic technique for placement of an HAI pump (Fig 1). PATIENT: A 62-year-old male presented with a symptomatic ascending colon cancer and multiple bilobar unresectable liver metastases. He underwent laparoscopic right colectomy followed by six cycles of FOLFOXIRI and bevacizumab with stable disease by RECIST (Response Evaluation Criteria in Solid Tumors) criteria, and also underwent robotic HAI pump placement...
August 5, 2016: Annals of Surgical Oncology
Omer Burak Argun, Panagiotis Mourmouris, Ilter Tufek, Can Obek, Mustafa Bilal Tuna, Selcuk Keskin, Ali Riza Kural
BACKGROUND AND OBJECTIVE: Robotic upper urinary tract surgery is in most of the cases performed utilizing a standard 5 port configuration. Fewer ports can potentially produce a less invasive operation. Taking in consideration the above we report a novel technique for robot assisted laparoscopic partial nephrectomy utilizing fewer ports and we test its feasibility and safety profile. METHODS: Data on 11 robot-assisted laparoscopic partial nephrectomies performed by using our technique from February 2015 through June 2015 were retrospectively analyzed...
April 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Fabian Reche, Adrian Mancini, Anne-Laure Borel, Jean-Luc Faucheron
BACKGROUND: Gastric bypass procedures can potentially lead to middle and long-term complications (Podnos et al. Arch Surg 138(9):957-61, 2003). For several years, Roux-en-Y gastric bypass reversal procedures performed by laparotomy or laparoscopic way have been described in literature (Moon et al. Surg Obes Relat Dis 11(4):821-6, 2015). Major complications are anastomotic ulcers, anastomotic complications or functional disorder such as dumping syndrome, hypocalcemia, severe hypoglycemia, and malnutrition (Moon et al...
August 2016: Obesity Surgery
Giorgio Gandaglia, Elisa De Lorenzis, Giacomo Novara, Nicola Fossati, Ruben De Groote, Zach Dovey, Nazareno Suardi, Francesco Montorsi, Alberto Briganti, Bernardo Rocco, Alexandre Mottrie
BACKGROUND: Limited data are available on the role of robot-assisted radical prostatectomy (RARP) in patients with locally advanced prostate cancer (PCa). OBJECTIVE: To describe our surgical technique of extrafascial RARP and extended pelvic lymph node dissection (ePLND) in locally advanced PCa. DESIGN, SETTING, AND PARTICIPANTS: Ninety-four patients with clinical stage ≥T3 undergoing RARP with ePLND at three European centers between 2011 and 2015 were retrospectively evaluated...
May 18, 2016: European Urology
Naoki Saji, Kazumi Kimura, Yohei Tateishi, Shigeru Fujimoto, Nobuyuki Kaneko, Takao Urabe, Akira Tsujino, Yasuyuki Iguchi
The safety and efficacy of non-vitamin K oral anticoagulant (NOAC) compared with warfarin in treating patients with non-valvular atrial fibrillation (NVAF) who developed acute ischemic stroke or transient ischemic attack (AIS/TIA), particularly those receiving tissue-plasminogen activator (tPA) therapy, remains unclear. Between April 2012 and December 2014, we conducted a multicenter prospective cohort study to assess the current clinical practice for treating such patients. We divided the patients into two groups according to the administration of oral anticoagulants (warfarin or NOACs) and tPA therapy...
November 2016: Journal of Thrombosis and Thrombolysis
Stephan Buse, Carolin Eva Hach, Assen Alexandrov, Rene Mager, Axel Haferkamp
The objectives of this study are to describe the surgical technique for simultaneous en-bloc robot-assisted radical cystectomy and nephro-ureterectomy, to report its surgical bench marks, and finally, to summarize the current evidence on the procedure. After written informed consent, we prospectively enrolled consecutive patients undergoing simultaneous en-bloc robot-assisted radical cystectomy and nephro-ureterectomy in a prospective institutional database. We performed all procedures with robotic assistance from the DaVinci Si-HD(®), a four-arm robotic system...
May 6, 2016: Journal of Robotic Surgery
Chi-Feng Hung, Cheng-Kuang Yang, Yen-Chuan Ou
For the past three decades, cancer is the number one cause of death in Taiwan. An increasing trend in the incidence of urologic cancers has also been noticed since 1979. In 2012, urologic cancer accounted for 10.0% of all the new malignant cases. Prostate, bladder and kidney cancers are the most common types. Metastatic prostate cancer still accounted for nearly 30% of new cases in Taiwan between 2004 and 2012. There are several specifically noticeable characteristics of urothelial carcinoma in Taiwan, associated with arseniasis and aristolochic acid...
July 2016: Japanese Journal of Clinical Oncology
Jerome R Lyn-Sue, Josh S Winder, Shannon Kotch, Jacob Colello, Salvatore Docimo
The Roux-en-Y gastric bypass is the gold standard procedure for weight loss. This relatively complex procedure has excellent outcomes when performed via laparoscopy. The advent of the DaVinci robotic platform has been a technological advancement. Our goal is to provide information regarding the cost, time commitment, and advantages of transitioning an LRYGB program to an RRYGB program in an academic setting. We retrospectively reviewed the last 25 laparoscopic gastric bypass procedures and the first 25 robotic gastric bypass procedures performed by a single surgeon...
June 2016: Journal of Robotic Surgery
Theo Malthouse, Veeru Kasivisvanathan, Nicholas Raison, Wayne Lam, Ben Challacombe
Innovation in recent times has accelerated due to factors such as the globalization of communication; but there are also more barriers/safeguards in place than ever before as we strive to streamline this process. From the first planned partial nephrectomy completed in 1887, it took over a century to become recommended practice for small renal tumours. At present, identified areas for improvement/innovation are 1) to preserve renal parenchyma, 2) to optimise pre-operative eGFR and 3) to reduce global warm ischaemia time...
March 11, 2016: International Journal of Surgery
E Vicente, Y Quijano, B Ielpo, I Fabra
BACKGROUND: ALPPS procedure is gaining interest. Indications and technical aspects of this technique are still under debate [1]. Only 4 totally laparoscopic ALPPS procedures have been described in the literature and none by robotic approach [2-4]. This video demonstrates the technical aspects of totally robotic ALPPS. METHODS: A 58 year old man with sigmoid adenocarcinoma with multiple right liver metastases extended to segment IV and I underwent Xelox and 5 Fluoro-uracil neoadjuvancy...
November 14, 2015: Surgical Oncology
Jaschar Shakuri-Rad, Patrick W Gavin, Shawn P Todd, Tony T Tran, Cody R Christensen, Kenneth F Shockley, Thomas J Maatman
Guillain-Barre Syndrome is a well described acute demyelinating polyradiculoneuropathy with a likely autoimmune basis characterized by progressive ascending muscle paralysis. Classically, GBS is attributed to antecedent upper respiratory and gastrointestinal infections. We present the first case of GBS after Robotically Assisted Laparoscopic Prostatectomy using the daVinci(®) Surgical System.
March 2015: Urology Case Reports
Christian Lanz, Johan Mattsson, Umut Soydaner, Rudolf Brenneisen
Inhalation by vaporization is a promising application mode for cannabis in medicine. An in vitro validation of 5 commercial vaporizers was performed with THC-type and CBD-type cannabis. Gas chromatography/mass spectrometry was used to determine recoveries of total THC (THCtot) and total CBD (CBDtot) in the vapor. High-performance liquid chromatography with photodiode array detection was used for the quantitation of acidic cannabinoids in the residue and to calculate decarboxylation efficiencies. Recoveries of THCtot and CBDtot in the vapor of 4 electrically-driven vaporizers were 58...
2016: PloS One
Arif Ahmad, Jared D Carleton, Zoha F Ahmad, Ashish Agarwala
BACKGROUND: The purpose of this study was to compare the operative and early perioperative outcomes of laparoscopic versus robotic-assisted Roux-en-Y gastric bypass procedures performed in a community hospital setting. METHODS: The study was a chart review and analysis of the early perioperative outcomes of a total of 345 Roux-en-Y gastric bypass procedures performed by a single surgeon in a community hospital setting from January 2011 to October 2014. Of these, 173 procedures were performed laparoscopically and 172 were performed with robotic assistance utilizing the daVinci(®) surgical platform...
September 2016: Surgical Endoscopy
Surender Dabas, Abhinav Dewan, Reetesh Ranjan, Ajay Kumar Dewan, Himanshu Shukla, Rupal Sinha
BACKGROUND: The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients. MATERIALS AND METHODS: Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded. RESULTS: The feasibility of salvage TORS in our study was observed to be 100%...
2015: Asian Pacific Journal of Cancer Prevention: APJCP
Alyssa Tanaka, Courtney Graddy, Khara Simpson, Manuela Perez, Mireille Truong, Roger Smith
BACKGROUND: The introduction of simulation into minimally invasive robotic surgery is relatively recent and has seen rapid advancement; therefore, a need exists to develop training curriculums and identify systems that will be most effective at training surgical skills. Several simulators have been introduced to support these aims-the daVinci skills simulator, Mimic dV-Trainer, Surgical Simulated Systems' RoSS, and Simbionix Robotix Mentor. While multiple studies have been conducted to demonstrate the validity of these systems, studies comparing the perceived value of these devices as tools for education and skills are lacking...
September 2016: Surgical Endoscopy
Sondra Summers, Jennifer Anderson, Amy Petzel, Megan Tarr, Kimberly Kenton
A robotics practice curriculum was developed utilizing dry lab skills and testing parameters based upon the objective structured assessment of surgical tasks (OSATS) to determine its effectiveness in training novice surgeons. We recruited 20 medical students who were oriented to the DaVinci S console and instrumentation. They were pre-tested with four dry lab skills including manipulation, transection, suturing and knot tying. A control group was instructed to practice once weekly to attain proficiency and the intervention group was provided specific instructions regarding practice goals...
March 2015: Journal of Robotic Surgery
Khurram Khan, Tom Dobbs, Marc C Swan, Gregory S Weinstein, Tim E E Goodacre
BACKGROUND/AIM: Robot-assisted surgery has become increasingly routine, replacing open and laparoscopic techniques in certain domains, with recent extension to head and neck surgery through trans-oral access. Some advantages of the robot-assisted surgery include the ability to access confined spaces, enhanced dexterity instrumentation with intuitive movement, motion scaling, tremor elimination and three-dimensional (3D) endoscopic viewing with true depth perception. The aim of this study was to investigate the technical feasibility of trans-oral robotic cleft surgery (TORCS) to access the posterior pharyngeal wall and palate for potential use in the cleft population...
January 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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