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Robotic hysterectomy

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https://www.readbyqxmd.com/read/28098574/new-developments-in-robotics-and-single-site-gynecologic-surgery
#1
Catherine A Matthews
Within the last 10 years there have been significant advances in minimal-access surgery. Although no emerging technology has demonstrated improved outcomes or fewer complications than standard laparoscopy, the introduction of the robotic surgical platform has significantly lowered abdominal hysterectomy rates. While operative time and cost were higher in robotic-assisted procedures when the technology was first introduced, newer studies demonstrate equivalent or improved robotic surgical efficiency with increased experience...
January 17, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28094020/the-wertheim-hysterectomy-development-modifications-and-impact-in-the-present-day
#2
Alexa L Swailes, Allison Gockley, Rébécca Phaëton, Joshua P Kesterson
Ernst Wertheim was a pioneer in the history of the surgical treatment of cervical cancer. His English-language manuscript "The extended abdominal operation for carcinoma uteri (based on 500 operative cases)," which was published in 1912, detailed his standardization of the radical hysterectomy and formed the basis of the current treatment for early stage cervical cancer. We contextualize the Wertheim hysterectomy, emphasizing medical advances that allowed for its development and subsequent modification. We then discuss modifications to the originally proposed procedure, including a maximally extended parametrical resection pioneered by Takayama, and the addition of the Taussig en bloc lymph node dissection by Meigs, both of which afforded an improved mortality profile due to decreased disease recurrence...
January 13, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28067743/comparative-perioperative-pain-and-recovery-in-women-undergoing-vaginal-reconstruction-versus-robotic-sacrocolpopexy
#3
Lauren B Westermann, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
BACKGROUND: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy. OBJECTIVES: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28043722/metabolic-and-inflammatory-responses-and-subsequent-recovery-in-robotic-versus-abdominal-hysterectomy-a-randomised-controlled-study
#4
Lena Wijk, Kerstin Nilsson, Olle Ljungqvist
BACKGROUND & AIMS: Surgery causes inflammatory and metabolic responses in the body. The aim of the study was to investigate whether robotic-assisted total laparoscopic hysterectomy induces less insulin resistance than abdominal hysterectomy, and to compare inflammatory response and clinical recovery between the two techniques. METHODS: A randomised controlled study at the Department of Obstetrics and Gynaecology, Örebro University Hospital, Sweden. Twenty women scheduled for a planned total hysterectomy with or without salpingo-oophorectomy between October 2014 and May 2015, were randomly allocated to robotic-assisted total laparoscopic hysterectomy or abdominal hysterectomy...
December 23, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28038476/single-site-robotic-radical-hysterectomy-and-sentinel-lymphnode-biopsy-in-cervical-cancer-a-case-report
#5
Alexandre Silva E Silva, Rodrigo Pinto Fernandes, Marcia Pereira de Araujo, João Paulo Mancusi de Carvalho, Filomena Marino Carvalho, Giovani Mastrantônio Favero, Jesus Paula Carvalho
Robotic surgeries for cervical cancer have several advantages compared with laparotomic or laparoscopic surgeries. Robotic single-site surgery has many advantages compared with the multiport approach, but its safety and feasibility are not established in radical oncologic surgeries. We report a case of a Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical carcinoma whose radical hysterectomy, sentinel lymph node mapping, and lymph node dissection were entirely performed by robotic single-site approach...
December 30, 2016: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28034651/patient-surgeon-and-hospital-disparities-associated-with-benign-hysterectomy-approach-and-perioperative-complications
#6
Ambar Mehta, Tim Xu, Susan Hutfless, Martin A Makary, Abdulrahman K Sinno, Edward J Tanner, Rebecca L Stone, Karen Wang, Amanda N Fader
BACKGROUND: Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary U.S. hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these two factors with patient, surgeon, and hospital characteristics. OBJECTIVES: To describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28011096/minimally-invasive-radical-hysterectomy-for-cervical-cancer-is-associated-with-reduced-morbidity-and-similar-survival-outcomes-compared-with-laparotomy
#7
Elisabeth Diver, Emily Hinchcliff, Allison Gockley, Alexander Melamed, Leah Contrino, Sarah Feldman, Whitfield Growdon
STUDY OBJECTIVE: In cervical cancer, there are limited randomized trials to indicate whether patient outcomes are equivalent after radical hysterectomy (RH) via minimally invasive (MIS) or traditional laparotomy (XL) approach. The aim of this study was to assess patient outcomes of women with cervical cancer undergoing upfront RH at two large academic institutions to determine if mode of surgery affects patient outcomes. DESIGN: A retrospective cohort study Design classification: Canadian Task Force Classification II-1 SETTING: Two academic medical institutions in the United States from 2000 to 2013 PATIENTS: Women undergoing upfront RH for cervical cancer INTERVENTION: Minimally invasive techniques (laparoscopic and robotic) for RH, as compared with XL MEASUREMENTS AND MAIN RESULTS: 383 women met eligibility requirements...
December 20, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28007583/towards-a-privacy-preserving-cohort-discovery-framework-for-clinical-research-networks
#8
Jiawei Yuan, Bradley Malin, François Modave, Yi Guo, William R Hogan, Elizabeth Shenkman, Jiang Bian
BACKGROUND: The last few years have witnessed an increasing number of clinical research networks (CRNs) focused on building large collections of data from electronic health records (EHRs), claims, and patient-reported outcomes (PROs). Many of these CRNs provide a service for the discovery of research cohorts with various health conditions, which is especially useful for rare diseases. Supporting patient privacy can enhance the scalability and efficiency of such processes; however, current practice mainly relies on policy, such as guidelines defined in the Health Insurance Portability and Accountability Act (HIPAA), which are insufficient for CRNs (e...
December 19, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27994668/the-learning-curves-of-robotic-and-three-dimensional-laparoscopic-surgery-in-cervical-cancer
#9
Xue-Lian Li, Dan-Feng Du, Hua Jiang
BACKGROUND: The 3D laparoscopy systems and robotic systems have been introduced into clinical practice for a few years. But the comparison of robotic and 3D laparoscopic gynecologic surgery is still needed. OBJECTIVE: To retrospectively compare the learning curves of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer. STUDY DESIGN: The operational duration, blood loss, peritoneal drainage of first 24 hours after operation, total hospitalization days, hospitalization days after operation, lymph nodes collected, learning curves and cost of robotic and 3D laparoscopic hysterectomy and pelvic lymphadenectomy in cervical cancer performed by one experienced surgeon were studied...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/27973253/the-adoption-trends-of-robotic-assisted-benign-hysterectomy-in-united-states-from-2008-to-2014
#10
G Moawad, C Song, J Lavin, S Tackett, E Liu
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27938988/incidence-and-risk-factors-for-surgical-site-infection-post-hysterectomy-in-a-tertiary-care-center
#11
Aurora Pop-Vicas, Jackson S Musuuza, Michelle Schmitz, Ahmed Al-Niaimi, Nasia Safdar
BACKGROUND: Preoperative antibiotic prophylaxis and surgical technological advances have greatly reduced, but not totally eliminated surgical site infection (SSI) posthysterectomy. We aimed to identify risk factors for SSI posthysterectomy among women with a high prevalence of gynecologic malignancies, in a tertiary care setting where compliance with the Joint Commission's Surgical Care Improvement Project core measures is excellent. METHODS: The study was a matched case-control, 2 controls per case, matched on date of surgery...
December 9, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27926638/determining-optimal-route-of-hysterectomy-for-benign-indications-clinical-decision-tree-algorithm
#12
Jennifer J Schmitt, Daniel A Carranza Leon, John A Occhino, Amy L Weaver, Sean C Dowdy, Jamie N Bakkum-Gamez, Kalyan S Pasupathy, John B Gebhart
OBJECTIVE: To evaluate practice change after initiation of a robotic surgery program using a clinical algorithm to determine the optimal surgical approach to benign hysterectomy. METHODS: A retrospective postrobot cohort of benign hysterectomies (2009-2013) was identified and the expected surgical route was determined from an algorithm using vaginal access and uterine size as decision tree branches. We excluded the laparoscopic hysterectomy route. A prerobot cohort (2004-2005) was used to evaluate a practice change after the addition of robotic technology (2007)...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27924377/robot-assisted-extravesical-vesicovaginal-fistula-repair-utilizing-laparoscopically-mobilized-omental-flap-interposition
#13
Kara L Watts, Richard Ho, Reza Ghavamian, Nitya Abraham
INTRODUCTION AND HYPOTHESIS: High vesicovaginal fistulas (VVF) in the setting of good apical support are best repaired via a transabdominal approach. Laparoscopic VVF repair was first reported in 1998. Several series of robot-assisted VVF repairs have since been published. The robot-assisted approach allows repair of high apical vaginal fistulas while avoiding the morbidity of laparotomy, shortening convalescence, and facilitating the use of omental interposition flaps. This video presents the technique for robot-assisted extravesical VVF repair utilizing a laparoscopically mobilized omental flap...
December 6, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27923167/long-term-outcomes-for-different-vaginal-cuff-closure-techniques-in-robotic-assisted-laparoscopic-hysterectomy-a-randomized-controlled-trial
#14
Ziv Tsafrir, Matthew Palmer, Marisa Dahlman, A Karim Nawfal, Joelle Aoun, Andrew Taylor, Jay Fisher, Evan Theoharis, David Eisenstein
OBJECTIVE: This randomized controlled trial aimed to evaluate the outcomes of different vaginal cuff closure techniques in robotic-assisted total laparoscopic hysterectomy. STUDY DESIGN: Ninety women undergoing robotic-assisted total laparoscopic hysterectomy for benign disease were randomized to three vaginal cuff closure techniques: running 2.0 V-Lock™ (Arm 1), 0 Vicryl™ figure-of-eight (Arm 2), and running 0 Vicryl™ with Lapra-Ty(®) (Arm 3). Patients' records were reviewed for age, body mass index, smoking status and relevant co-morbidities...
November 16, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27919731/nerve-sparing-laparoscopic-colposacropexy-using-a-percutaneous-surgical-system-a-case-report
#15
Federico Romano, Francesco Legge, Giovanni Scambia, Maurizio Guido
STUDY OBJECTIVE: To evaluate the feasibility, efficacy and safeness of nerve-sparing laparoscopic colposacropexy performed with a minimally invasive approach by using 2,9 mm Percuvance(TM) Percutaneous Surgical System (PSS) (The Percuvance(TM) System, Teleflex Inc., USA). DESIGN: Step-by-step video demonstration of the surgical technique. The Internal Department Committee approved this study. The patient was adequately informed about the possible risks and benefits of this experimental technique and a written consent agreeing to undergo the described procedure was signed...
December 2, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27867048/feasibiility-and-learning-curve-of-robotic-laparo-endoscopic-single-site-surgery-in-gynecology
#16
Alexandre Buckley de Meritens, Julia Kim, Helen Dinkelspiel, Eloise Chapman-Davis, Thomas Caputo, Kevin Holcomb
Single-site laparoscopy has proven to be a desirable option for patients undergoing gynecologic surgery with some studies indicating improved cosmesis and less perioperative pain compared to standard approaches. This study describes the safety and feasibility of a novel robotic laparo-endoscopic single-site surgery (R-LESS) platform as it is incorporated into a surgeon's practice with extensive multiport robotic surgical experience but limited laparo-endoscopic single-site experience. We reviewed 83 women undergoing R-LESS by a single surgeon from September 2013 through August 2015...
November 17, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27856385/wound-infiltration-with-extended-release-versus-short-acting-bupivacaine-before-laparoscopic-hysterectomy-a-randomized-controlled-trial
#17
Kenneth I Barron, Georgine M Lamvu, R Cole Schmidt, Matthew Fisk, Emily Blanton, Insiyyah Patanwala
STUDY OBJECTIVE: To evaluate if pre-incision infiltration with extended-release liposomal bupivacaine provides improved overall pain relief compared to 0.25% bupivacaine after laparoscopic or robotic-assisted hysterectomy. DESIGN: Single center double-masked randomized controlled trial (Canadian Task Force Classification I). SETTING: Tertiary-care community hospital PATIENTS: Patients recruited from July 2015 through January 2016. Sixty-four patients were randomized and 59 were analyzed for the primary outcome...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27853733/pedagogic-approach-in-the-surgical-learning-the-first-period-of-assistant-surgeon-may-improve-the-learning-curve-for-laparoscopic-robotic-assisted-hysterectomy
#18
Angeline Favre, Stephanie Huberlant, Marie Carbonnel, Julie Goetgheluck, Aurelie Revaux, Jean Marc Ayoubi
BACKGROUND: Hysterectomy is the most frequent surgery done with robotic assistance in the world and has been widely studied since its emergence. The surgical outcomes of the robotic hysterectomy are similar to those obtained with other minimally invasive hysterectomy techniques (laparoscopic and vaginal) and appear as a promising surgical technique in gynecology surgery. The aim of this study was to observe the learning curve of robot-assisted hysterectomy in a French surgical center, and was to evaluate the impact of the surgical mentoring...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27844235/robot-assisted-laparoscopic-colpectomy-in-female-to-male-transgender-patients-technique-and-outcomes-of-a-prospective-cohort-study
#19
Freek Groenman, Charlotte Nikkels, Judith Huirne, Mick van Trotsenburg, Hans Trum
BACKGROUND: Gender-affirming surgeries in female-to-male (FtM) transgender patients include mostly hysterectomy, bilateral salpingo-oophorectomy and mastectomy. Sometimes further surgery is performed, such as phalloplasty. Colpectomy may be performed to overcome gender dysphoria and disturbing vaginal discharge; furthermore, it may be important in reducing the risk of fistulas due to the phalloplasty procedure with urethral elongation. Colpectomy prior to the reconstruction of the neourethra seems to reduce fistula rates on the very first anastomosis...
November 14, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27843219/transvaginal-bowel-evisceration-following-robot-assisted-radical-cystectomy
#20
Sameer Chopra, Arjuna Dharmaraja, Hooman Djaladat, Monish Aron
Transvaginal evisceration of the bowel has been found to most commonly occur following hysterectomy. To date, the reports of this complication following radical cystectomy are minimal. Herein, we report a case of transvaginal bowel evisceration 45 days following robotic-assisted radical cystectomy (RARC) in a postmenopausal woman.
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
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