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https://www.readbyqxmd.com/read/28444558/evolution-of-surgical-treatment-for-rectal-cancer-a-review
#1
Sanjeev Dayal, Nick Battersby, Tom Cecil
Surgery that produces an optimal total mesorectal excision (TME) resection specimen remains the cornerstone of curative rectal cancer management. In the modern era, despite the results of recent randomised trials, laparoscopic TME is a crucial technique in the TME surgery armamentarium. Laparoscopic surgery offers the benefit of magnified views that aid sharp and precise dissection. However operating in the confines of a narrow pelvis, particularly when the mesorectum is bulky, requires significant technical skill...
April 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28411345/an-appraisal-of-the-learning-curve-in-robotic-general-surgery
#2
Luise I M Pernar, Faith C Robertson, Ali Tavakkoli, Eric G Sheu, David C Brooks, Douglas S Smink
BACKGROUND: Robotic-assisted surgery is used with increasing frequency in general surgery for a variety of applications. In spite of this increase in usage, the learning curve is not yet defined. This study reviews the literature on the learning curve in robotic general surgery to inform adopters of the technology. METHODS: PubMed and EMBASE searches yielded 3690 abstracts published between July 1986 and March 2016. The abstracts were evaluated based on the following inclusion criteria: written in English, reporting original work, focus on general surgery operations, and with explicit statistical methods...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28408112/outcome-comparisons-between-high-volume-robotic-and-laparoscopic-surgeons-in-a-large-healthcare-system
#3
Laila Rashidi, Chris Neighorn, Amir Bastawrous
Robotic colorectal surgery has been performed for nearly a decade, but has been criticized for high cost. We sought to assess outcomes of colorectal operations performed by surgeons with higher experience in robotics and laparoscopy across a large health system. We performed a retrospective review of colon or rectal resections performed between January 2013 and May 2016 within the Providence Health and Services. Surgeons were only included if they performed 30 or more procedures with an approach per year. We assessed outcomes including operative time, hospital length of stay, complications, readmission, conversion to open rates and total direct costs...
April 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28403973/a-national-snapshot-of-the-surgical-management-of-deep-infiltrating-endometriosis-of-the-rectum-and-colon-in-france-in-2015-a-multicenter-series-of-1135-cases
#4
H Roman
OBJECTIVE: To perform a survey on the characteristics of the surgical management of patients with deep infiltrating endometriosis of the rectum and the sigmoid colon (DIERS) in France in 2015. METHOD: Case-series study enrolling patients with DIERS involving muscularis, submucosa or mucosa, operated on from January 1st to December 31st 2015, in 56 healthcare facilities in France. Surgeons filled in questionnaires concerning the number of patients, deep endometriosis localizations, surgical route and techniques used on digestive tract, associated surgical procedures and major complications...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403962/management-of-deep-infiltrating-endometriosis-by-laparoscopic-route-with-robotic-assistance-3-year-experience
#5
C Abo, H Roman, V Bridoux, E Huet, J-J Tuech, B Resch, E Stochino, L Marpeau, B Darwish
OBJECTIVE: To assess the feasibility of deep endometriosis surgery using robotic assistance, benefits and limits of this approach. METHOD: Case-series study enrolling patients managed for deep infiltrating endometriosis (DIE) using robotic assistance in our department between September 2011 and March 2014 (NCT02294825). Self-questionnaires including pain and digestive symptoms were filled in preoperatively and 1 year after surgery. RESULTS: Thirty-five patients were enrolled in the series...
January 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28378076/training-value-of-laparoscopic-colorectal-videos-on-the-world-wide-web-a-pilot-study-on-the-educational-quality-of-laparoscopic-right-hemicolectomy-videos
#6
V Celentano, M Browning, C Hitchins, M C Giglio, M G Coleman
INTRODUCTION: Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but unfortunately there are no guidelines for annotating these videos or agreed methods to measure the educational content and the safety of the procedure presented. Aim of this study is to systematically search the World Wide Web to determine the availability of laparoscopic colorectal surgery videos and to objectively establish their potential training value...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28363438/reducing-surgical-site-infections-after-hysterectomy-metronidazole-plus-cefazolin-compared-with-cephalosporin%C3%A2-alone
#7
Sara R Till, Daniel M Morgan, Ali A Bazzi, Mark D Pearlman, Zaid Abdelsattar, Darrell A Campbell, Shitanshu Uppal
BACKGROUND: Organisms that are isolated from vaginal cuff infections and pelvic abscesses after hysterectomy frequently include anaerobic vaginal flora. Metronidazole has outstanding coverage against nearly all anaerobic species, which is superior to both cefazolin and second-generation cephalosporins. Cefazolin plus metronidazole has been demonstrated to reduce infectious morbidity compared with either cefazolin or second-generation cephalosporins in other clean-contaminated procedures, which include both as colorectal surgery and cesarean delivery...
March 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28347491/diffusion-of-technology-trends-in-robotic-assisted-colorectal-surgery
#8
Aneel Damle, Rachelle N Damle, Julie M Flahive, Andrew T Schlussel, Jennifer S Davids, Paul R Sturrock, Justin A Maykel, Karim Alavi
Following FDA approval, robotic-assisted colorectal surgery (RACS) has increased in prevalence. We aimed to identify trends in utilization and patient characteristics of RACS in the United States using the University HealthSystem Consortium database between October 2011-September 2015. Outcome measures were number and percentage of procedures performed with robotic-assistance. 7100 patients were identified. The most common procedures were low anterior resection, sigmoid colectomy, abdominoperineal resection, right colectomy, rectopexy, left colectomy, and total colectomy...
March 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28323223/robotic-assisted-conservative-excision-of-retrocervical-rectal-deep-infiltrating-endometriosis-a-case-series
#9
Alfredo Ercoli, Emma Bassi, Stefania Ferrari, Daniela Surico, Anna Fagotti, Francesco Fanfani, Fiorenzo De Cicco, Nicola Surico, Giovanni Scambia
Deep infiltrating endometriosis (DIE) is a complex disease that impairs the quality of life and the fertility of women. Colorectal DIE accounts for 70% to 93% of all the intestinal endometriotic sites and frequently needs a surgical approach. However, the indications for the surgical management of this condition are still controversial. From March 2010 to June 2014, we scheduled 33 consecutive patients presenting with retrocervical-rectal DIE of any diameter not involving the mucosa nor producing rectal stenosis > 50% for laparoscopic robotic assisted nerve-sparing rectal nodulectomy (LRN)...
March 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28317582/robotic-right-hemicolectomy-analysis-of-108-consecutive-procedures-and-multidimensional-assessment-of-the-learning-curve
#10
Amilcare Parisi, Luca Scrucca, Jacopo Desiderio, Alessandro Gemini, Salvatore Guarino, Francesco Ricci, Roberto Cirocchi, Giorgio Palazzini, Vito D'Andrea, Liliana Minelli, Stefano Trastulli
PURPOSE: Surgeons tend to view the robotic right colectomy (RRC) as an ideal beginning procedure to gain proficiency in robotic general and colorectal surgery. Nevertheless, oncological RRC, especially if performed with intracorporeal ileocolic anastomosis confectioning, cannot be considered a technically easier procedure. The aim of this study was to assess the learning curve of the RRC performed for oncological purposes and to evaluate its safety and efficacy investigating the perioperative and pathology outcomes in the different learning phases...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28299807/evolving-application-of-minimally-invasive-cancer-operations-at-a-tertiary-cancer-center
#11
Luke V Selby, Ronald P DeMatteo, Renee M Tholey, William R Jarnagin, Julio Garcia-Aguilar, Paul D Strombom, Peter J Allen, T Peter Kingham, Martin R Weiser, Murray F Brennan, Vivian E Strong
BACKGROUND: Patients and providers are increasingly interested in the utilization, safety, and efficacy of minimally invasive surgery (MIS). We reviewed 11 years of MIS resections (laparoscopic and robotic) for intra-abdominal malignancies. METHODS: Patients who underwent gastrectomy, distal pancreatectomy, hepatic resection, and colorectal resection between 2004 and 2014 were identified. Cases were categorized as open, laparoscopic, and robotic based on the initial operation approach...
March 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28275893/multiquadrant-robotic-colorectal-surgery-the-da-vinci-xi-vs-si-comparison
#12
Bogdan Protyniak, Jeffrey Jorden, Russell Farmer
The newly introduced da Vinci Xi Surgical System hopes to address the shortcomings of its predecessor, specifically robotic arm restrictions and difficulty working in multiple quadrants. We compare the two robot platforms in multiquadrant surgery at a major colorectal referral center. Forty-four patients in the da Vinci Si group and 26 patients in the Xi group underwent sigmoidectomy or low anterior resection between 2014 and 2016. Patient demographics, operative variables, and postoperative outcomes were compared using descriptive statistics...
March 8, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28271268/robotic-versus-laparoscopic-rectal-resection-for-sphincter-saving-surgery-pathological-and-short-term-outcomes-in-a-single-center-analysis-of-130-consecutive-patients
#13
Alain Valverde, Nicolas Goasguen, Olivier Oberlin, Magali Svreck, Jean-François Fléjou, Alain Sezeur, Henri Mosnier, Rémi Houdart, Renato M Lupinacci
BACKGROUND: Minimally invasive sphincter-saving rectal resection represents a challenging procedure. Robotic surgery for rectal cancer has several advantages over conventional surgery in performing precise dissection and was proved to be safe and effective in previous studies. However, comparison between laparoscopic and robotic rectal resection has drawn contradictory results. The aim of the present study was to compare robotic and laparoscopic sphincter-saving rectal resections for short-term and pathological outcomes...
March 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28271267/prior-experience-in-laparoscopic-rectal-surgery-can-minimise-the-learning-curve-for-robotic-rectal-resections-a-cumulative-sum-analysis
#14
Manfred Odermatt, Jamil Ahmed, Sofoklis Panteleimonitis, Jim Khan, Amjad Parvaiz
BACKGROUND: The learning curve for robotic colorectal surgery is ill-defined. This study aimed to investigate the learning curve of experienced laparoscopic rectal surgeons when starting with robotic total mesorectal excision (TME) using cumulative sum (CUSUM) charts. METHODS: This retrospective case series analysed patients who underwent curative and elective laparoscopic or robotic TMEs for rectal cancer performed by two surgeons. The first consecutive robotic TME cases of each surgeon were 1:1 propensity score matched to their laparoscopic TME cases using age, body mass index, American Society of Anesthesiologists grade, T stage (AJCC) and tumour location height...
March 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28236012/application-of-a-computer-assisted-flexible-endoscope-system-for-transoral-surgery-of-the-hypopharynx-and-upper-esophagus
#15
Daniel T Friedrich, M O Scheithauer, J Greve, N Rotter, J Doescher, T K Hoffmann, P J Schuler
Zenker's diverticulum is a common pathology in the transition zone of the posterior hypopharynx and esophagus. Surgical treatment is routinely performed by ENT and general surgeons. Besides the traditional open transcervical diverticulectomy, the introduction of transoral rigid treatment led to a paradigm change and is now the preferred treatment option for patients who are fit for general anesthesia. The implementation of interventional flexible endoscopy has opened another new micro-invasive approach for patients with high morbidity...
February 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28196361/introduction-of-robotic-surgery-into-a-community-hospital-setting-a-prospective-comparison-of-robotic-and-open-colorectal-resection-for-cancer
#16
Marek Zawadzki, Małgorzata Krzystek-Korpacka, Marek Rząca, Roman Czarnecki, Zbigniew Obuszko, Wojciech Witkiewicz
PURPOSE: The aim of this study was to compare robotic colorectal surgery (RCS) performed by a team having limited expertise in robotic surgery with open colorectal surgery (OCS) performed by experienced colorectal surgeons. METHODS: This was a prospective comparative nonrandomized study. RESULTS: Between March 2013 and June 2015, 79 patients with colon and rectal adenocarcinoma were enrolled into the study. Of these, 41 patients underwent OCS and 38 underwent RCS...
February 15, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28132735/robotic-hepatic-arterial-infusion-pump-placement
#17
Motaz Qadan, Michael I D'Angelica, Nancy E Kemeny, Andrea Cercek, T Peter Kingham
BACKGROUND: Hepatic artery infusion pump (HAIP) placement is associated with improved outcomes in the treatment of colorectal liver metastases (CRLM). In this study, we examined outcomes following robotic HAIP placement, which were compared with open and laparoscopic placement. METHODS: A retrospective review of HAIP placements by 2 surgeons at a single institution was carried out. All statistical tests were 2-sided and p < 0.05 was considered significant. RESULTS: There were a total of 53 open HAIP cases, 21 laparoscopic cases, and 24 robotic cases...
January 26, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#18
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#19
Audrey L Stokes, Sanjib D Adhikary, Ashley Quintili, Frances J Puleo, Christine S Choi, Christopher S Hollenbeak, Evangelos Messaris
BACKGROUND: Enhanced recovery protocols frequently use multimodal postoperative analgesia to improve postoperative outcomes in patients undergoing colorectal surgery. OBJECTIVE: The purpose of this study was to evaluate liposomal bupivacaine use in transversus abdominis plane blocks on postoperative pain scores and opioid use after colorectal surgery. DESIGN: This was a retrospective cohort study comparing outcomes between patients receiving nonliposomal anesthetic (n = 104) and liposomal bupivacaine (n = 303) blocks...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28058512/a-novel-approach-for-robotic-mobilization-of-the-splenic-flexure
#20
O Isik, C Benlice, E Gorgun
BACKGROUND: The techniques of robotic splenic flexure mobilization in the colorectal surgery setting are not well defined and have been challenging due to limited range of motion of the second-generation robotic platform in multiple quadrants. METHODS: This report describes a novel technique for robotic splenic flexure mobilization with medial-to-lateral approach without a need for robotic cart repositioning during left-sided colon and rectal surgery. The dissection is started with ligation of the inferior mesenteric artery and vein...
January 2017: Techniques in Coloproctology
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