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robotic cholecystectomy

Rodolfo J Oviedo, Jarrod C Robertson, Sharifah Alrajhi
BACKGROUND AND OBJECTIVES: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. METHODS: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Nicola Di Lorenzo, Livia Cenci, Massimiliano Simi, Claudio Arcudi, Valeria Tognoni, Achille Lucio Gaspari, Pietro Valdastri
BACKGROUND: Minimally invasive surgery (MIS) is rising in popularity generating a revolution in operative medicine during the past few decades. Although laparoscopic techniques have not significantly changed in the last 10 years, several advances have been made in visualization devices and instrumentation. METHODS: Our team, composed of surgeons and biomedical engineers, developed a magnetic levitation camera (MLC) with a magnetic internal mechanism dedicated to MIS...
September 22, 2016: Surgical Endoscopy
Mario Testini, Lucia Ilaria Sgaramella, Giuseppe Massimiliano De Luca, Alessandro Pasculli, Angela Gurrado, Antonio Biondi, Giuseppe Piccinni
INTRODUCTION: Mirizzi syndrome (MS) is a rare complication of cholelithiasis. Despite the success of laparoscopic cholecystectomy as a minimally invasive approach to gallstone disease, MS remains a challenge, also for open and robotic approaches, due to the subverted anatomy of the hepatocystic triangle. Moreover, when emergency surgery is needed, the optimal preoperative diagnostic assessment could not be always achievable. We aim to analyze our experience of MS treated in emergency and to assess the feasibility of a diagnostic and therapeutic decisional algorithm...
September 9, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Takeaki Ishizawa, Akio Saiura, Norihiro Kokudo
In hepatobiliary surgery, the fluorescence and bile excretion of indocyanine green (ICG) can be used for real-time visualization of biological structure. Fluorescence cholangiography is used to obtain fluorescence images of the bile ducts following intrabiliary injection of 0.025-0.5 mg/mL ICG or intravenous injection of 2.5 mg ICG. Recently, the latter technique has been used in laparoscopic/robotic cholecystectomy. Intraoperative fluorescence imaging can be used to identify subcapsular hepatic tumors. Primary and secondary hepatic malignancy can be identified by intraoperative fluorescence imaging using preoperative intravenous injection of ICG through biliary excretion disorders that exist in cancerous tissues of hepatocellular carcinoma (HCC) and in non-cancerous hepatic parenchyma around adenocarcinoma foci...
August 2016: Hepatobiliary Surgery and Nutrition
David S Strosberg, Michelle C Nguyen, Peter Muscarella, Vimal K Narula
INTRODUCTION: Robotic-assisted surgery is gaining popularity in general surgery. Our objective was to evaluate and compare operative outcomes and total costs for robotic cholecystectomy (RC) and laparoscopic cholecystectomy (LC). METHODS AND PROCEDURES: A retrospective review was performed for all patients who underwent single-procedure RC and LC from January 2011 to July 2015 by a single surgeon at a large academic medical center. Demographics, diagnosis, perioperative variables, postoperative complications, 30-day readmissions, and operative and hospital costs were collected and analyzed between those patient groups...
August 5, 2016: Surgical Endoscopy
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
Jin Soo Kim, Jong Bum Choi, Sook Young Lee, Wook Hwan Kim, Nam Hyun Baek, Jayoun Kim, Chu Kyung Park, Yeon Ju Lee, Sung Yong Park
BACKGROUND: Robotic cholecystectomy (RC) using port sites in the lower abdominal area (T12-L1) rather than the upper abdomen has recently been introduced as an alternative procedure for laparoscopic cholecystectomy. Therefore, we investigated the time course of different components of pain and the analgesic effect of the bilateral ultrasound-guided split injection technique for rectus sheath block (sRSB) after RC in female patients. METHODS: We randomly assigned 40 patients to undergo ultrasound-guided sRSB (RSB group, n = 20) or to not undergo any block (control group, n = 20)...
August 2016: Medicine (Baltimore)
L F Gonzalez-Ciccarelli, P Quadri, D Daskalaki, L Milone, A Gangemi, P C Giulianotti
Robot-assisted hepatobiliary surgery has been steadily growing in recent years. It represents an alternative to the open and laparoscopic approaches in selected patients. Endowristed instruments and enhanced visualization provide important advantages in terms of selective bleeding control, microsuturing, and dissection. Cholecystectomies and minor hepatectomies are being performed with comparable results to open and laparoscopic surgery. Even complex procedures, such as major and extended hepatectomies, can have excellent outcomes, in expert hands...
August 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
A Gangemi, R Danilkowicz, F E Elli, F Bianco, M Masrur, P C Giulianotti
Comparative studies between robotic and laparoscopic cholecystectomy (LC) focus heavily on economic considerations under the assumption of comparable clinical outcomes. Advancement of the robotic technique and the further widespread use of this approach suggest a need for newer comparison studies. 676 ICG-aided robotic cholecystectomies (ICG-aided RC) performed at the University of Illinois at Chicago (UIC) Division of General, Minimally Invasive and Robotic Surgery were compiled retrospectively. Additionally, 289 LC were similarly obtained...
July 19, 2016: Journal of Robotic Surgery
Sae Byeol Choi, Sang Yong Choi
Recent advances in minimally invasive surgery include laparoscopic and robotic surgery. These surgical techniques have changed the paradigm of surgical treatment for hepatobiliary diseases. Minimally invasive surgery has the advantages of minimal wound extension for cosmetic effect, early postoperative recovery, and few postoperative complications in patients. For laparoscopic liver resection, the indications have been expanded and oncological outcome was proven to be similar with open surgery in the malignant disease...
June 2016: Kaohsiung Journal of Medical Sciences
Dimitrios Stefanidis, Brittany Anderson-Montoya, Robert V Higgins, Manuel E Pimentel, Patrick Rowland, Madison O Scarborough, Danelle Higgins
BACKGROUND: While performance feedback and assessment are hallmarks of surgical training, they abruptly cease after training is completed. In their absence, performance may stagnate and poor habits persist. Our aim was to develop a coaching mechanism for practicing surgeons with feedback provision based on objective performance assessment. METHODS: Technical and nontechnical intraoperative video recordings from laparoscopic or robotic cholecystectomies, colectomies, and hysterectomies were assessed by a blinded surgeon and a human factors expert, respectively...
September 2016: Surgery
Yoen T K van der Linden, Hylke J F Brenkman, Sylvia van der Horst, Wilhelmina M U van Grevenstein, Richard van Hillegersberg, Jelle P Ruurda
BACKGROUND: For cholecystectomy, multiport laparoscopy is the recommended surgical approach. Single-port laparoscopy (SPL) was introduced to reduce postoperative pain and provide better cosmetic results, but has technical disadvantages. Robotic SPL (RSPL) was developed to overcome these disadvantages. In this prospective study, we aim to describe intraoperative results and postoperative outcomes of RSPL cholecystectomies and evaluate technical aspects of the technique. METHODS: A prospective database of all patients who underwent a RSPL cholecystectomy between January 2012 and December 2014 was analyzed...
June 3, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Wen-Lung Su, Jian-Wei Huang, Shen-Nien Wang, King-Teh Lee
BACKGROUND: Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. The latest evolution is single incision laparoscopic cholecystectomy (SILC). Single-site robotic cholecystectomy (SSRC) overcomes several limitations of manual SILC. The aim of this study is to present our initial experiences in SSRC and to compare its clinical outcomes with those of SILC. METHODS: This study retrospectively reviewed data for patients who received SSRC or SILC from February 2014 to September 2015...
May 14, 2016: Asian Journal of Surgery
Rana M Higgins, Matthew J Frelich, Matthew E Bosler, Jon C Gould
BACKGROUND: Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization...
May 2, 2016: Surgical Endoscopy
Jonathan C King, Herbert J Zeh, Amer H Zureikat, James Celebrezze, Matthew P Holtzman, Michael L Stang, Allan Tsung, David L Bartlett, Melissa E Hogg
Background Robotic-assisted surgery has potential benefits over laparoscopy yet little has been published on the integration of this platform into complex surgical oncology. We describe the outcomes associated with integration of robotics into a large surgical oncology program, focusing on metrics of safety and efficiency. Methods A retrospective review of a prospectively maintained database of robotic procedures from July 2009 to October 2014 identifying trends in volume, operative time, complications, conversion to open, and 90-day mortality...
August 2016: Surgical Innovation
Melanie Adams Boyle, Aviva Wallace Kaplin, Leon Kushnir, Per Montero-Pearson
Gallbladder duplication is a rare congenital anomaly. Here, we describe a 29-year-old female who presents with classic symptoms of biliary colic. A duplicated gallbladder was recognized on preoperative ultrasound. This case report reviews a single-site robotic-assisted cholecystectomy with a cystic duct duplication. The patient underwent the surgery without complication. Due to the aberrant anatomy of the cystic triangle, it was decided to mobilize the gallbladder in a dome-down fashion. True gallbladder duplication can be categorized according to cystic duct orientation based on Boyden's classification...
June 2016: Journal of Robotic Surgery
Zheng Li, Guohui Wang, Guokai Zhang, Zhi Song, Bo Yi, Juan Tan, Hao Lin, Xulong Sun, Xuejie Li, Shaihong Zhu
BACKGROUND AND OBJECTIVE: With the ongoing developments in robotic surgery, the associated adverse events need to be carefully evaluated. Virtual fixtures (VFs), a safety design feature against unintended motion during robotic surgery, have been proposed, but the methodology for designing VFs remains experimental. In this study, we propose a novel methodology for designing VFs for robotic cholecystectomy. MATERIALS AND METHODS: Laparoscopic cholecystectomy (LC) was performed in 24 patients with cholecystitis...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Kinyas Kartal, Mehmet Uludag
UNLABELLED: Since the first laparoscopic cholecystectomy (LC), laparoscopic approach has been the focus of surgical authorities and continued its technical revolution. With increasing surgical experience, a trend toward even more minimally invasive approaches has led to laparoscopic surgery to new inovations. Current surgical procedures are: four ports (4PLC), still the gold standart technique, three ports (3PLC), two ports (2PLC) and single port laparoscopic cholecystectomy (SPLC). Robotic cholecystectomy (RC) and natural orifice translumenal endoscopic surgery (NOTES) are the other new techniques for performing cholecystectomy...
2016: Annali Italiani di Chirurgia
Richard M Newman, Affan Umer, Bethany J Bozzuto, Jennifer L Dilungo, Scott Ellner
BACKGROUND: As the cost of health care is subjected to increasingly greater scrutiny, the assessment of new technologies must include the surgical value (SV) of the procedure. Surgical value is defined as outcome divided by cost. STUDY DESIGN: The cost and outcome of 50 consecutive traditional (4-port) laparoscopic cholecystectomies (TLC) were compared with 50 consecutive, nontraditional laparoscopic cholecystectomies (NTLC), between October 2012 and February 2014...
March 2016: Journal of the American College of Surgeons
Nam Hyun Baek, GuangYi Li, Ji Hun Kim, Jae Chul Hwang, Jin Hong Kim, Byung Moo Yoo, Wook Hwan Kim
BACKGROUND/AIMS: Robotic cholecystectomy has emerged as an established technique for the treatment of gallbladder disease. We report our experience and surgical results of RC for patients with gallbladder polyps or minimal symptomatic gallstones, and with inflamed gallbladder diseases including acute cholecystitis, empyematous cholecystitis, and gangrenous cholecystitis. METHODOLOGY: 925 patients with gallbladder disease were selected to undergo RC at our institution...
May 2015: Hepato-gastroenterology
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