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https://www.readbyqxmd.com/read/29343662/cost-benefit-performance-simulation-of-robot-assisted-thoracic-surgery-as-required-for-financiall-viability-under-the-2016-revised-reimbursement-paradigm-of-the-japanese-national-health-insurance-system
#1
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29340922/prevention-of-internal-hernia-during-robotic-total-gastrectomy-for-gastric-cancer
#2
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29312746/-five-on-a-dice-port-placement-for-robot-assisted-thoracoscopic-right-upper-lobectomy-using-robotic-stapler
#3
Min P Kim, Edward Y Chan
Early versions of the da Vinci robot system (S and Si) have been used to perform pulmonary lung resection with severe limitations. The lack of a vascular robot stapler required the presence of a trained bedside assistant whose role was to place, manipulate and fire the stapler around major vascular structures. Thus, the techniques developed for the Si robot required a skilled bedside assistant to perform stapling of the hilar structure and manipulation of the lung. With the advent of the da Vinci Xi system with a vascular robot stapler, we postulated that we could develop a new port placement and technique to provide total control for the surgeon during the pulmonary lung resection...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29307098/a-single-incision-thoracoscopic-and-robotic-hybrid-procedure-via-the-axillary-approach-in-a-patient-with-thyroid-lung-and-mediastinal-tumors
#4
Norihiko Ishikawa, Yumiko Ohtake, Go Watanabe
A 66-year-old woman was referred to our institute for an enlarging tumor of the thyroid, and neck and chest computed tomography scan showed not only a thyroid tumor, but also an anterior mediastinal tumor and ground-glass nodules in the lung. Because of persisting symptoms, an enlarging thyroid mass, and the possibility of cancer, excision of the tumors was proposed. A 6-cm-long vertical skin incision was made in the right axilla, a mini-thoracotomy was made in the third intercostal space, and an additional port was placed in the fifth intercostal space...
January 6, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29303068/soft-robotic-manipulator-for-improving-dexterity-in-minimally-invasive-surgery
#5
Alessandro Diodato, Margherita Brancadoro, Giacomo De Rossi, Haider Abidi, Diego Dall'Alba, Riccardo Muradore, Gastone Ciuti, Paolo Fiorini, Arianna Menciassi, Matteo Cianchetti
BACKGROUND: Combining the strengths of surgical robotics and minimally invasive surgery (MIS) holds the potential to revolutionize surgical interventions. The MIS advantages for the patients are obvious, but the use of instrumentation suitable for MIS often translates in limiting the surgeon capabilities (eg, reduction of dexterity and maneuverability and demanding navigation around organs). To overcome these shortcomings, the application of soft robotics technologies and approaches can be beneficial...
December 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29300963/no-touch-aorta-robot-assisted-atrial-septal-defect-repair-via-two-ports
#6
Norihiko Ishikawa, Go Watanabe, Tatsuya Tarui
OBJECTIVES: Atrial septal defect (ASD) repairs have been successfully performed on arrested hearts with robotic assistance. The present study assessed the feasibility, safety, and efficacy of totally endoscopic cardiac surgery using a no-touch aorta technique for ASD via only 2 ports, and we named this procedure two-port robotic cardiac surgery (TROCS). METHODS: Between May 2014 and June 2016, 8 consecutive patients underwent TROCS for ASD using the da Vinci surgical system (Intuitive Surgical Inc...
January 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29288372/robotic-assisted-laparoscopic-surgery-for-pediatric-tumors-a-bicenter-experience
#7
P Meignan, Q Ballouhey, J Lejeune, K Braik, B Longis, A R Cook, H Lardy, L Fourcade, Aurélien Binet
Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial. 12 robotic-assisted tumor resections with the da Vinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA) were attempted in 11 children (mean age 7.65 years; age range 0.75-16.75 years; mean weight 30.3 kg; weight range 8.6-62 kg) in two centers. Mean total operative time was 145 min (range 72-263 min)...
December 29, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29273875/robotic-total-pancreatectomy-with-splenectomy-technique-and-outcomes
#8
Ioannis T Konstantinidis, Zeljka Jutric, Oliver S Eng, Susanne G Warner, Laleh G Melstrom, Yuman Fong, Byrne Lee, Gagandeep Singh
BACKGROUND: Robotic total pancreatectomy (TP) represents a minimally invasive approach to a major intra-abdominal operation. Its utility, technique, and outcomes are evolving. METHODS: In this video, we describe a systematic approach to a robotic total pancreatectomy performed for multifocal intraductal papillary mucinous neoplasm (IPMN). Additionally, we reviewed the National Cancer Database (NCDB) to examine the outcomes of robotic TP compared to laparoscopic and open TP between 2010 and 2014...
December 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29273373/robotic-assisted-single-port-donor-nephrectomy-using-the-da-vinci-single-site-platform
#9
John C LaMattina, Josue Alvarez-Casas, Irene Lu, Jessica M Powell, Samuel Sultan, Michael W Phelan, Rolf N Barth
BACKGROUND: Although single-port donor nephrectomy offers improved cosmetic outcomes, technical challenges have limited its application to selected centers. Our center has performed over 400 single-port donor nephrectomies. The da Vinci single-site robotic platform was utilized in an effort to overcome the steric, visualization, ergonomic, and other technical limitations associated with the single-port approach. MATERIALS AND METHODS: Food and Drug Administration device exemption was obtained...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29251382/robotic-da-vinci-xi-assisted-nipple-sparing-mastectomy-first-clinical-report
#10
Benjamin Sarfati, Jean-Francois Honart, Nicolas Leymarie, Francoise Rimareix, Heba Al Khashnam, Frederic Kolb
Nipple-sparing mastectomy (NSM) is increasingly popular for the treatment of selected breast cancers and prophylactic mastectomy. Surgical scarring and esthetic outcomes are important patient-related cosmetic considerations. Today, the concept of minimally invasive surgery has become popular, especially using robotic surgery. The authors report the first case of NSM using the latest version of the da Vinci Xi surgical system (Xi). The final incision used to remove the entire mammary gland was located behind the axillary line...
December 18, 2017: Breast Journal
https://www.readbyqxmd.com/read/29214515/robotic-skills-can-be-aided-by-laparoscopic-training
#11
Daniel G Davila, Melissa C Helm, Matthew J Frelich, Jon C Gould, Matthew I Goldblatt
BACKGROUND: General Surgery is currently the fastest growing specialty with regards to robotic surgical system utilization. Contrary to the experience in laparoscopy, simulator training for robotic surgery is not widely employed partly because robotic surgical simulators are expensive. We sought to determine the effect of a robotic simulation curriculum and whether robotic surgical skills could be derived from those psychomotor skills attained in laparoscopic training. METHODS: Twenty-seven trainees with no prior robotic experience and limited laparoscopy exposure were randomly assigned to one of three training groups: no simulator training, training on a fundamentals of laparoscopic surgery (FLS™) standard box trainer, and training on a robotic computer based simulator (da Vinci Skills Simulator™)...
December 6, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29211396/retroperitoneal-approach-for-robot-assisted-partial-nephrectomy-technique-and-early-outcomes
#12
A Porreca, D D'Agostino, D Dente, M Dandrea, A Salvaggio, E Cappa, A Zuccala, A Del Rosso, F Chessa, D Romagnoli, F Mengoni, M Borghesi, R Schiavina
OBJECTIVES: The aim of our study is to present early outcomes of our series of retroperitoneal-RAPN (Robot Assisted Partial Nephrectomy). MATERIALS AND METHODS: From September 2010 until December 2015, we performed 81 RAPN procedures (44 at left kidney and 37 at right). Average size was 3cm (1-9). Average PADUA score 7.1 (5-10). Average surgical time (overall and only robot time), ischemia time, blood loss, pathological stage, complications and hospital stay have been recorded...
December 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29205061/does-advancing-technology-improve-outcomes-comparison-of-the-da-vinci-standard-s-si-to-the-xi-robotic-platforms-during-robotic-nephroureterctomy
#13
Manish Navnitlal Patel, Ashok Hemal
INTRODUCTION: With the introduction of laparoscopy and now robotics, more patients are able to reap benefit from minimally invasive techniques during urologic surgery. With these advancing technologies it is important to evaluate whether the outlay of hospital capital actually improves patient care. To date, there has been very little literature regarding the impact of these advances on patient outcomes. In this paper, we directly compare perioperative outcomes and hospital costs between the older da Vinci Standard/S/Si platform the newer Xi robotic platform during nephroureterectomy...
December 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29199663/robotic-resections-in-hepatobiliary-oncology-initial-experience-with-xi-da-vinci-system-in-india
#14
M Chandarana, S Patkar, A Tamhankar, S Garg, M Bhandare, M Goel
INTRODUCTION: Minimal invasive surgery has proven its advantages over open surgeries in the perioperative period. Food and Drug Administration approved da Vinci robot in 2000. The latest version, da Vinci Xi system has a mobile tower-based robot with several modifications to improve the functionality, versatility, and operative ease. None of the centers have reported exclusively on hepatobiliary oncology using the da Vinci Xi system. We report our initial experience. AIMS AND OBJECTIVES: To study the feasibility, advantages, and discuss the operative technique of da Vinci Xi system in hepatobiliary oncology...
January 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29197913/an-alternative-finger-in-robotic-assisted-thoracic-surgery-intraoperative-ultrasound-localization-of-pulmonary-nodules
#15
Zhenyu Zhou, Zhitian Wang, Zhelan Zheng, Jinlin Cao, Chong Zhang, Zhehao He, Wang Lv, Jian Hu
AIM: Robotic-assisted thoracic surgery (RATS) has become a promising treatment for pulmonary neoplasms. During RATS, intraoperative ultrasonography can act as an "alternative finger" to "touch" and locate lesions, especially pulmonary nodules. This study was aimed to investigate the efficacy of intraoperative ultrasonographic localization during da Vinci RATS procedures. MATERIAL AND METHODS: Patients with pulmonary nodules were randomly divided into an Experimental Group and Control Group in which nodules were respectively located using intraoperative ultrasonography or by the surgeon's anatomic knowledge...
November 29, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/29185260/robotic-single-site-radical-hysterectomy-plus-pelvic-lymphadenectomy-in-gynecological-cancers
#16
Enrico Vizza, Benito Chiofalo, Giuseppe Cutillo, Emanuela Mancini, Ermelinda Baiocco, Ashanti Zampa, Arabella Bufalo, Giacomo Corrado
OBJECTIVE: To evaluate the feasibility and the safety of robotic single-site radical hysterectomy (RSSRH) plus pelvic lymphadenectomy (PL) in endometrial or cervical cancer. METHODS: Patients with endometrial cancer (EC) International Federation of Gynecology and Obstetrics (FIGO) stage II, early cervical cancer (ECC) FIGO stage IB1 or locally advanced cervical cancer (LACC) FIGO stage IB2-IIB with clinical response ≥50% after neo-adjuvant chemotherapy (NACT) were enrolled in a prospective cohort trial...
January 2018: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/29180207/residents-response-to-bleeding-during-a-simulated-robotic-surgery-task
#17
Jessica L Walker, Jay N Nathwani, Hossein Mohamadipanah, Shlomi Laufer, Frank F Jocewicz, Eran Gwillim, Carla M Pugh
BACKGROUND: The aim of this study was to assess performance measurement validity of our newly developed robotic surgery task trainer. We hypothesized that residents would exhibit wide variations in their intercohort performance as well as a measurable difference compared to surgeons in fellowship training. MATERIALS AND METHODS: Our laboratory synthesized a model of a pelvic tumor that simulates unexpected bleeding. Surgical residents and fellows of varying specialties completed a demographic survey and were allowed 20 minutes to resect the tumor using the da Vinci robot and achieve hemostasis...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29177195/total-preperitoneal-robot-assisted-kidney-transplantation
#18
Clement Michiels, Jean Rouffilange, Vincent Comat, Adeline Guillaume, Samuel Lagabrielle, Henri Bensadoun, Gregoire Capon, Jean-Marie Ferrière, Jean-Christophe Bernhard, Gregoire Robert
To date, kidney transplant recipients have always undergone open surgery. The type and length of the wound vary, but most commonly, a modified Gibson's incision is made in the lower abdomen for the transplantation. Risk factors for wound complications are well defined in general surgery literature. The laparoscopic kidney transplantation (LKT) technique has been developed recently, and several teams have published studies on the intraperitoneal technique. In this case report, we present our technique of total preperitoneal LKT using the Da Vinci robotic surgical system...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29134384/totally-robotic-single-docking-low-anterior-resection-for-rectal-cancer-pearls-and-pitfalls
#19
J W T Toh, A Zakaria, I Yang, S H Kim
Total robotic resection of mid- and low rectal cancers confers technical advantages within the confines of the pelvis and allows difficult rectal cancer cases to be performed efficiently with less risk of conversion to open. To maximize the advantage of robotic surgery, we utilize the technique of single docking totally robotic dissection for rectal cancer for both the Da Vinci Si and Xi Surgical Systems. All steps are performed robotically, with the surgery divided into two phases. The first phase consists of inferior mesenteric artery and vein ligation, sigmoid and descending colon mobilization and splenic flexure takedown...
November 13, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29130568/flexible-next-generation-robotic-surgical-system-for-transoral-endoscopic-hypopharyngectomy-a-comparative-preclinical-study
#20
Ichiro Tateya, Yoon Woo Koh, Raymond K Tsang, Steven S Hong, Ryuji Uozumi, Yo Kishimoto, Taro Sugimoto, F Christopher Holsinger
BACKGROUND: The purpose of this cadaveric study was to determine the efficacy of a flexible, next-generation robotic surgical system for transoral robotic hypopharyngectomy. METHODS: A comparative evaluation study of the flexible versus rigid robotic surgical systems for the hypopharynx was conducted using 3 cadavers. Endpoints for assessment were visualization of the hypopharynx, access to the hypopharynx, and difficulty of dissection. Hypopharyngectomy was performed on 3 other cadavers using the da Vinci Sp surgical system...
November 11, 2017: Head & Neck
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