Comparison of the Short‐term Operative, Oncological,and Functional Outcomes between two types of robot‐assisted total mesorectal excision for Rectal Cancer: da Vinci Versus Micro Hand S surgical robot

2021 ◽  
Author(s):  
Juan Jiang ◽  
Shaihong Zhu ◽  
Bo Yi ◽  
Jianmin Li
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Da Vinci ◽  
Surgical Robot ◽  
Mesorectal Excision ◽  
Robot Assisted ◽  
Short Term

scholarly journals Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer: a retrospective study

2020 ◽  
Author(s):  
Yanlei Wang ◽  
Guohui Wang ◽  
Zheng Li ◽  
Ling Hao ◽  
Bo Yi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Surgical Robot ◽  
Postoperative Outcomes ◽  
Large Sample Size ◽  
Mesorectal Excision ◽  
Robot Assisted ◽  
Short Term ◽  
Significant Difference

Abstract Background As the first domestically produced Chinese surgical robot for clinical use, the Micro Hand S robot has been applied to total mesorectal excision (TME) for rectal cancer in our center since 2017. The aim of this study was to evaluate the safety and feasibility of the Micro Hand S robot-assisted TME (R-TME) in comparison with laparoscopic TME (L-TME).Methods Between May 2017 and February 2018, patients who underwent R-TME and L-TME in the Third Xiangya Hospital were included in this study. The data including intraoperative outcomes, postoperative outcomes, pathological outcomes, and functional outcomes were analyzed and compared. Results Totally, 30 patients underwent L-TME and 21 patients underwent R-TME. The patient characteristics of the two groups were similar. Regarding intraoperative and postoperative outcomes, the R-TME group had significantly less blood loss (95.2 vs. 130.0 ml, p = 0.022), shorter time to first flatus (2.1 vs. 2.9 d, p = 0.017) and first liquid intake (2.8 vs. 3.7 d, p = 0.027) than the L-TME group. There was no significant difference in the operative time, conversion, protective ileostomy, length of hospital stay, pain score, complications, and 30-day mortality between the two groups (p > 0.05). In addition, the pathological and functional outcomes also did not differ significantly.Conclusion The Micro Hand S robot-assisted total mesorectal excision is safe and feasible with short-term outcomes comparable to laparoscopic surgery. Prospective and large sample size trials are needed to further confirm this conclusion.

scholarly journals Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer

2020 ◽  
Author(s):  
Yanlei Wang ◽  
Guohui Wang ◽  
Zheng Li ◽  
Ling Hao ◽  
Bo Yi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Surgical Robot ◽  
Postoperative Outcomes ◽  
Large Sample Size ◽  
Mesorectal Excision ◽  
Robot Assisted ◽  
Significant Difference

Abstract Background As the first domestically produced Chinese surgical robot for clinical use, the Micro Hand S robot has been applied to total mesorectal excision (TME) for rectal cancer in our center since 2017. The aim of this study was to evaluate the safety and feasibility of the Micro Hand S robot-assisted TME (R-TME) in comparison with laparoscopic TME (L-TME).Methods Between May 2017 and February 2018, patients who underwent R-TME and L-TME in the Third Xiangya Hospital were prospectively included in this study. The data including intraoperative outcomes, postoperative outcomes, pathological outcomes, and functional outcomes were analyzed and compared.Results Totally, 30 patients underwent L-TME and 21 patients underwent R-TME. The patient characteristics of the two groups were similar. Regarding intraoperative and postoperative outcomes, the R-TME group had significantly less blood loss (95.2 vs. 130.0 ml, p = 0.022), shorter time to first flatus (2.1 vs. 2.9 d, p = 0.017) and first liquid intake (2.8 vs. 3.7 d, p = 0.027) than the L-TME group. There were no significant difference in the operative time, conversion, protective ileostomy, length of hospital stay, pain score, complications, and 30-day mortality between the two groups (p > 0.05). In addition, the pathological and functional outcomes also did not differ significantly.Conclusion The Micro Hand S robot-assisted total mesorectal excision is safe and feasible for rectal cancer. However, prospective and large sample size trials are needed to further confirm this conclusion.Trial registration:Clinicaltrial.gov, NCT02752698, Registered on 27 April 2016, https://clinicaltrials.gov/ct2/show/study/NCT02752698?term=Micro+hand&cntry=CN&draw=2&rank=1

scholarly journals Robotic Total Mesorectal Excision for Rectal Cancer: Short-Term Oncological Outcomes of Initial 178 Cases

2020 ◽  
Vol 11 (4) ◽  
pp. 653-661
Author(s):  
C. Ramachandra ◽  
Pavan Sugoor ◽  
Uday Karjol ◽  
Ravi Arjunan ◽  
Syed Altaf ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Total Mesorectal Excision ◽  
Resection Margin ◽  
Da Vinci ◽  
Rectal Resection ◽  
Mesorectal Excision ◽  
Short Term ◽  
Oncological Outcomes ◽  
Duration Of Surgery

AbstractEmerging techniques in minimally invasive rectal resection include robotic total mesorectal excision (R-TME). The Da Vinci Surgical System offers precise dissection in narrow and deep confined spaces and is gaining increasing acceptance during recent times. The aim of this study is to analyse our initial experience of R-TME with Da Vinci Xi platform in terms of perioperative and oncological outcomes in the context of data from recently published randomised ROLARR trial amongst minimally invasive novice surgeons. Patients who underwent R-TME or tumour specific mesorectal excision for rectal cancer between May 2016 and November 2019 were identified from a prospectively maintained single institution colorectal database. Demographic, clinical-pathological and short-term oncological outcomes were analysed. Of the 178 patients, 117 (65.7%) and 31 (17.4%) patients had lower and mid third rectal cancer. Most of the tumours were locally advanced, cT3–T4: 138 (77.5%). One hundred/178 (56.2%) underwent sphincter preserving TME. Eighty-seven (48.8%) were grade II adenocarcinoma. Nonmucinous adenocarcinoma was the predominant histology, 138 (78.4%). One hundred one cases (56.7%) were pT3. The mean number of lymph node yield was 13 ± 5. Distal resection margin and circumferential resection margin were positive in 2 (1.12%), 12 cases (6.74%) respectively. Eleven cases (6.7%) had to be converted to open TME. Mean blood loss and duration of surgery was 170 ± 60 ml and 286 ± 45 min respectively. Five percent cases had an anastomotic leak. Grade IIIa–IIIb Clavien Dindo (CD) morbidity score was reported to be in 12 (6.75%) and 10 (5.61%) cases. Median length of hospitalisation was 7 days (range 4–14 days). Perioperative and pathologic outcomes following robotic rectal resection is associated with good short-term oncological outcomes and is safe, effective, and reproducible by a minimally invasive novice surgeon.

scholarly journals The Micro Hand S vs. da Vinci Surgical Robot-Assisted Surgery on Total Mesorectal Excision: Short-Term Outcomes Using Propensity Score Matching Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yijia Zeng ◽  
Guohui Wang ◽  
Zheng Li ◽  
Hao Lin ◽  
Shaihong Zhu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Total Mesorectal Excision ◽  
Propensity Score Matching ◽  
Da Vinci ◽  
Operation Time ◽  
Mesorectal Excision ◽  
Robot Assisted ◽  
Short Term ◽  
Da Vinci Surgical Robot ◽  
Robot Assisted Surgery

Objective: To compare the operation mode and clinical short-term outcomes of the Micro Hand S and the da Vinci surgical robot, we chose total mesorectal excision (TME) as the standard procedure for its good reflection of robot-assisted surgery advantages.Methods: We collected a total of 54 consecutive patients who underwent robot-assisted TME by two surgical robots from January 2016 to October 2020. We used propensity score matching (PSM) to create balanced cohorts of Micro Hand S group (n = 14) and da Vinci group (n = 14). Robotic installation and operation time, hospital and surgery costs, and intraoperative and postoperative clinical outcomes were compared.Results: In terms of robotic installation time, the Micro Hand S robot took longer than the da Vinci robot (24.2 ± 9.4 min vs. 17.1 ± 5.1 min, P < 0.05). As for the costs, the Micro Hand S group had lower total hospital costs (87,040.1 ± 24,676.9 yuan vs. 125,292.3 ± 17,706.7 yuan, P < 0.05) and surgery costs (25,772.3 ± 4,117.0 yuan vs. 46,940.9 ± 10,199.7 yuan, P < 0.05) than the da Vinci group. There were no statistically significant differences (P > 0.05) in other indicators, including total operation time, robotic operation time, blood loss, time to first liquid diet, time of getting out of bed, and hospital stay.Conclusion: The Micro Hand S enables patients with rectal cancer to enjoy lower medical costs of robotic surgery.Clinical Trial Registration:ClinicalTrials.gov [NCT02752698]

scholarly journals Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

2021 ◽  
Author(s):  
Gabriele Anania ◽  
Richard Justin Davies ◽  
Alberto Arezzo ◽  
Francesco Bagolini ◽  
Vito D’Andrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Neoadjuvant Therapy ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Mesorectal Excision ◽  
Timeline Analysis

Abstract The role of lateral lymph node dissection (LLND) during total mesorectal excision (TME) for rectal cancer is still controversial. Many reviews were published on prophylactic LLND in rectal cancer surgery, some biased by heterogeneity of overall associated treatments. The aim of this systematic review and meta-analysis is to perform a timeline analysis of different treatments associated to prophylactic LLND vs no-LLND during TME for rectal cancer. Methods A literature search was performed in PubMed, SCOPUS and WOS for publications up to 1 September 2020. We considered RCTs and CCTs comparing oncologic and functional outcomes of TME with or without LLND in patients with rectal cancer. Results Thirty-four included articles and 29 studies enrolled 11,606 patients. No difference in 5-year local recurrence (in every subgroup analysis including preoperative neoadjuvant chemoradiotherapy), 5-year distant and overall recurrence, 5-year overall survival and 5-year disease-free survival was found between LLND group and non LLND group. The analysis of post-operative functional outcomes reported hindered quality of life (urinary, evacuatory and sexual dysfunction) in LLND patients when compared to non LLND. Conclusion Our publication does not demonstrate that TME with LLND has any oncological advantage when compared to TME alone, showing that with the advent of neoadjuvant therapy, the advantage of LLND is lost. In this review, the most important bias is the heterogeneous characteristics of patients, cancer staging, different neoadjuvant therapy, different radiotherapy techniques and fractionation used in different studies. Higher rate of functional post-operative complications does not support routinely use of LLND.

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