The Origins of Minimally Invasive and Robotic Surgery and Their Impact on Surgical Practice: A Sociological, Technological History

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

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Ergonomics of minimally invasive surgery: an analysis of muscle effort and fatigue in the operating room between laparoscopic and robotic surgery

Surgical Endoscopy ◽

10.1007/s00464-018-6515-3 ◽

2018 ◽

Vol 33 (7) ◽

pp. 2323-2331 ◽

Cited By ~ 10

Author(s):

Priscila R. Armijo ◽

Chun-Kai Huang ◽

Robin High ◽

Melissa Leon ◽

Ka-Chun Siu ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Operating Room ◽

Invasive Surgery

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Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000450 ◽

2015 ◽

Vol 25 (6) ◽

pp. 1121-1127 ◽

Cited By ~ 75

Author(s):

Lesley B. Conrad ◽

Pedro T. Ramirez ◽

William Burke ◽

R. Wendel Naumann ◽

Kari L. Ring ◽

...

Keyword(s):

Cervical Cancer ◽

Endometrial Cancer ◽

Minimally Invasive Surgery ◽

Robotic Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Single Port ◽

Gynecologic Oncology ◽

Pelvic Lymphadenectomy ◽

Single Port Laparoscopy

ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

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Reconstruction methods during laparoscopic gastrectomy

Journal of Gastric Surgery ◽

10.36159/jgs.v1i1.11 ◽

2019 ◽

Vol 1 (1) ◽

pp. 19-21

Author(s):

Amilcare Parisi ◽

Chang-Ming Huang

Keyword(s):

Robotic Surgery ◽

Minimally Invasive ◽

Laparoscopic Gastrectomy ◽

Present Report ◽

Gastric Surgery ◽

Extensive Lymphadenectomy ◽

Reconstruction Methods

Gastric surgery is one of the most relevant fi elds of development for minimally invasive technologies. Laparoscopy is now widespread, and several studies have demonstrated its feasibility and safety even in some advanced oncological procedures. Robotic surgery has several intrinsic advantages that theoretically can improve an extensive lymphadenectomy or the reconstruction phase. Much remains to be addressed in this field and further studies are necessary to offer the patient the best possible approach based on his characteristics and the stage of his disease. The present report off ers an overview on robotics and its role in gastric surgery.

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Anesthetic and critical care challenges in massive chyle leak following robotic surgery: a special case report

Journal of Society of Anesthesiologists of Nepal ◽

10.3126/jsan.v2i2.13534 ◽

2015 ◽

Vol 2 (2) ◽

pp. 73-76

Author(s):

Uma Hariharan ◽

Itee Choudhary ◽

Ajay Kumar Bhargava

Keyword(s):

Critical Care ◽

Case Report ◽

Lymph Node ◽

Robotic Surgery ◽

Minimally Invasive ◽

Germ Cell ◽

Retroperitoneal Lymph Node Dissection ◽

Node Dissection ◽

Retroperitoneal Lymph Node ◽

Chyle Leak

A unique case report is hereby presented which entails the multi-modality management of a very rare complication of modern minimally-invasive robotic surgery. Chyle leak can be an extremely challenging problem following certain surgeries, especially in cancer patients. Medical, nutritional and/or surgical management is required to control the leak. Prolonged massive chyle leaks which do not respond to conservative management require surgical intervention. Retroperitoneal lymph node dissection is a complex procedure undertaken for lymph node clearance in germ cell tumors after primary radical surgery. Robotic surgeries have revolutionized the field of minimally invasive operations. A patient who underwent robotic nerve sparing retroperitoneal lymph node dissection for non-seminomatous germ cell tumor of the right testis, post-chemotherapy, developed a continuous large volume chylous ascites, presenting with electrolyte imbalances and hypotension. Exploratory laparotomy in the operation theatre was required for sealing the chyle leak after failure of medical and nutritional management in the intensive care unit. The main take-away message is that refractory chyle leak can occur in retroperitoneal surgeries requiring multidisciplinary management. Careful coordinated action between critical care, oncological, anesthesia and surgical teams is mandatory for a favourable outcome. Familiarity with the nuances of robotic surgery and eternal vigilance are the keys to successful conduction of complex robotic procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 73-76

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