Standardized single-incision plus one-port laparoscopic left lateral sectionectomy: a safe alternative to the conventional procedure

Abstract Purpose Laparoscopic left lateral sectionectomy (LLLS) is a feasible and safe procedure with a relatively smooth learning curve. However, single-incision LLLS requires extensive surgical experience and advanced techniques. The aim of this study is to report the standardized single-incision plus one-port LLLS (reduced port LLLS, RPLLLS) technique and evaluate its safety, feasibility, and effectiveness for junior surgeons. Methods Between January 2008 and November 2020, the clinical records of 49 patients who underwent LLLS, divided into the conventional LLLS (n = 37) and the RPLLLS group (n = 12), were retrospectively reviewed. The patient characteristics, pathologic results, and operative outcomes were evaluated. Results A history of previous abdominal surgery in the RPLLLS group was significantly high (56.8% vs. 91.7%, p = 0.552). Notably, junior surgeons performed 62.2% of the conventional LLLSs and 58.4% of the standardized RPLLLSs. There were no significant differences between the two groups in terms of median operative time (121.0 vs. 113.5, p = 0.387), median blood loss (13.0 vs. 8.5, p = 0.518), median length of hospital stays (7.0 vs. 7.0, p = 0.408), and morbidity rate (2.7% vs. 0%, p = 0.565), respectively. Conclusion This standardized RPLLLS is a feasible and safe alternative to conventional LLLS and may become the ideal training procedure for both junior surgeons and surgeons aiming to learn more complex procedures.

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Laparoscopic left lateral sectionectomy as a training procedure for surgeons learning laparoscopic hepatectomy

Journal of Hepato-Biliary-Pancreatic Sciences ◽

10.1007/s00534-012-0591-x ◽

2013 ◽

Vol 20 (5) ◽

pp. 525-530 ◽

Cited By ~ 27

Author(s):

Yasushi Hasegawa ◽

Hiroyuki Nitta ◽

Akira Sasaki ◽

Takeshi Takahara ◽

Naoko Ito ◽

...

Keyword(s):

Laparoscopic Hepatectomy ◽

Training Procedure ◽

Left Lateral Sectionectomy ◽

Lateral Sectionectomy

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Solo single incision laparoscopic S8 non‐anatomical resection and left lateral sectionectomy

Journal of Hepato-Biliary-Pancreatic Sciences ◽

10.1002/jhbp.995 ◽

2021 ◽

Author(s):

Hye‐Sol Jung ◽

YoungRok Choi ◽

Suk Kyun Hong ◽

Jai Young Cho ◽

Nam‐Joon Yi ◽

...

Keyword(s):

Single Incision ◽

Anatomical Resection ◽

Left Lateral Sectionectomy ◽

Lateral Sectionectomy

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Robot single incision left lateral sectionectomy via da Vinci® Xi™ Single Site™ & vaginal extraction of the specimen

Surgical Oncology ◽

10.1016/j.suronc.2019.11.002 ◽

2020 ◽

Vol 33 ◽

pp. 254-255 ◽

Cited By ~ 1

Author(s):

Woochul Kim ◽

YoungRok Choi ◽

Jai Young Cho ◽

Yoo-Seok Yoon ◽

Ho-Seong Han

Keyword(s):

Da Vinci ◽

Single Incision ◽

Single Site ◽

Left Lateral Sectionectomy ◽

Lateral Sectionectomy

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Robotic Pneumonectomy for Lung Cancer: Perioperative Outcomes and Factors Leading to Conversion to Thoracotomy

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/1556984520978227 ◽

2021 ◽

pp. 155698452097822

Author(s):

Byron D. Patton ◽

Daniel Zarif ◽

Donna M. Bahroloomi ◽

Iam C. Sarmiento ◽

Paul C. Lee ◽

...

Keyword(s):

Lung Cancer ◽

Statistical Significance ◽

Patient Characteristics ◽

Perioperative Outcomes ◽

Safe Procedure ◽

Open Approach ◽

Robotic Approach ◽

Robotic Group ◽

Robot Assisted ◽

Estimated Blood Loss

Objective In the tide of robot-assisted minimally invasive surgery, few cases of robot-assisted pneumonectomy exist in the literature. This study evaluates the perioperative outcomes and risk factors for conversion to thoracotomy with an initial robotic approach to pneumonectomy for lung cancer. Methods This study is a single-center retrospective review of all pneumonectomies for lung cancer with an initial robotic approach between 2015 and 2019. Patients were divided into 2 groups: surgeries completed robotically and surgeries converted to thoracotomy. Patient demographics, preoperative clinical data, surgical pathology, and perioperative outcomes were compared for meaningful differences between the groups. Results Thirteen total patients underwent robotic pneumonectomy with 8 of them completed robotically and 5 converted to thoracotomy. There were no significant differences in patient characteristics between the groups. The Robotic group had a shorter operative time ( P < 0.01) and less estimated blood loss ( P = 0.02). There were more lymph nodes harvested in the Robotic group ( P = 0.08) but without statistical significance. There were 2 major complications in the Robotic group and none in the Conversion group. Neither tumor size nor stage were predictive of conversion to thoracotomy. Conversions decreased over time with a majority occurring in the first 2 years. There were no conversions for bleeding and no mortalities. Conclusions Robotic pneumonectomy for lung cancer is a safe procedure and a reasonable alternative to thoracotomy. With meticulous technique, major bleeding can be avoided and most procedures can be completed robotically. Larger studies are needed to elucidate any advantages of a robotic versus open approach.

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Role of robotic natural orifice specimen extraction surgery in colorectal neoplasms

Scientific Reports ◽

10.1038/s41598-021-89323-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hongliang Yao ◽

Tiegang Li ◽

Weidong Chen ◽

Sanlin Lei ◽

Kuijie Liu ◽

...

Keyword(s):

Colorectal Neoplasms ◽

Average Distance ◽

Neoadjuvant Chemoradiotherapy ◽

Operation Time ◽

Patient Characteristics ◽

Safe Procedure ◽

Natural Orifice ◽

Specimen Extraction ◽

Natural Orifice Specimen Extraction

AbstractNatural orifice specimen extraction surgery (NOSES) is especially suitable for colorectal surgery. Until now, most of the reports published were about laparoscopic NOSES, the reports about robotic NOSES are extremely rare. This study aims to explore the safety and feasibility of robotic NOSES for colorectal neoplasms. All patients underwent robotic NOSES from March 2016 to October 2019 in our hospital were enrolled for retrospective analysis. Clinicopathological data including patient characteristics, perioperative information and pathological information were collected and analyzed. According to the distance between tumor and anus or whether neoadjuvant chemoradiotherapy (nRCT) is performed, we grouped the cases and studied its influence on robotic NOSES. Also, we compared the previous reports on laparoscopic NOSES with our study and revealed advantages of robotic NOSES in terms of safety and feasibility. A total of 180 patients were enrolled. The average distance from the lower edge of the tumor to the anus was (8.64 ± 3.64) cm and maximum circumferential diameter (CDmax) of specimen was (3.5 ± 1.6) cm. In terms of safety, the average operation time, intraoperative blood loss, and postoperative hospital stay were (187.5 ± 78.3) min, (47.4 ± 34) mL, and (11.3 ± 7.5) days, respectively. In terms of feasibility, the average number of lymph node harvested was (14.8 ± 5). Robotic NOSES shows advantages in terms of safety and feasibility compared with laparoscopic NOSES. This procedure could not only be a safe procedure but also could achieve good oncological outcomes.

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