scholarly journals Robotic-assisted cholecystectomy is superior to laparoscopic cholecystectomy in the initial training for surgical novices in an ex vivo porcine model: a randomized crossover study

2021 ◽  
Author(s):  
E. Willuth ◽  
S. F. Hardon ◽  
F. Lang ◽  
C. M. Haney ◽  
E. A. Felinska ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Crossover Study ◽  
Porcine Model ◽  
Haptic Feedback ◽  
Ex Vivo ◽  
Operating Time ◽  
Surgical Performance ◽  
Robotic Assisted ◽  
Subjective Workload ◽  
Randomized Crossover Study

Abstract Background Robotic-assisted surgery (RAS) potentially reduces workload and shortens the surgical learning curve compared to conventional laparoscopy (CL). The present study aimed to compare robotic-assisted cholecystectomy (RAC) to laparoscopic cholecystectomy (LC) in the initial learning phase for novices. Methods In a randomized crossover study, medical students (n = 40) in their clinical years performed both LC and RAC on a cadaveric porcine model. After standardized instructions and basic skill training, group 1 started with RAC and then performed LC, while group 2 started with LC and then performed RAC. The primary endpoint was surgical performance measured with Objective Structured Assessment of Technical Skills (OSATS) score, secondary endpoints included operating time, complications (liver damage, gallbladder perforations, vessel damage), force applied to tissue, and subjective workload assessment. Results Surgical performance was better for RAC than for LC for total OSATS (RAC = 77.4 ± 7.9 vs. LC = 73.8 ± 9.4; p = 0.025, global OSATS (RAC = 27.2 ± 1.0 vs. LC = 26.5 ± 1.6; p = 0.012, and task specific OSATS score (RAC = 50.5 ± 7.5 vs. LC = 47.1 ± 8.5; p = 0.037). There were less complications with RAC than with LC (10 (25.6%) vs. 26 (65.0%), p = 0.006) but no difference in operating times (RAC = 77.0 ± 15.3 vs. LC = 75.5 ± 15.3 min; p = 0.517). Force applied to tissue was similar. Students found RAC less physical demanding and less frustrating than LC. Conclusions Novices performed their first cholecystectomies with better performance and less complications with RAS than with CL, while operating time showed no differences. Students perceived less subjective workload for RAS than for CL. Unlike our expectations, the lack of haptic feedback on the robotic system did not lead to higher force application during RAC than LC and did not increase tissue damage. These results show potential advantages for RAS over CL for surgical novices while performing their first RAC and LC using an ex vivo cadaveric porcine model. Registration number researchregistry6029 Graphic abstract

Initial Experience With a New Robotic Surgical System for Cholecystectomy

2019 ◽  
Vol 27 (2) ◽  
pp. 136-142 ◽  
Author(s):  
Ravi Aggarwal ◽  
Jasmine Winter Beatty ◽  
James Kinross ◽  
Alexander von Roon ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Haptic Feedback ◽  
Surgical Complication ◽  
Demographic Data ◽  
Operating Time ◽  
Surgical Techniques ◽  
Laparoscopic Group ◽  
Interquartile Range ◽  
Hospital Data

Background. Laparoscopic cholecystectomy has been the gold standard treatment for symptomatic cholelithiasis for more than 3 decades. Robotic techniques are gaining traction in surgery, and recently, the Senhance™ robotic system was introduced. The system offers advantages over other robotic systems such as improved ergonomics, haptic feedback, eye tracking, and usability of standard laparoscopic trocars and reusable instruments. The Senhance was evaluated to understand the feasibility, benefits, and drawbacks of its use in cholecystectomy. Study Design. A prospectively maintained database of the first 20 patients undergoing cholecystectomy with the Senhance was reviewed at a single hospital. Data including operative time, console time, set up time, and adverse events were collected, with clinical outcome and operative time as primary outcome measures. A cohort of 20 patients having laparoscopic cholecystectomy performed by the same surgeon was used as a comparator group. Results. The 2 groups had comparable demographic data (age, sex, and body mass index). In the Senhance group, 19 of the 20 procedures (95%) were completed robotically. The median (interquartile range) total operating, docking, and console times were 86.5 (60.5-106.5), 11.5 (9-13), and 30.8 (23.5-35) minutes, respectively. In the laparoscopic group, the median (interquartile range) operating time was 31.5 (26-41) minutes. Postoperatively, only one patient had a surgical complication, namely a wound infection treated with antibiotics. Conclusion. Our results suggest that Senhance-assisted cholecystectomy is safe, feasible, and effective, but currently has longer operative times. Further prospective and randomized trials are required to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.

scholarly journals The Effects of Preferred Music on Laparoscopic Surgical Performance: A Randomized Crossover Study

2020 ◽  
Vol 44 (8) ◽  
pp. 2614-2619 ◽  
Author(s):  
Pim Oomens ◽  
Victor X. Fu ◽  
Vincent E. E. Kleinrensink ◽  
Gert-Jan Kleinrensink ◽  
Johannes Jeekel
Keyword(s):  
Crossover Study ◽  
Surgical Performance ◽  
Randomized Crossover Study

Differential Outcomes for Long Term ex vivo Lung Perfusion in a Porcine Model - With or without Red Cells?

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
W. Sommer ◽  
M. Avsar ◽  
J. Salman ◽  
C. Kühn ◽  
I. Tudorache ◽  
...  
Keyword(s):  
Porcine Model ◽  
Ex Vivo ◽  
Lung Perfusion ◽  
Red Cells ◽  
Ex Vivo Lung Perfusion ◽  
Differential Outcomes

755-P: A Plant-Based Meal Stimulates Incretin and Insulin Secretion More than an Energy- and Macronutrient-Matched Standard Meal in Type 2 Diabetes: A Randomized Crossover Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 755-P
Author(s):  
HANA KAHLEOVA ◽  
ANDREA TURA ◽  
MARTA KLEMENTOVA ◽  
LENKA BELINOVA ◽  
MARTIN HALUZIK ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Crossover Study ◽  
Standard Meal ◽  
Randomized Crossover Study

SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY IN HUE CENTRAL HOSPITAL

2012 ◽  
pp. 25-30
Author(s):  
Xuan Dong Pham ◽  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Hai Thanh Nguyen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Port ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Central Hospital ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Hospital Patients ◽  
Wound Pain ◽  
Initial Results

Purpose: Evaluating the initial results in applying single port laparoscopic cholecystectomy at Hue Central Hospital. Patients and methods: 29 gallbladder polyps, gallstones with symptoms of acute or chronic cholecystitis and surgeried by single port laparoscopic cholecystectomy at Hue Central Hospital from March 2011 to December 2011. Results: Male/female was 0.45/1. Age: 49.24 ± 16.43 (21-81), 40 to 60 years 54.6%. Cholecystitis: 75.9%, 17.3% gallbladder polyp, gallbladder adenomyomatosis 3.4%. Added 1 trocart because difficult dissection surgery 10.2%, bleeding 6.8% difficult to handle, added 2 trocart 3.4%. Bleeding intraoperative 10.3%. Operating time: 76.2 ± 33.5 minutes, hospital stay: 4 - 6 days 51.7%. Wound pain after 2 weeks of hospital discharge 6.9%, with no wound seromas and no wound infection. Conclusions: Single port laparoscopic cholecystestomy is safe, has fewer complications, can be done with experienced surgeons laparoscopic surgery. Keywords: Single port laparoscopic cholecystectomy, gallbladder ston Key words: Single port laparoscopic cholecystectomy, gallbladder stone

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