Exploration of robotic-assisted surgical techniques in vascular surgery

2019 ◽  
Vol 13 (5) ◽  
pp. 689-693
Author(s):  
Kyle Miller ◽  
Dale Bergman ◽  
Glenn Stante ◽  
Chandu Vemuri
Keyword(s):  
Vascular Surgery ◽  
Surgical Techniques ◽  
Robotic Assisted

scholarly journals EVALUATION OF A TRAINING COURSE ON OPEN VASCULAR SURGICAL TECHNIQUES IN AORTOILIAC PATHOLOGY - 5 YEARS OF EXPERIENCE

2015 ◽  
Vol 88 (2) ◽  
pp. 196-202
Author(s):  
Bogdan Stancu ◽  
Florin Beteg ◽  
Aurel Mironiuc ◽  
Aurel Muste ◽  
Claudia Gherman
Keyword(s):  
Surgical Technique ◽  
Vascular Surgery ◽  
Prospective Study ◽  
Surgical Techniques ◽  
Surgical Skills ◽  
Technical Quality ◽  
Statistical Association ◽  
Abdominal Aortic

Introduction. The aim of this prospective study was to assess the efficacy of a vascular surgery course (2008-2012), and to verify the viability and the feasibility of the vascular anastomoses.Material and method. Vascular surgical techniques performed simultaneously on pigs were: enlargement prosthetic angioplasty, abdominal aortic interposition graft and aortoiliac bypass. Endpoints of the study were the surgical skills and the technical quality, evaluated on a scale ranging from 1 (satisfactory) to 3 (very good) for our participants.Result. A significant improvement in vascular surgical skills tasks was observed during the study years and we also found a semnificative statistical association between the quality of suture and the surgical technique used (Kendall coefficient=0.71, p=0.001<0.05).Conclusions. Our course contributed to the improvement of technical vascular surgical skills of the operator teams, reproducing in vivo, in pigs, the intraoperative environment as in human patients.

Gefäßchirurgie an der Jahrtausendwende

VASA ◽  
2000 ◽  
Vol 29 (1) ◽  
pp. 17-27 ◽  
Author(s):  
Polterauer ◽  
Nanobachvili ◽  
Fuegl ◽  
Huk
Keyword(s):  
Gene Therapy ◽  
Vascular Surgery ◽  
Intimal Hyperplasia ◽  
Surgical Techniques ◽  
Aortic Aneurysms ◽  
Long Term Results ◽  
Prosthetic Material ◽  
Vascular Medicine ◽  
The Future

Modern diagnostic modalities as well as ongoing improvement of vascular prosthetic material and surgical techniques have stimulated progress in vascular surgery. New discoveries concerning the mechanism of endothelial function, atherosclerosis, developments in gene therapy and endovascular techniques will expand the future therapeutic spectrum of vascular surgery. Endoluminal implantation of stent grafts for the treatment of aortic aneurysm may be a reasonable alternative to conventional surgery, especially in high-risk patients. Long-term results of this procedure, however, are not yet available. Stenting of internal carotid artery stenosis may be considered as an experimental method of treatment. Its feasibility, efficacy, safety and long-term results must be analyzed before the application of the method may be restricted or recommended. Endoluminal irradiation (brachytherapy) reduces intimal hyperplasia/restenosis and can improve the long-term results of percutaneous transluminal angioplasty. Anti-atherosclerotic and anti-aggregatory therapy (with statins, estrogens, antibiotics, nitric oxide precursor/donors, glycoprotein IIb/IIIa receptor inhibitors) will play an important role in the prevention of ischemic diseases and improve the results of surgical/interventional treatment by reducing intimal hyperplasia and restenosis. Gene therapy opens new vistas in vascular medicine. Angiogenetic factors can be used for the treatment of patients with distal occlusion of the peripheral arteries. Gene transfer may be useful in the conservative treatment of progressive aortic aneurysms. A more unified vision toward vascular medicine might be the key for research and development in the future.

scholarly journals Advances in Minimally Invasive Surgery for Lung Cancer

2020 ◽  
Author(s):  
Rachit Shah ◽  
Nils-Tomas Delagar McBride
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Wedge Resection ◽  
Surgical Techniques ◽  
Robotic Assisted ◽  
Current State ◽  
Chest Disease ◽  
History Of ◽  
Vats Wedge Resection

Over the last 25 years, improvement in instrumentation and surgical techniques has led to widespread adaptation of thoracoscopic (VATS) surgery in the field of thoracic oncology. What once was a niche operation like VATS wedge resection to now hybrid VATS chest wall resections, and advanced surgeries like bronchoplasty and sleeve resections are done with VATS. This has led to improved surgical outcomes for our patients and increased use of surgery in the treatment of chest disease. We review the history of VATS and its current state with most recent changes and upgrades in the technique in this chapter. We review the advancement in uniportal VATS, robotic assisted resection, complex VATS resection, and awake lung surgery with VATS.

Reflux Nephropathy

2019 ◽  
Author(s):  
Isa F. Ashoor ◽  
Michael J.G. Somers
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Surgical Techniques ◽  
Reflux Nephropathy ◽  
Ureteral Reimplantation ◽  
Robotic Assisted ◽  
Minimally Invasive Surgical ◽  
Excellent Safety Profile ◽  
Primary Vesicoureteral Reflux

Minimally invasive surgical techniques including robotic-assisted laparoscopic ureteral reimplantation and endoscopic transurethral injection are becoming increasingly prevalent. They are associated with a high success rate, shorter hospital stay, and an excellent safety profile.   This review contains 6 figures, 5 tables, 1 video, and 90 references. Key words: congenital reflux nephropathy, acquired reflux nephropathy, robotic-assisted laparoscopic ureteral reimplantation, reflux nephropathy, primary vesicoureteral reflux, urinary tract infection

Robotic-Assisted Endoscopic Thoracic Aortic Anastomosis in Juvenile Lambs

2005 ◽  
Vol 6 (1) ◽  
pp. 38 ◽  
Author(s):  
Sunil P. Malhotra ◽  
David Le ◽  
Stephan Thelitz ◽  
Frank L. Hanley ◽  
R. Kirk Riemer ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Surgical Techniques ◽  
Lung Ventilation ◽  
Large Animal Model ◽  
Burst Pressure ◽  
Computer Assisted ◽  
Large Animal ◽  
Robotic Assisted ◽  
The Mean ◽  
Aortic Anastomosis

<P>Background: Advances in robotic technology have enabled a wider range of applications for minimally invasive techniques in cardiac surgery, including mitral valve repair and coronary artery bypass grafting. With increased technical sophistication, robotic-assisted techniques can be developed for the endoscopic repair of certain congenital cardiac lesions. </P><P>Objective: The purpose of this study was to assess the feasibility of closed chest thoracic aortic anastomosis in a juvenile ovine model. </P><P>Methods: Lambs, aged 45 to 55 days, underwent surgery that was performed using the da Vinci robotic surgical system. Using 3 ports, the surgeon dissected the descending thoracic aorta and mobilized it free from attachments, using single-lung ventilation and CO<SUB>2</SUB> insufflation. Snares were introduced through 2 stab wounds for aortic occlusion proximally and distally. In 4 lambs, the aorta was completely transected and reanastomosed using interrupted nitinol sutures. One lamb underwent longitudinal aortotomy, and patch aortoplasty was performed with the placement of a Gore-Tex patch. Snares were released and the animals were recovered once hemodynamically stable. Animals were sacrificed at 6 to 12 hours after surgery and the descending aorta was harvested. Burst-pressure testing was performed on the anastomoses. </P><P>Results: All 5 lambs survived the procedure with stabilization of hemodynamic parameters following surgery. The mean aortic clamp time was 47 � 17 minutes, and the anastomosis was completed in 26 � 5 minutes. The mean burst pressure was 163 � 9 mm Hg. Conclusions: Endoscopic thoracic aortic anastomosis can be performed safely and with adequate exposure in a juvenile large-animal model using computer-assisted surgical techniques. With further refinements, these approaches could be applied to the repair of congenital anomalies of the aorta, including interrupted aortic arch and aortic coarctation.</P>

Cost-Effectiveness of Conventional vs Robotic-Assisted Laparoscopy in Gynecologic Oncologic Indications

2015 ◽  
Vol 25 (6) ◽  
pp. 1102-1108 ◽  
Author(s):  
Patricia Marino ◽  
Gilles Houvenaeghel ◽  
Fabrice Narducci ◽  
Agnès Boyer-Chammard ◽  
Gwenaël Ferron ◽  
...  
Keyword(s):  
Hospital Costs ◽  
Surgical Techniques ◽  
Cost Effective ◽  
Conventional Laparoscopy ◽  
Fixed Cost ◽  
Operating Theater ◽  
Robotic Assisted ◽  
Number Of Patients ◽  
The Cost ◽  
Robotic Assisted Laparoscopy

ObjectiveRobotic surgical techniques are known to be expensive, but they can decrease the cost of hospitalization and improve patients’ outcomes. The aim of this study was to compare the costs and clinical outcomes of conventional laparoscopy vs robotic-assisted laparoscopy in the gynecologic oncologic indications.MethodsBetween 2007 and 2010, 312 patients referred for gynecologic oncologic indications (endometrial and cervical cancer), including 226 who underwent conventional laparoscopy and 80 who underwent robot-assisted laparoscopy, were included in this prospective multicenter study. The direct costs, operating theater costs, and hospital costs were calculated for both surgical strategies using the microcosting method.ResultsBased on an average number of 165 surgical cases performed per year with the robot, the total extra cost of using the robot was €1456 per intervention. The robot-specific costs amounted to €2213 per intervention, and the cost of the robot-specific surgical supplies was €957 per intervention. The cost of the surgical supplies specifically required by conventional laparoscopy amounted to €1432, which is significantly higher than that of the robotic supplies (P < 0.001). Hospital costs were lower in the case of the robotic strategy (€2380 vs €2841, P < 0.001) because these patients spent less time in intensive care (0.38 vs 0.85 days). Operating theater costs were higher in the case of the robotic strategy (€1490 vs €1311, P = 0.0004) because the procedure takes longer to perform (4.98 hours vs 4.38 hours).ConclusionsThe main driver of additional costs is the fixed cost of the robot, which is not compensated by the lower hospital room costs. The robot would be more cost-effective if robotic interventions were performed on a larger number of patients per year or if the purchase price of the robot was reduced. A shorter learning curve would also no doubt decrease the operating theater costs, resulting in financial benefits to society.

scholarly journals Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e044778
Author(s):  
Yifeng Sun ◽  
Wei Liu ◽  
Jian Hou ◽  
Xiuhua Hu ◽  
Wenqiang Zhang
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Robotic Assisted ◽  
Unicompartmental Knee

ObjectiveWe conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.DesignSystematic review and meta-analysis.Data sourcesThe PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.Eligibility criteriaCase–control studies comparing robotic-assisted and conventional UKA.Data extraction and synthesisData from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ2 and I2 tests. All analyses were performed using the ‘metafor’ package of R V.3.6.2 software.ResultsA total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.ConclusionsThis study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.PROSPERO registration numberCRD42021246927.

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