A roadmap for robotic-assisted sigmoid resection in diverticular disease using a Senhance™ Surgical Robotic System: results and technical aspects

Abstract Aims Minimally symptomatic diverticular stricture poses diagnostic and management dilemma for the Colorectal Surgeon. Long term outcome, risk of missing a cancer and complications are not well documented in the literature. This study aims at assessment of outcomes of patients with minimally symptomatic diverticular stricture who were treated conservatively. Methods Retrospective chart review of all patients with confirmed diverticular stricture on endoscopy and imaging scans who had minimal or mild symptoms over a 6-year period from January,2014 to June,2020 in a large tertiary referral hospital. Search methods included diverticular disease with stricture using ICD10 code K57 and K56.6. Outcome measures included complications while on conservative treatment including missed cancer, any subsequent surgery and complications including stomas. Results 29 patients fitted the inclusion criteria, 18 females with median age 75(43-92). Median follow up was 32.5 months (8-93). All had endoscopic and CT imaging confirmation of diverticular stricture. Repeat investigations were recorded as 16 endoscopies in 9 patients and 30 CT scans in 14 patients during follow up. Four patients had at least one episode of diverticulitis; only one underwent emergency surgery at 5 years from diagnosis. 2/29 (6.9%) patients presented with diverticular perforation requiring Hartmann’s procedure. One patient (3%) had elective sigmoid resection with average duration of follow up 29 months (11.5-59) months. There were no missed diagnosis of cancer and no mortality due to diverticular disease. Conclusions In this patient population, diverticular stricture runs a relatively benign course with few complications or surgical intervention during follow up.

Download Full-text

Surgery for acute complications of diverticular disease: primary or secondary anastomosis after sigmoid resection

10.1002/14651858.cd006141 ◽

2006 ◽

Author(s):

Sachiendra V Amaragiri ◽

Shalini Reddy ◽

Robert Wilson

Keyword(s):

Diverticular Disease ◽

Sigmoid Resection ◽

Acute Complications

Download Full-text

The role of robotic-assisted surgery for the treatment of diverticular disease

Journal of Robotic Surgery ◽

10.1007/s11701-019-01008-y ◽

2019 ◽

Vol 14 (1) ◽

pp. 239-240

Author(s):

Matteo Bianchini ◽

Matteo Palmeri ◽

Gianni Stefanini ◽

Niccolò Furbetta ◽

Gregorio Di Franco

Keyword(s):

Diverticular Disease ◽

Robotic Assisted ◽

Robotic Assisted Surgery

Download Full-text

Comparable surgery time for robotic assisted total knee arthroplasty after initial learning curve

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00312 ◽

2020 ◽

Vol 8 (5_suppl4) ◽

pp. 2325967120S0031

Author(s):

Peter Savov ◽

Lars-René Tücking ◽

Henning Windhagen ◽

Max Ettinger

Keyword(s):

Learning Curve ◽

Robotic System ◽

Robotic Group ◽

Absolute Deviation ◽

Robotic Assisted ◽

Time Of Surgery ◽

Implant Positioning ◽

Initial Learning ◽

Manual Group ◽

The Mean

Aims and Objectives: In the past years, further development in knee replacement still continues. Computer-assisted surgery techniques in total knee arthroplasty (TKA) are on the rise. One point of criticism is the prolonged time of surgery and associated cost as known from old techniques like navigation. The primary objective of this study was to determine the learning curve for the time of surgery and accuracy in implant positioning for an imageless robotic system for TKA. Materials and Methods: In this prospective study, the first 30 robotic-assisted TKA from a single senior surgeon were analyzed with regard to time of surgery and accuracy of implant position on the basis of the intraoperative plan and the postoperative x-rays. This data was compared to the last 30 manual TKAs of the same surgeon with the same prosthesis. Evaluation of the learning curve was performed with CUSUM analysis. The time of surgery after finishing the learning curve in the robotic group was compared to the manual group. Results: The learning curve in the robotic group for surgery time was finished after 11 cases. The robotic experience did not affect the accuracy of implant positioning, such as limb alignment and restoration of the joint line. The mean absolute deviation of the postoperative limb alignment to the intraoperative plan was 2° (+/- 1,1). The mean absolute deviation of the medial proximal tibial (mPTA) and distal lateral femoral angle (dLFA) was 1° (+/- 0,9) for both. The mean surgery time in the robotic group after finishing the learning curve was 66 minutes (+/- 4,2) and in the total manual group 67 minutes (+/- 3,5) (n.s.). Conclusion: After finishing the initial learning curve of 11 cases for robotic-assisted TKA the time of surgery is equal to the manual conventional technique. However, there is no learning curve for implant positioning with the imageless robotic system. The implementation of the intraoperative plan is accurate to 1° with the robotic system.

Download Full-text