Minimally invasive surgery and stoma-related complications after restorative proctocolectomy for ulcerative colitis. A two-centre comparison with open approach

Aim. To evaluate the reproducibility and safety of the developed pancreatogastric anastomosis with various surgical approaches during pancreatoduodenectomy.Materials and methods. The experience of surgical treatment of 47 patients with malignant tumours of the periampullary zone, who underwent pancreatoduodenectomy, was considered. The proposed variant of anastomose was performed to 14 (29.8%) patients: in 7 cases with a minimally invasive approach to perform pancreatoduodenectomy; and in 7 cases with an open approach. To compare retrospectively 33 (70.2%) patients who underwent pancreatogastric anastomosis according to the Bassi technique: 9 – with minimally invasive surgery, 24 – with open surgery. The frequency of pancreatic fistulas, the number of repeated interferences, and hospital mortality were taken into account.Results. A significant advantage of the new method of forming an anastomosis in the duration of the operation was noted in comparison with the Bassi technique. There were no statistically significant differences in blood loss while various types of anastomoses (p > 0.05). When using the proposed technique, the formation of pancreatic fistulas was not revealed. The development of pancreatic fistula was observed in 4 (16.7%) patients after open surgery and in 7 (77.8%) patients after minimally invasive Bassi anastomose formation. Reoperations were performed after open surgery in 3 (12.5%) cases and in 4 (44.4%) cases of minimally invasive surgery according to the Bassi technique. There were 2 (22.2%) deaths in the minimally invasive group.Conclusion. The proposed pancreatogastric anastomosis is applicable in clinical practice. This method allows to create relatively fast and less challenging anastomosis, including with a minimally invasive approach. The use of this technique makes it possible to reduce mortality and postoperative complications in patients with a “complex” pancreas.

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Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-020-03372-x ◽

2020 ◽

Author(s):

Giacomo Corrado ◽

Francesca Ciccarone ◽

Francesco Cosentino ◽

Francesco Legge ◽

Andrea Rosati ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Early Stage ◽

Open Approach ◽

Multicentric Study

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Decision Making in Ventral Hernia Repair: Minimally Invasive Surgery or Open Approach

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2018.07.198 ◽

2018 ◽

Vol 227 (4) ◽

pp. S98

Author(s):

Kathryn Schlosser ◽

Michael R. Arnold ◽

Javier Otero ◽

Tanushree Prasad ◽

Paul D. Colavita ◽

...

Keyword(s):

Decision Making ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Hernia Repair ◽

Ventral Hernia ◽

Invasive Surgery ◽

Ventral Hernia Repair ◽

Open Approach

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Pattern of relapse in patients with stage IB1 cervical cancer after radical hysterectomy as primary treatment. Minimally invasive surgery vs. open approach. Systematic review and meta-analysis.

Gynecologic Oncology ◽

10.1016/j.ygyno.2021.11.018 ◽

2021 ◽

Author(s):

Nabil Manzour ◽

Jorge M. Núñez-Cordoba ◽

Luis Chiva ◽

Enrique Chacón ◽

Felix Boria ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Radical Hysterectomy ◽

Meta Analysis ◽

Primary Treatment ◽

Open Approach

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Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study

Updates in Surgery ◽

10.1007/s13304-021-01159-4 ◽

2021 ◽

Author(s):

Marco Milone ◽

Maurizio Degiuli ◽

Nunzio Velotti ◽

Michele Manigrasso ◽

Sara Vertaldi ◽

...

Keyword(s):

Colon Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Anastomotic Leak ◽

Invasive Surgery ◽

Transverse Colon ◽

Open Approach ◽

Transverse Colon Cancer ◽

Robotic Approach ◽

Solid Diet

AbstractThe role of minimally invasive surgery in the treatment of transverse colon cancer is still controversial. The aim of this study is to investigate the advantages of a totally laparoscopic technique comparing open versus laparoscopic/robotic approach. Three hundred and eighty-eight patients with transverse colon cancer, treated with a segmental colon resection, were retrospectively analyzed. Demographic data, tumor stage, operative time, intraoperative complications, number of harvested lymph nodes and recovery outcomes were recorded. Recurrences and death were also evaluated during the follow-up. No differences were found between conventional and minimally invasive surgery, both for oncological long-term outcomes (recurrence rate p = 0.28; mortality p = 0.62) and postoperative complications (overall rate p = 0.43; anemia p = 0.78; nausea p = 0.68; infections p = 0.91; bleeding p = 0.62; anastomotic leak p = 0.55; ileus p = 0.75). Nevertheless, recovery outcomes showed statistically significant differences in favor of minimally invasive surgery in terms of time to first flatus (p = 0.001), tolerance to solid diet (p = 0.017), time to first mobilization (p = 0.001) and hospital stay (p = 0.004). Compared with laparoscopic approach, robotic surgery showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.005) and tolerance to solid diet (p = 0.001). Finally, anastomosis evaluation confirmed the superiority of intracorporeal approach which showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.003) and tolerance to solid diet (p = 0.001); moreover, we recorded a statistical difference in favor of intracorporeal approach for infection rate (p = 0.04), bleeding (p = 0.001) and anastomotic leak (p = 0.03). Minimally invasive approach is safe and effective as the conventional open surgery, with comparable oncological results but not negligible advantages in terms of recovery outcomes. Moreover, we demonstrated that robotic approach may be considered a valid option and an intracorporeal anastomosis should always be preferred.

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Pediatric Challenges in Robot-Assisted Kidney Transplantation

Frontiers in Surgery ◽

10.3389/fsurg.2021.649418 ◽

2021 ◽

Vol 8 ◽

Author(s):

Julien Grammens ◽

Michal Yaela Schechter ◽

Liesbeth Desender ◽

Tom Claeys ◽

Céline Sinatti ◽

...

Keyword(s):

Kidney Transplantation ◽

Minimally Invasive Surgery ◽

Cost Effectiveness ◽

Minimally Invasive ◽

Clinical Outcomes ◽

Invasive Surgery ◽

Graft Function ◽

Open Approach ◽

Robot Assisted ◽

Ckd Stage

Kidney transplantation is universally recognized as the gold standard treatment in patients with End-stage Kidney Disease (ESKD, or according to the latest nomenclature, CKD stage 5). Robot-assisted kidney transplantation (RAKT) is gradually becoming preferred technique in adults, even if applied in very few centra, with potentially improved clinical outcomes compared with open kidney transplantation. To date, only very few RAKT procedures in children have been described. Kidney transplant recipient patients, being immunocompromised, might be at increased risk for perioperative surgical complications, which creates additional challenges in management. Applying techniques of minimally invasive surgery may contribute to the improvement of clinical outcomes for the pediatric transplant patients population and help mitigate the morbidity of KT. However, many challenges remain ahead. Minimally invasive surgery has been consistently shown to produce improved clinical outcomes as compared to open surgery equivalents. Robot-assisted laparoscopic surgery (RALS) has been able to overcome many restrictions of classical laparoscopy, particularly in complex and demanding surgical procedures. Despite the presence of these improvements, many challenges lie ahead in the surgical and technical–material realms, in addition to anesthetic and economic considerations. RALS in children poses additional challenges to both the surgical and anesthesiology team, due to specific characteristics such as a small abdominal cavity and a reduced circulating blood volume. Cost-effectiveness, esthetic and functional wound outcomes, minimal age and weight to undergo RALS and effect of RAKT on graft function are discussed. Although data on RAKT in children is scarce, it is a safe and feasible procedure and results in excellent graft function. It should only be performed by a RAKT team experienced in both RALS and transplantation surgery, fully supported by a pediatric nephrology and anesthesiology team. Further research is necessary to better determine the value of the robotic approach as compared to the laparoscopic and open approach. Cost-effectiveness will remain an important subject of debate and is in need of further evaluation as well.

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