2180 Experience of Centro Medico Nacional “20 De Noviembre“ in Robotic-assisted Hysterectomy for Large Uteri: A Case Series of 20 Women

AbstractSagittal deformity of the knee is commonly corrected to neutral biomechanical axis (±3 degrees) during total knee arthroplasty (TKA), which is a widely accepted goal. Recent advances in surgical technology have made it possible to accurately plan and fulfill these goals. One of these is robotic-assisted TKA, which has been noted to help increase accuracy and precision of restoring a neutral mechanical axis. While there are data confirming the ability of robotic devices to better correct knee alignment than the manual technique, there is a lack of data concerning the use of the robotic devices in more complex cases, such as those in patients with severe varus or valgus deformity, as well as in flexion contractures. Therefore, the purpose of this case study is to present three cases in which the robotic-assisted TKA device was used to correct a severe varus and severe valgus deformities. Based on this case series, it should be noted that the robotic device can also help correct severe varus/valgus deformities and flexion contractures.

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Assessment of Anastomotic Perfusion in Left-Sided Robotic Assisted Colorectal Resection by Indocyanine Green Fluorescence Angiography

Minimally Invasive Surgery ◽

10.1155/2019/3267217 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Emanuel Shapera ◽

Roger W. Hsiung

Keyword(s):

Indocyanine Green ◽

Colorectal Resection ◽

Case Series ◽

Fluorescence Angiography ◽

Control Group ◽

Invasive Approach ◽

Robotic Assisted ◽

Anastomotic Complications ◽

Intraoperative Management ◽

Resection And Anastomosis

Background. Indocyanine green fluorescent angiography (IcGA) has been used with success in guiding intraoperative management to prevent colorectal anastomotic complications. Prior studies in open and laparoscopic colorectal surgery, such as PILLAR II, have demonstrated a low anastomotic leak rate (1.4%). As the minimally invasive approach progresses from laparoscopic to robotic approach, the effect and safety of IcGA in assessing anastomotic perfusion in the latter deserve further investigation. Methods. The objective of the study was to determine the safety of IcGA in guiding intraoperative management of robotic assisted colorectal resection via perfusion assessment. The design was single-surgeon, retrospective case-control study. 74 patients underwent left-sided robotic assisted colorectal resection and anastomosis with IcGA guidance. 30 historical controls underwent left-sided robotic assisted colorectal resection and anastomosis without IcGA. Clinical, demographic, operative, and outcome variables were tabulated. Results. In the control group, 1 patient suffered a postoperative anastomotic stricture requiring no surgery, and 1 patient suffered an anastomotic dehiscence requiring return to the operating room. There were no anastomotic complications in the IcGA group, including 4 patients who underwent a change in the chosen level of anastomosis based on intraoperative IcGA. Conclusion. IcGA is safe to use as demonstrated by the very low rate of complications in this case series. It is also safe to rely on to guide re-resection and recreation of an anastomosis intraoperatively by demonstration of blood flow. This may help offset the loss of tactile feedback and assessment of tension in the robotic platform.

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Robotic-assisted partial nephrectomy in horseshoe kidneys: A case series

European Urology Supplements ◽

10.1016/s1569-9056(19)32741-1 ◽

2019 ◽

Vol 18 (6) ◽

pp. e2629

Author(s):

A. Gulamhusein ◽

M. Tran ◽

F. Mumtaz ◽

R. Barod ◽

P. Patki ◽

...

Keyword(s):

Partial Nephrectomy ◽

Case Series ◽

Robotic Assisted ◽

Robotic Assisted Partial Nephrectomy

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Vaginal Dehiscence and Evisceration After Robotic-assisted Radical Cystectomy: A Case Series and Review of the Literature

Urology ◽

10.1016/j.urology.2019.09.009 ◽

2019 ◽

Vol 134 ◽

pp. 90-96 ◽

Cited By ~ 2

Author(s):

Frank C. Lin ◽

Andrew Medendorp ◽

Michelle Van Kuiken ◽

Steven A. Mills ◽

Christopher M. Tarnay

Keyword(s):

Radical Cystectomy ◽

Case Series ◽

Review Of The Literature ◽

Robotic Assisted

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Corneal Abrasion in Hysterectomy and Prostatectomy

Anesthesiology ◽

10.1097/aln.0000000000000630 ◽

2015 ◽

Vol 122 (5) ◽

pp. 994-1001 ◽

Cited By ~ 8

Author(s):

Ajay Sampat ◽

Isaac Parakati ◽

Rangesh Kunnavakkam ◽

David B. Glick ◽

Nita K. Lee ◽

...

Keyword(s):

Radical Prostatectomy ◽

Chronic Conditions ◽

Nationwide Inpatient Sample ◽

Case Series ◽

Laparoscopic Hysterectomy ◽

Multivariate Models ◽

Robotic Assisted ◽

Increased Risk ◽

Invasive Techniques ◽

Preoperative Factors

Abstract Background: Radical prostatectomy (RP) is most commonly performed laparoscopically with a robot (robotic-assisted laparoscopic radical prostatectomy, R/PROST). Hysterectomy, which may be open hysterectomy (O/HYST) or laparoscopic hysterectomy (L/HYST), has been increasingly frequently done via robot (R/HYST). Small case series suggest increased corneal abrasions (CAs) with less invasive techniques. Methods: The authors identified RP (166,942), O/HYST (583,298), or L/HYST (216,890) discharges with CA in the Nationwide Inpatient Sample (2000–2011). For 2009–2011, they determined odds ratios (ORs) and 95% confidence intervals (CIs) for CA, in R/PROST, non-R/PROST, L/HYST, O/HYST, and R/HYST. Uni- and multivariate models studied CA risk depending on surgical procedure, age, race, year, chronic illness, and malignancy. Results: In 2000–2011, 0.18% RP, 0.13% L/HYST, and 0.03% O/HYST sustained CA. Compared with 17,554 non-R/PROSTs (34 abrasions, 0.19%) in 2009–2011, OR was not significantly higher in 28,521 R/PROSTs (99, 0.35%; OR 1.508; CI 0.987 to 2.302; P < 0.057). CA significantly increased in L/HYST (70/51,323; 0.136%) versus O/HYST (70/191,199; 0.037%; OR 3.821; CI 2.594 to 5.630; P < 0.0001), further increasing in R/HYST (63/21, 213; 0.297%; OR 6.505; CI 4.323 to 9.788; P < 0.0001). For hysterectomy, risk of CA increased with age (OR 1.020; CI 1.007 to 1.034; P < 0.003) and number of chronic conditions (OR 1.139; CI 1.065 to 1.219; P < 0.0001). CA risk was likewise elevated in R/HYST with number of chronic conditions. Being African American significantly decreased CA risk in R/PROST and in R/HYST or L/HYST. Conclusions: L/HYST increased CA nearly four-fold, and R/HYST approximately 6.5-fold versus O/HYST. Identifiable preoperative factors are associated with either increased risk (age, chronic conditions) or decreased risk (race).

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