scholarly journals Surgical outcomes of hysterectomy via robotic assisted versus traditional transvaginal natural orifice transluminal endoscopic surgery

2021 ◽  
Author(s):  
Tamisa Koythong ◽  
Brooke Thigpen ◽  
Sowmya Sunkara ◽  
Hadi Erfani ◽  
Stephanie Delgado ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Surgical Outcomes ◽  
Natural Orifice ◽  
Robotic Assisted

Comparison of Surgical Outcomes between Natural Orifice Transluminal Endoscopic Surgery for Hysterectomy and Conventional Total Laparoscopic Hysterectomy

2021 ◽  
Vol 104 (8) ◽  
pp. 1255-1262
Keyword(s):  
Blood Loss ◽  
Endoscopic Surgery ◽  
Surgical Outcomes ◽  
Operative Time ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Natural Orifice ◽  
Operative Complication ◽  
Post Operative Pain ◽  
Uterine Diseases

Objective: To compare surgical outcomes between transvaginal natural orifice transluminal endoscopic surgery for hysterectomy (vNOTESH) and total laparoscopic hysterectomy (TLH) for the benign uterine diseases. Materials and Methods: A retrospective review of electronic medical records of women that underwent vNOTESH between January 2019 and June 2020 (n=33) and TLH between June 2017 and August 2019 (n=33) in Bangkok Hospital Udon, Udonthani Province, Thailand was carried out. Measurement outcomes included operative time, estimated blood loss, intra- and post- operative complications, and post-operative pain assessment. Results: One woman of the TLH group was excluded from the study because of severe adhesion. The mean age and BMI were not significantly different between the groups. There was no intra-operative complication in both groups. A median operative time was significantly shorter in the vNOTESH at 73 minutes (30 to 260 minutes than in the TLH at 140 minutes (75 to 296minutes), p<0.0001]. Post-operative pain scores were significantly less in the vNOTESH than in the TLH. In addition, the number of women who needed the added analgesics were significantly less in the vNOTESH than the TLH groups at 6.1% versus 46.9% (p=0.001), respectively. However, the amount of blood loss and post-operative complication were not significantly different between the two groups. Conclusion: The present retrospective study demonstrated that the vNOTES is a feasible and safe procedure for hysterectomy in experienced hands and well-selected cases. This new technique is superior not only in taking less operative time and in achieving less postoperative pain, but also from the cosmetic aspect. Hence, it may be an alternative method for hysterectomy of the benign uterine diseases in the future. Keywords: Hysterectomy; Natural orifice transluminal endoscopic surgery (NOTES); Surgical outcomes; Total laparoscopic hysterectomy

Robotic Natural Orifice Transluminal Endoscopic Surgery Hysterectomy and Salpingo-Oophorectomy in a Porcine Model

2021 ◽  
pp. 155335062110184
Author(s):  
KarenKar-Loen Chan ◽  
Chung-Kwong Yeung ◽  
Kwok-Wai Lam ◽  
Jo Lai-Ken Cheung ◽  
Biji Sreedhar ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Robotic System ◽  
Pelvic Cavity ◽  
Confined Space ◽  
Natural Orifice ◽  
Robotic Arms ◽  
Robotic Assisted ◽  
Optimal Triangulation

Purpose. The emergence of robotic-assisted surgical techniques has gained significant indications in terms of reduced trauma, shortened recovery, and higher patients’ satisfaction. However, limitations by present surgical robotic systems used in natural orifice transluminal endoscopic surgery (NOTES) gynecology still exists, such as arm collisions, countertraction, instrument dexterity, and, in particular, space confinement due to the narrow pelvic anatomy. The current study evaluated the use of a miniaturized single-site surgical robotic system and its feasibility in performing robotic NOTES gynecological procedures using a live porcine animal model. Methods. Using a transrectal approach, the fully internalized robotic arms were deployed in a reverse configuration to access the lower pelvic cavity of the animals to perform NOTES gynecological procedures. Results. Robotic-assisted transrectal gynecological procedures were successfully performed using the new robotic system. A hemi-hysterectomy with unilateral salpingo-oophorectomy was completed in the first animal and a total hysterectomy with bilateral salpingo-oophorectomy in the second animal with an average docking time of 22.5 minutes and console time of 63 minutes and 58 minutes, respectively. The overall blood loss for each procedure was estimated to be <20 mL per animal with no intraoperative complications. Conclusions. The reverse configuration of the miniaturized surgical robotic system has demonstrated its capability to provide a potential solution to maintain clear visualization of the surgical field, optimal triangulation, and dexterity robotic NOTES gynecological procedures within the deep confined space of the pelvic cavity.

scholarly journals Surgical outcomes of conventional laparoscopic and robotic‐assisted hysterectomy

2021 ◽  
Author(s):  
Georgios Gitas ◽  
Ibrahim Alkatout ◽  
Louisa Proppe ◽  
Nele Werner ◽  
Achim Rody ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Robotic Assisted ◽  
Conventional Laparoscopic

scholarly journals Robotic natural orifice specimen extraction surgery versus traditional robotic-assisted surgery (NOTR) for patients with colorectal cancer: a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Luo ◽  
Fangfang Zheng ◽  
Haobo Zhang ◽  
Weiquan Zhu ◽  
Penghui He ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Natural Orifice Specimen Extraction ◽  
Robotic Assisted ◽  
Randomized Controlled ◽  
Robotic Assisted Surgery ◽  
Secondary Outcomes

Abstract Background Natural orifice specimen extraction surgery for colorectal cancer has been introduced in order to reduce the abdominal incision, demonstrating major development potential in minimally invasive surgery. We are conducting this randomized controlled trial to assess whether robotic NOSES is non-inferior to traditional robotic-assisted surgery for patients with colorectal cancer in terms of primary and secondary outcomes. Method/design Accordingly, a prospective, open-label, randomized controlled, parallel-group, multicenter, and non-inferiority trial will be conducted to discuss the safety and efficacy of robotic natural orifice extraction surgery compared to traditional robotic-assisted surgery. Here, 550 estimated participants will be enrolled to have 80% power to detect differences with a one-sided significance level of 0.025 in consideration of the non-inferiority margin of 10%. The primary outcome is the incidence of surgical complications, which will be classified using the Clavien-Dindo system. Discussion This trial is expected to reveal whether robotic NOSES is non-inferior to traditional robotic-assisted surgery, which is of great significance in regard to the development of robotic NOSES for patients with colorectal cancer in the minimally invasive era. Furthermore, robotic NOSES is expected to exhibit superiority to traditional robotic-assisted surgery in terms of both primary and secondary outcomes. Trial registration ClinicalTrials.govNCT04230772. Registered on January 15, 2020.

scholarly journals Natural Orifice Translumenal Endoscopic Surgery for Anterior Spinal Procedures

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Priscilla Magno ◽  
Mouen A. Khashab ◽  
Manuel Mas ◽  
Samuel A. Giday ◽  
Jonathan M. Buscaglia ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Endoscopic Surgery ◽  
Vertebral Column ◽  
Bone Biopsy ◽  
Posterior Mediastinum ◽  
Direct Access ◽  
Thoracic Vertebrae ◽  
Natural Orifice ◽  
Vertebral Bone ◽  
Vertebral Bodies

Background. NOTES techniques allow transesophageal access to the mediastinum. The aim of this study was to assess the feasibility of transesophageal biopsy of thoracic vertebrae.Methods. Nonsurvival experiments on four 50-kg porcine animals were performed. Transesophageal access to the mediastinum was attained using submucosal tunneling technique.Results. The posterior mediastinum was successfully accessed and navigated in all animals. Vertebral bodies and intervertebral spaces were easily approached while avoiding damage to adjacent vessels. Bone biopsy was successfully performed without complications, but the hardness of bone tissue resulted in small and fragmented samples.Conclusions. Peroral transesophageal access into the posterior mediastinum and thoracic vertebral bone biopsy was feasible and safe. The proximity of the esophagus to the vertebral column provides close and direct access to the thoracic spine and opens up new ground for the performance of multilevel anterior spine procedures using NOTES techniques.

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