A tale of two robots: Operating times and learning curves in robot-assisted lumbar fusion

2022 ◽  
Vol 97 ◽  
pp. 42-48
Author(s):  
Nikhil Vasan ◽  
Daniel B. Scherman ◽  
Andrew Kam
Author(s):  
Nikolaos Grivas ◽  
Ioannis Zachos ◽  
Georgios Georgiadis ◽  
Markos Karavitakis ◽  
Vasilis Tzortzis ◽  
...  

BJS Open ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 27-44 ◽  
Author(s):  
N. A. Soomro ◽  
D. A. Hashimoto ◽  
A. J. Porteous ◽  
C. J. A. Ridley ◽  
W. J. Marsh ◽  
...  

2020 ◽  
Vol 136 ◽  
pp. e635-e645 ◽  
Author(s):  
Bowen Jiang ◽  
Zach Pennington ◽  
Tej Azad ◽  
Ann Liu ◽  
A. Karim Ahmed ◽  
...  

2019 ◽  
Vol 22 ◽  
pp. S371-S372
Author(s):  
R. Ditto ◽  
D. Nagle ◽  
C. Ridley ◽  
A. Porteous ◽  
W. Marsh ◽  
...  

2022 ◽  
Vol 52 (1) ◽  
pp. E8

OBJECTIVE Pedicle screw insertion for stabilization after lumbar fusion surgery is commonly performed by spine surgeons. With the advent of navigation technology, the accuracy of pedicle screw insertion has increased. Robotic guidance has revolutionized the placement of pedicle screws with 2 distinct radiographic registration methods, the scan-and-plan method and CT-to-fluoroscopy method. In this study, the authors aimed to compare the accuracy and safety of these methods. METHODS A retrospective chart review was conducted at 2 centers to obtain operative data for consecutive patients who underwent robot-assisted lumbar pedicle screw placement. The newest robotic platform (Mazor X Robotic System) was used in all cases. One center used the scan-and-plan registration method, and the other used CT-to-fluoroscopy for registration. Screw accuracy was determined by applying the Gertzbein-Robbins scale. Fluoroscopic exposure times were collected from radiology reports. RESULTS Overall, 268 patients underwent pedicle screw insertion, 126 patients with scan-and-plan registration and 142 with CT-to-fluoroscopy registration. In the scan-and-plan cohort, 450 screws were inserted across 266 spinal levels (mean 1.7 ± 1.1 screws/level), with 446 (99.1%) screws classified as Gertzbein-Robbins grade A (within the pedicle) and 4 (0.9%) as grade B (< 2-mm deviation). In the CT-to-fluoroscopy cohort, 574 screws were inserted across 280 lumbar spinal levels (mean 2.05 ± 1.7 screws/ level), with 563 (98.1%) grade A screws and 11 (1.9%) grade B (p = 0.17). The scan-and-plan cohort had nonsignificantly less fluoroscopic exposure per screw than the CT-to-fluoroscopy cohort (12 ± 13 seconds vs 11.1 ± 7 seconds, p = 0.3). CONCLUSIONS Both scan-and-plan registration and CT-to-fluoroscopy registration methods were safe, accurate, and had similar fluoroscopy time exposure overall.


2020 ◽  
Vol 33 (Supplement_2) ◽  
Author(s):  
B Feike Kingma ◽  
Edin Hadzijusufovic ◽  
Pieter C Van der Sluis ◽  
Erida Bano ◽  
Hauke Lang ◽  
...  

ABSTRACT To ensure safe implementation of robot-assisted minimally invasive esophagectomy (RAMIE), the learning process should be optimized. This study aimed to report the results of a surgeon who implemented RAMIE in a German high-volume center by following a tailored and structured training pathway that involved proctoring. Consecutive patients who underwent RAMIE during the course of the program were included from a prospective database. A single surgeon, who had prior experience in conventional MIE, performed all RAMIE procedures. Cumulative sum (CUSUM) learning curves were plotted for the thoracic operating time and intraoperative blood loss. Perioperative outcomes were compared between patients who underwent surgery before and after a learning curve plateau occurred. Between 2017 and 2018, the adopting center adhered to the structured training pathway, and a total of 70 patients were included in the analysis. The CUSUM learning curves showed plateaus after 22 cases. In consecutive cases 23 to 70, the operating time was shorter for both the thoracic phase (median 215 vs. 249 minutes, P = 0.001) and overall procedure (median 394 vs. 440 minutes, P = 0.005), intraoperative blood loss was less (median 210 vs. 400 milliliters, P = 0.029), and lymph node yield was higher (median 32 vs. 23 nodes, P = 0.001) when compared to cases 1 to 22. No significant differences were found in terms of conversion rates, postoperative complications, length of stay, completeness of resection, or mortality. In conclusion, the structured training pathway resulted in a short and safe learning curve for RAMIE in this single center’s experience. As the pathway seems effective in implementing RAMIE without compromising the early oncological outcomes and complication rates, it is advised for surgeons who are wanting to adopt this technique.


2016 ◽  
Vol 15 (3) ◽  
pp. e664
Author(s):  
M. Okano ◽  
R. Ivanovic ◽  
Q.S.S. Nomelini ◽  
H. Morais ◽  
J. Pontes ◽  
...  

2021 ◽  
Vol 25 ◽  
pp. 101214
Author(s):  
Nathan J. Lee ◽  
Venkat Boddapati ◽  
Justin Mathew ◽  
Gerard Marciano ◽  
Michael Fields ◽  
...  

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