Review of Operative Outcomes of Robotic Surgical Procedures Performed with Robotic vs. Endoscopic Linear Staplers

Introduction: The impact of beta blocker use on surgical outcomes of cancer patients receiving immunotherapy is unknown. Hypothesis: Beta blocker use is associated with lower post-operative mortality in cancer patients on immunotherapy. Methods: We used an institutional Advanced Cohort Explorer to identify all patients who underwent any surgical procedure less than 90 days after receiving immunotherapy. Data on the procedure performed as well as the post-operative outcome were collected and analyzed per the pre-operative beta blocker use status. Results: A total of 233 patients underwent surgery between 09/2011-06/2019. Mean age was 64.7 years (range: 16-92). The most common cancer diagnoses were lung (48, 44.4%), melanoma (49, 45.4%) and kidney (11, 10.2%). Immunotherapy medications were pembrolizumab ( 127, 54.5%), nivolumab (51, 21.9%), ipilimumab (43, 18.5%), atezolizumab (11, 4.7%) and avelumab (1, 0.43%). Pre-operative beta blocker use was documented in 140 (60.1%) patients. Most common surgical procedures were skin resection (75, 32.1%), wound repair (47, 20.2%), vascular procedures (36, 15.5%), urethral procedures 16 (6.9%) and sentinel lymph node biopsies (10, 4.3%). The 30-day mortality rate was 10.3% (24 deaths). In a multi-variable logistic regression analysis, pre-operative use of beta blockers was associated with a lower risk of death within 30 days from surgery (OR 0.34, CI 0.13-0.87, P=0.024). 30-day mortality rates were higher in patients undergoing vascular (50%, 17 of 34) versus non-vascular (3.5%, 7 of 199) procedures (P<0.0001) in a Chi Square test. Conclusions: Beta blocker use is associated with a lower 30-day mortality rate after surgical procedures in cancer patients treated with immunotherapy. Further investigation is warranted.

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Successful Triple Valve Surgery in an Undernourished Patient: What to Prepare?

Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya ◽

10.30651/jqm.v5i2.6189 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Dian Paramita Kartikasari ◽

Esti Hindariati

Keyword(s):

Cardiac Surgery ◽

Heart Disease ◽

Surgical Procedures ◽

Valvular Heart Disease ◽

Nutritional Assessment ◽

Cardiac Surgical Procedures ◽

The United States ◽

Organ Injury ◽

Individual Risk ◽

Operative Outcomes

ABSTRACT Valvular heart disease accountsfor 10% to 20% of all cardiac surgical procedures in the United States. The decision to intervene, as well as the type of intervention for a patient with severe valvular heart disease, should be based on an individual risk-benefit analysis. Once a patient is considered a candidate for cardiac surgery, a comprehensive patient evaluation of medical conditions and comorbidities helps improve operative outcomes and minimize the mortality rate. Patients with severe valvular heart disease with chronic heart failure at times, progressing to malnutrition. Patients undergoing cardiac surgery experience a systemic inflammatory response, which contributes to acute organ injury leading to a higher incidence of comorbidities and worse malnutrition. Therefore, preoperative risk and nutritional assessment are critical in performing safe cardiac surgical procedures. We report a case of a malnourished 17-year-old man with multiple valvular heart disease with optimal preparation, including good nutritional status leading to good outcome of complex cardiac surgery even in the high risk patients. Keywords : valvular heart disease, malnutrition, perioperative assessmentCorrespondence : [email protected]

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Robotic surgical procedures in children

Turkish Association of Pediatric Surgeons ◽

10.5222/jtaps.2015.093 ◽

2015 ◽

Author(s):

Rahşan Özcan ◽

Gonca Topuzlu Tekant

Keyword(s):

Surgical Procedures ◽

Robotic Surgical Procedures

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Going Hands-Free: MagnetoSuture™ for Untethered Guided Needle Penetration of Human Tissue Ex Vivo

Robotics ◽

10.3390/robotics10040129 ◽

2021 ◽

Vol 10 (4) ◽

pp. 129

Author(s):

Lamar O. Mair ◽

Sagar Chowdhury ◽

Xiaolong Liu ◽

Onder Erin ◽

Oleg Udalov ◽

...

Keyword(s):

Surgical Procedures ◽

Ex Vivo ◽

Robotic Surgical Procedures ◽

Needle Penetration ◽

Field Gradients ◽

Surgical Tool ◽

Surgical Suture ◽

Magnetic Field Gradients ◽

Proof Of Principle

The application of force in surgical settings is typically accomplished via physical tethers to the surgical tool. While physical tethers are common and critical, some internal surgical procedures may benefit from a tetherless operation of needles, possibly reducing the number of ports in the patient or the amount of tissue damage caused by tools used to manipulate needles. Magnetic field gradients can dynamically apply kinetic forces to magnetizable objects free of such tethers, possibly enabling ultra-minimally invasive robotic surgical procedures. We demonstrate the untethered manipulation of a suture needle in vitro, exemplified by steering through narrow holes, as well as needle penetration through excised rat and human tissues. We present proof of principle manipulations for the fully untethered control of a minimally modified, standard stainless steel surgical suture needle.

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