PE39: Use of 3D HD auxiliary monitor by bedside assistant results in shorter console-time and ischemia-time in robot-assisted laparoscopic partial tumor-nephrectomy

2014 ◽  
Vol 13 (3) ◽  
pp. 29-30
Author(s):  
M. Alamyar ◽  
H. Bouma ◽  
W. Goossens ◽  
F. Wieringa ◽  
B. Kroon ◽  
...  
Keyword(s):  
Robot Assisted ◽  
Ischemia Time ◽  
Tumor Nephrectomy ◽  
Bedside Assistant

The First Assistant Sparing Technique Robot-Assisted Partial Nephrectomy Decreases Warm Ischemia Time While Maintaining Good Perioperative Outcomes

2012 ◽  
Vol 26 (11) ◽  
pp. 1448-1453 ◽  
Author(s):  
William T. Berg ◽  
Chad R. Rich ◽  
Gina M. Badalato ◽  
Christopher M. Deibert ◽  
Chris O. Wambi ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Ischemia Time

scholarly journals Intraoperative ultrasound in robot-assisted partial nephrectomy: State of the art

2018 ◽  
Vol 90 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Giacomo Di Cosmo ◽  
Enrica Verzotti ◽  
Tommaso Silvestri ◽  
Andrea Lissiani ◽  
Roberto Knez ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
State Of The Art ◽  
Short Review ◽  
Robot Assisted ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Ischemia Time ◽  
Oncological Safety ◽  
Nephron Sparing ◽  
Operative Ultrasound

Introduction: Nephron-sparing surgery (NSS) is of one of the most studied fields in urology due to the balancing between renal function preservation and oncological safety of the procedure. Aim of this short review is to report the state of the art of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during robotassisted partial nephrectomy (RAPN). Material and methods: We performed a literature review by electronic database on Pubmed about the use of intra-operative US in RAPN to evaluate the usefulness and the feasibility of this procedure. Results: Several studies analyzed the use of different US probes during RAPN. Among them some focused on using contrastenhanced ultra sonography (CEUS) for improving the dynamic evaluation of microvascular structure allowing the reduction of ischemia time (IT). We reported that nowaday the use of intraoperative US during RAPN could be helpful to improve the preservation of renal tissue without compromising oncological safety. Moreover, during RAPN there is no need for assistant to hand the US probe increasing surgeon autonomy. Conclusions: The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure. Moreover US could be useful to reduce ischemia time (IT). The advantages of nephron-sparing surgery over radical nephrectomy is well established with a pool of data providing strong evidence of oncological and survival equivalency. With the progressive growth of robot-assisted partial nephrectomy (RAPN) techniques, the use of several tools has been progressively developed to help the surgeon in the identification of masses and its vascular net. In this short review we tried to analyze the current use of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during RAPN.

scholarly journals Robot-assisted minimally invasive esophagectomy (RAMIE): tips and tricks from the bedside assistant view—expert experiences

2020 ◽  
Vol 33 (Supplement_2) ◽  
Author(s):  
S van der Horst ◽  
C Voli ◽  
I A Polanco ◽  
R van Hillegersberg ◽  
J P Ruurda ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Da Vinci Surgical System ◽  
Robot Assisted ◽  
Communicative Skills ◽  
Invasive Esophagectomy ◽  
Bedside Assistant ◽  
Vinci Surgical System ◽  
Surgical System

ABSTRACT The role of bedside assistants in robot-assisted minimally invasive esophagectomy is important. It includes knowledge of the procedure, knowledge of the da Vinci Surgical System, skills in laparoscopy, and good communicative skills. An experienced bedside assistant will likely improve efficiency and safety of robot-assisted minimally invasive esophagectomy.

scholarly journals Does the experience of the bedside assistant effect the results of robotic surgeons in the learning curve of robot assisted radical prostatectomy?

2019 ◽  
Vol 45 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Haci Ibrahim Cimen ◽  
Yavuz Tarik Atik ◽  
Serkan Altinova ◽  
Oztug Adsan ◽  
Mevlana Derya Balbay
Keyword(s):  
Radical Prostatectomy ◽  
Learning Curve ◽  
Robot Assisted ◽  
Bedside Assistant

The role of bedside assistant during robot assisted radical prostatectomy: Is more experience better? Analysis on perioperative and clinical outcomes

2020 ◽  
pp. 039156032095108
Author(s):  
Mario Salvatore Mangano ◽  
Claudio Lamon ◽  
Francesco Beniamin ◽  
Alberto De Gobbi ◽  
Matteo Ciaccia ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Loss ◽  
Clinical Outcomes ◽  
Operative Time ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Robot Assisted ◽  
Estimated Blood Loss ◽  
Bedside Assistant ◽  
The Impact

Objectives: To analyze the impact of the bedside assistant’s experience during RARP. It is believed that the outcome of robotic surgery during Robot Assisted Radical Prostatectomy (RARP) for prostate cancer depends not only on the console surgeon’s experience. Materials and Methods: All consecutive RARPs from January 2017 to March 2018 were sourced from a prospectively maintained database. All cases were performed by the same surgeon. He was supported by three bedside assistants: one with bedside and console experience, one only with relevant bedside experience, one basically inexperienced. The patient’s parameters analyzed: age, Body Mass Index (BMI), previous abdominal surgery, prostate volume (by TRUS), pre-operative PSA, bioptic grading. Surgical outcomes analyzed included skin-to-skin operative time and estimated blood loss; clinical outcomes included length of hospital stay and time to catheter removal; the oncological outcome was represented by positive surgical margin rate. Results: A total of 116 RARPs were identified: 38 RARPs were performed with the console experienced bedside assistant, 38 with the experienced one, 40 with the novice one. The variables were similar between the three groups. As far as outcomes are concerned, there were no statistically significant differences between the three bedside assistants in terms of operative time, estimated blood loss, length of stay, days of catheterization, positive surgical margin rate.

scholarly journals Factors Influencing Warm Ischemia Time in Robot-assisted Partial Nephrectomy Change Depending on the Surgeon’s Experience

2021 ◽  
Author(s):  
Kazuyuki Numakura ◽  
Mizuki Kobayashi ◽  
Atsushi Koizumi ◽  
Soki Kashima ◽  
Ryohei Yamamoto ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Kidney Function ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Clinical Staging ◽  
Tumor Diameter ◽  
Clinical Factors ◽  
Robot Assisted ◽  
Ischemia Time ◽  
Component Score

Abstract INTRODUCTION: Warm ischemia time (WIT) is a primary concern for robot-assisted laparoscopic partial nephrectomy (RALPN) patients because longer WIT is significantly associated with postoperative deteriorating kidney function. Tumor complexity, determined by the RENAL nephrometry score (RENAL score), can help predict surgical outcomes, but it is unclear what RENAL score and clinical factors affect WIT. This study explored the clinical factors predicting long WIT in RALPN.MATERIALS AND METHODS: In our institute, 174 RALPNs were performed between November 2013 and February 2021, of which 114 were performed by a single surgeon and included in this study. Clinical staging and the total RENAL score were determined based on preoperative CT scans. The cases were divided into three groups based on experience: period 1: 1–38, period 2: 39–76, and period 3: 77–114. The clinical factors associated with longer WIT were analyzed per period. RESULTS: The overall median tumor diameter was 32 mm, and one patient had a positive surgical margin, but there were no cancer-related deaths. In total, there were 18 complications (15.8 %). Periods 2 and 3 had larger tumor diameters (p<0.01) and worse preoperative kidney function (p=0.029) than period 1. A RENAL L-component score of 3 was associated with longer WIT in period 3 (odds ratio: 3.900; 95 % confidence interval: 1.004–15.276; p = 0.044), but the tumor diameter and the total RENAL score were not.CONCLUSIONS: A large tumor in the central lesion indicated by the RENAL L-component score was associated with increased WIT in RALPN.

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