Robotics for Acute Care in Colorectal Surgery

2021 ◽  
Vol 34 (05) ◽  
pp. 328-333
Author(s):  
Garrett Friedman
Keyword(s):  
Robotic Surgery ◽  
Colorectal Surgery ◽  
Acute Care ◽  
Perforated Diverticulitis ◽  
Anastomotic Leaks ◽  
Technical Aspects ◽  
Emergency Procedures ◽  
Safe Access ◽  
Colorectal Procedures

AbstractRobotic surgery is growing exponentially in elective colorectal procedures, but utilization of robotics in urgent and emergency procedures remains low. Robotic surgery can be safely utilized for the management of several acute colorectal operations such as anastomotic leaks, perforated diverticulitis, and more. This chapter discusses safe access principles and planning, as well as technical aspects of these complex procedures, and the pathway to building a 24/7 robotic access culture.

scholarly journals Technical essential aspects in robotic colorectal surgery: mastering the Da Vinci Si and Xi platforms

2021 ◽  
Vol 48 ◽  
Author(s):  
ANDRE LUIZ GIOIA MORRELL ◽  
ALEXANDER CHARLES MORRELL-JUNIOR ◽  
ALLAN GIOIA MORRELL ◽  
ELIAS COUTO ALMEIDA-FILHO ◽  
DUARTE MIGUEL FERREIRA RODRIGUES RIBEIRO ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Colorectal Surgery ◽  
Da Vinci ◽  
Port Placement ◽  
Technical Aspects ◽  
Essential Condition ◽  
Practical Applications ◽  
Technological Advances ◽  
Robotic Colorectal Surgery ◽  
Standard Laparoscopy

ABSTRACT Background: laparoscopy surgery has many proven clinical advantages over conventional surgery and more recently, robotic surgery has been the emerging platform in the minimally invasive era. In the colorectal field, although overcoming limitations of standard laparoscopy, robotic surgery still faces challenging situations even by the most experienced colorectal surgeons. This study reports essentials technical aspects and comparison between Da Vincis Si and Xi platforms aiming to master and maximize efficiency whenever performing robotic colorectal surgery. Methods: this study overviews the most structured concepts and practical applications in robotic colorectal surgery in both Si and Xi Da Vinci platforms. Possible pitfalls are emphasized and step-wise approach is described from port placement and docking process to surgical technique. We also present data collected from a prospectively maintained database. Results: our early experience includes forty-four patients following a standardized total robotic left-colon and rectal resection. Guided information and practical applications for a safe and efficient robotic colorectal surgery are described. We also present illustrations and describe technical aspects of a standardized procedure. Conclusion: performing robotic colorectal surgery is feasible and safe in experienced surgeons hands. Although the Da Vinci Xi platform demonstrates greater versatility in a more user-friendly design with technological advances, the correct mastery of technology by the surgical team is an essential condition for its fully robotic execution in a single docking approach.

scholarly journals Acute Care Surgery Billing, Coding and Documentation Series Part 3: Coding of Additional Select Procedures; Modifiers; Telemedicine Coding; Robotic Surgery

2020 ◽  
Vol 5 (1) ◽  
pp. e000587
Author(s):  
Thomas Esposito ◽  
Robert Reed ◽  
Raeanna C Adams ◽  
Samir Fakhry ◽  
Dolores Carey ◽  
...  
Keyword(s):  
Complex System ◽  
Robotic Surgery ◽  
Acute Care ◽  
Acute Care Surgery ◽  
Formal Training ◽  
Experienced Surgeon ◽  
Care Surgery

This series of reviews has been produced to assist both the experienced surgeon and coder, as well as those just starting practice that may have little formal training in this area. Understanding this complex system will allow the provider to work “smarter, not harder” and garner the maximum compensation for their work. We hope we have been successful in achieving and that goal that this series will provide useful information and be worth the time invested in reading it by bringing tangible benefits to the efficiency of practice and its reimbursement. This third section deals with coding of additional select procedures, modifiers, telemedicine coding, and robotic surgery.

Defining Anastomotic Leaks After Colorectal Surgery: Results of a National Survey

2021 ◽  
Vol 261 ◽  
pp. 242-247
Author(s):  
Vijaya T. Daniel ◽  
Karim Alavi ◽  
Jennifer S. Davids ◽  
Cristina R. Harnsberger ◽  
Justin A. Maykel
Keyword(s):  
Colorectal Surgery ◽  
National Survey ◽  
Anastomotic Leaks

scholarly journals Robotic rectosigmoidectomy: pioneer case report in Brazil. Current scene in colorectal robotic surgery

2010 ◽  
Vol 47 (1) ◽  
pp. 116-118 ◽  
Author(s):  
Marcelo Averbach ◽  
Pedro Popoutchi ◽  
Oswaldo Wiliam Marques Jr ◽  
Ricardo Z Abdalla ◽  
Sérgio Podgaec ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Colorectal Surgery ◽  
Colorectal Resection ◽  
Deep Infiltrating Endometriosis ◽  
Brazil Current ◽  
Current Series ◽  
Robotic Colorectal Surgery ◽  
Rectal Involvement ◽  
Surgical Device ◽  
Standard Laparoscopic Surgery

Laparoscopic colorectal surgery is believed to be technically and oncologically feasible. Robotic surgery is an attractive mode in performing minimally-invasive surgery once it has several advantages if compared to standard laparoscopic surgery. The aim of this paper is to report the first known case of colorectal resection surgery using the robotic assisted surgical device in Brazil. A 35-year-old woman with deep infiltrating endometriosis with rectal involvement was referred for colorectal resection using da Vinci® surgical system. The authors also reviewed the most current series and discussed not only the safety and feasibility but also the real benefits of robotic colorectal surgery

The management and outcome of anastomotic leaks in colorectal surgery

2008 ◽  
Vol 10 (6) ◽  
pp. 587-592 ◽  
Author(s):  
A. A. Khan ◽  
J. M. D. Wheeler ◽  
C. Cunningham ◽  
B. George ◽  
M. Kettlewell ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leaks

An Expanded Preoperative Component within an Enhanced Recovery Protocol Improves Outcomes in Colorectal Surgery

2017 ◽  
Vol 83 (8) ◽  
pp. 928-934
Author(s):  
Nathan M. Johnson ◽  
Sandy L. Fogel
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Enhanced Recovery ◽  
Statistical Significance ◽  
Current Evidence ◽  
P Value ◽  
Postoperative Length ◽  
Enhanced Recovery Protocol ◽  
Recovery Protocols ◽  
Colorectal Procedures

Enhanced Recovery Protocols (ERPs) have been shown to lead to quicker recovery in colorectal surgery, with reduced postoperative length of stay (LOS). ERPs could potentially be improved with an expanded preoperative component reflecting current evidence. We hypothesize that an ERP with an expanded preoperative component will reduce LOS consistent with or exceeding that seen with traditional ERPs. Our ERP was implemented in June of 2014. Data was collected for two full years from July 2014 through June 2016. The protocol was employed in colorectal cases, both elective and emergent. Data from ERP cases were compared with contemporaneous controls that did not go through the ERP. Patients who underwent colorectal procedures and participated in the ERP with the expanded preoperative component had an average LOS of 5.33 days, whereas controls stayed for an average of 7.93 days (P value, <0.01). ERP cases also experienced fewer read-missions and complications, although statistical significance could not be established. The results demonstrate that an ERP with an enhanced preoperative component significantly reduces LOS and potentially decreases the rate of readmissions and total complications.

Su2074 ROBOTIC SURGERY OFFERS ACCEPTABLE RATES OF CONVERSION TO OPEN IN THE OBESE POPULATION UNDERGOING COLORECTAL SURGERY

2020 ◽  
Vol 158 (6) ◽  
pp. S-1571-S-1572
Author(s):  
Majd Kabbani ◽  
Quincy Ogbogu ◽  
Yulia Kostenko ◽  
Eleni Stroumpi ◽  
Steven S. Tsoraides
Keyword(s):  
Robotic Surgery ◽  
Colorectal Surgery ◽  
Obese Population

Changing Paradigms in Acute Care Surgery: A Shift to the Hindgut

2014 ◽  
Vol 80 (1) ◽  
pp. 76-80
Author(s):  
Nitin Mishra ◽  
Patricia L. Roberts ◽  
Peter W. Marcello ◽  
Thomas E. Read ◽  
Jason F. Hall ◽  
...  
Keyword(s):  
Acute Care ◽  
Surgical Procedures ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Gastrointestinal Perforation ◽  
Acute Care Surgery ◽  
The Past ◽  
Care Surgery ◽  
Upper Gastrointestinal ◽  
Colorectal Procedures

In this study we sought to identify changes in the etiology and surgical treatment of acute gastrointestinal perforations in the United States over the past 20 years. We performed a retrospective review of the Nationwide Inpatient Sample from January 1, 1988, through December 31, 2007. We first identified all patients with gastrointestinal perforations, the perforated organ, and treatment rendered. During the study period, 550,132 patients experienced a gastrointestinal perforation for a mean rate of 3.9 cases per 1,000 discharges. Total number of perforations rose significantly over the study period, yet surgical procedures were performed in less than half of the patients (47.6%). The most common surgical procedures for gastrointestinal perforation were colorectal in origin (38.3%), upper gastrointestinal tract (30.0%), small intestine (29.2%), esophagus (3.0%), and anus (0.1%). At study end, colorectal procedures for perforation were the most commonly performed (40.4%), whereas upper gastrointestinal procedures experienced the greatest decline. In conclusion, our data demonstrate a decline in procedures for upper gastrointestinal perforation and an increase in colorectal procedures during the two-decade study period. These data should be used to assist in the training of acute care surgeons.

Antimicrobial Prophylaxis of Gastrointestinal Surgical Procedures and Treatment of Intra-Abdominal Infections

1987 ◽  
Vol 21 (5) ◽  
pp. 406-416 ◽  
Author(s):  
Larry Danziger ◽  
Erkan Hassan
Keyword(s):  
Colorectal Surgery ◽  
Antibiotic Prophylaxis ◽  
Abdominal Trauma ◽  
Antimicrobial Prophylaxis ◽  
Colonic Perforation ◽  
Antibiotic Administration ◽  
Penetrating Abdominal Trauma ◽  
Single Drug ◽  
Drug Regimens ◽  
Colorectal Procedures

Antibiotic prophylaxis and treatment regimens ideally are selected on the basis of efficacy, safety, and cost. This review evaluates current, selected literature on antibiotic prophylaxis for colorectal surgery, presumptive antibiotic administration following penetrating abdominal trauma, and treatment of intraabdominal infections. Single-drug regimens with the newer, broad-spectrum agents are assessed and compared with combination regimens; specific regimens are recommended. Colorectal procedures require an antimicrobial agent with activity against both aerobes and anaerobes. Patients undergoing elective colorectal procedures can be adequately protected with an orally administered three-dose regimen of neomycin/erythromycin. Parenteral antibiotic administration is generally not necessary, but, cefoxitin is recommended for nonelective colorectal surgery. The risk of potential infectious complications following penetrating abdominal trauma without colonic perforation is less than with colonic perforation; however, antibiotic therapy that includes activity against aerobes and anaerobes is recommended for all types of penetrating abdominal trauma. Although cephalothin, cefamandole, or cefoxitin alone may be used in abdominal trauma without perforation of the colon, only cefoxitin is recommended as a single-drug alternative to the standard clindamycin/gentamicin regimen in trauma with colonic perforation. Single-drug therapy with cefoxitin or moxalactam can be used successfully as alternatives to the standard regimens of clindamycin/gentamicin or metronidazole/gentamicin in many patients with intraabdominal sepsis. Single-drug regimens reduce the risk of developing adverse effects and are cost-effective. However, if resistant organisms are suspected, or if the patient has been hospitalized for a prolonged period or has multiple organ failure, it may be necessary to supplement cefoxitin therapy with an antibiotic that will enhance coverage against gram-negative aerobes.

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