scholarly journals EP.TU.493Attitudes of Irish General Surgery trainees to Robotic-Assisted Surgery

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sinead Ramjit ◽  
Lauren O'Connell ◽  
Noel Donlon ◽  
Paul Neary ◽  
Diarmuid O'Riordain ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
General Surgery ◽  
Unmet Need ◽  
Robotic Prostatectomy ◽  
Previous Exposure ◽  
Robotic Training ◽  
Robotic Assisted ◽  
Republic Of Ireland ◽  
Robotic Assisted Surgery ◽  
The Republic

Abstract Background While the use of robotic-assisted surgery is now mainstream for procedures such as robotic prostatectomy, its role in general surgery is less well established. Access to training in robotics for general surgery trainees in the Republic of Ireland is variable. Further, there is no data on attitudes of Irish trainees towards the role of robotics. We aimed to establish attitudes of Irish general surgery trainees towards the perceived utility of robotic surgery as well as access and satisfaction with training. Methods A survey was disseminated to trainees in the Republic of Ireland enrolled in a General Surgery training scheme via email and social media. Data collected included stage of training, intended subspecialty, interest in developing robotic skills, previous exposure to robotic surgery, satisfaction with current access to robotic training and opinion on formally incorporating training in robotics into the general surgery curriculum. Results The response rate was 44.8%. Of these, 83% reported interest in training in robotics and 69% anticipated using the technology regularly in consultant practice. Previous exposure to robotic-assisted surgery was significantly predictive of interest in developing the skillset (p = 0.014). Over 71% of trainees reported that they were not satisfied with access to robotic training. Of those satisfied with access, 40% felt there was a role for incorporating robotic training into the curriculum, compared to 68% of those dissatisfied. Conclusion Irish general surgery trainees perceive robotic-assisted surgery to be highly relevant to their future practice. There is an unmet need to provide additional training in the skillset.

Robotic Thoracic Surgery Training for Residency Programs

2018 ◽  
Vol 13 (6) ◽  
pp. 417-422 ◽  
Author(s):  
Wissam N. Raad ◽  
Adil Ayub ◽  
Chyun-Yin Huang ◽  
Landon Guntman ◽  
Sadiq S. Rehmani ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Thoracic Surgery ◽  
Residency Program ◽  
Program Directors ◽  
Robotic Assisted ◽  
Surgery Training ◽  
Robotic Assisted Surgery ◽  
Robotic Surgery Training ◽  
Surgery Residency Program ◽  
Residency Program Directors

Objective Robotic-assisted surgery is increasingly being used in thoracic surgery. Currently, the Integrated Thoracic Surgery Residency Program lacks a standardized curriculum or requirement for training residents in robotic-assisted thoracic surgery. In most circumstances, because of the lack of formal residency training in robotic surgery, hospitals are requiring additional training, mentorship, and formal proctoring of cases before granting credentials to perform robotic-assisted surgery. Therefore, there is necessity for residents in Integrated Thoracic Surgery Residency Program to have early exposure and formal training on the robotic platform. We propose a curriculum that can be incorporated into such programs that would satisfy both training needs and hospital credential requirements. Methods We surveyed all 26 Integrated Thoracic Surgery Residency Program Directors in the United States. We also performed a PubMed literature search using the key word “robotic surgery training curriculum.” We reviewed various robotic surgery training curricula and evaluation tools used by urology, obstetrics gynecology, and general surgery training programs. We then designed a proposed curriculum geared toward thoracic Integrated Thoracic Surgery Residency Program adopted from our credentialing experience, literature review, and survey consensus. Results Of the 26 programs surveyed, we received 17 responses. Most Integrated Thoracic Surgery Residency Program directors believe that it is important to introduce robotic surgery training during residency. Our proposed curriculum is integrated during postgraduate years 2 to 6. In the preclinical stage postgraduate years 2 to 3, residents are required to complete introductory online modules, virtual reality simulator training, and in-house workshops. During clinical stage (postgraduate years 4–6), the resident will serve as a supervised bedside assistant and progress to a console surgeon. Each case will have defined steps that the resident must demonstrate competency. Evaluation will be based on standardized guidelines. Conclusions Expansion and utilization of robotic assistance in thoracic surgery have increased. Our proposed curriculum aims to enable Integrated Thoracic Surgery Residency Program residents to achieve competency in robotic-assisted thoracic surgery and to facilitate the acquirement of hospital privileges when they enter practice.

Trends in Use of Robotic-Assisted Surgery for Inpatient Elective General Surgery in the United States, 2010–2015.

2019 ◽  
Vol 229 (4) ◽  
pp. S116
Author(s):  
Usman Aslam ◽  
Chima Amadi ◽  
Anirudha Goparaju ◽  
Collin EM. Brathwaite ◽  
Gina L. Adrales
Keyword(s):  
United States ◽  
General Surgery ◽  
The United States ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

scholarly journals 1141 Robotic Assisted Surgery in Horseshoe Kidneys: A Safety and Feasibility Multicentre Case Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Ng ◽  
A Nathan ◽  
N Campain ◽  
Y Yuminaga ◽  
F Mumtaz ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Anatomical Variation ◽  
High Volume ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Robot Assisted ◽  
Renal Masses ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Estimated Blood Loss

Abstract Introduction Horseshoe kidneys (HSK) are the most common renal fusion abnormality. However, they are only present in 0.2% of the population. Due to anatomical variation in vasculature, ectopia and malrotation, surgery has traditionally been performed via an open approach. We aimed to assess the safety and feasibility of robot-assisted surgery for HSK. Method Six patients (four female, two male) with HSKs were operated on between 2016 and 2019 across two high-volume centres by high-volume surgeons. All operations were robot-assisted, with three partial nephrectomies and one nephroureterectomy for renal masses and two benign nephrectomies for non-functioning kidneys. 3D reconstruction using CT renal angiograms was used to help identify vasculature and tumour location (where appropriate). Results The median age was 53 years (IQR 47-58.3) and the median BMI was 25 (IQR 25-25.8). Median tumour size in the four patients with renal masses was 35.5 mm (IQR 25.3-44.8). Median console time was 120 minutes (IQR 117-172.5) and the median estimated blood loss was 150 mL (IQR 112.5-262.5). The median pre-operative eGFR was 76 (IQR 70-86.5) and median post-operative eGFR was 65.5 (IQR 59.3-80.8). All operations were uneventful, there were no perioperative transfusions and no complications reported. Length of stay was two days for all patients. Conclusions We report the largest series of mixed robotic-assisted surgery on HSK. Robotic surgery is safe and feasible for HSK in high-volume centres with acceptable perioperative outcomes. Further prospective, longer-term, multi-centre studies are required to evaluative if robotic surgery for HSK is superior to open surgery.

Can Robotic-Assisted Surgery Overcome the Risk of Mortality in Cardiac Reoperation?

2018 ◽  
Vol 13 (6) ◽  
pp. 438-444 ◽  
Author(s):  
Hiroto Kitahara ◽  
Brody Wehman ◽  
Husam H. Balkhy
Keyword(s):  
Robotic Surgery ◽  
Three Dimensional ◽  
Robotic Assistance ◽  
Robotic Arms ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Risk Of Mortality ◽  
Prolonged Ventilation ◽  
Cardiac Reoperation ◽  
The Mean

Objective A robotic-assisted approach potentially has many advantages for cardiac reoperation, which include sternum-sparing and three-dimensional visualization leading to precise adhesiolysis and excellent exposure in a limited field. Methods We retrospectively reviewed our patients undergoing robotic cardiac reoperation (redo group) from July 2013 to April 2017 at our institution and compared with our patients undergoing standard robotic surgery (nonredo group). In the reoperative cases, a thoracoscope was inserted through a 5-mm port placed away from the previous scar. Another 5-mm port was inserted under direct vision to make space for one or two robotic arms, and further precise dissection was performed robotically. Results A total of 486 patients underwent robotic-assisted cardiac surgery. There were 36 patients who had one or more previous cardiac surgeries (42 surgeries). Although the mean operative and cardiopulmonary bypass time were longer in the redo group (median = 351 minutes vs. 289 minutes and 219 minutes vs. 178 minutes, P < 0.05, respectively), cardiac arrest time was similar between two groups. The redo group had a higher incidence of postoperative prolonged ventilation (16.7% vs. 6.9%, P = 0.046) and pneumonia (11.1% vs. 0.2%, P < 0.001). The 30-day mortality was 2.8% (1/36) in the redo group and similar to that in the nonredo group (1.3%, P = 0.419). Conclusions Robotic cardiac reoperation is feasible with acceptable clinical outcomes including a low mortality rate similar to standard robotic surgery in our hands. Robotic assistance may have the potential to minimize morbidity and mortality.

scholarly journals P105 Robosurgeons vs. robosceptics’: can we afford robotic technology or can we afford not to?

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Jasmesh Sandhu ◽  
Jasmesh Sandhu
Keyword(s):  
Cost Effectiveness ◽  
Radical Prostatectomy ◽  
High Volume ◽  
Robotic Prostatectomy ◽  
Robotic Technology ◽  
Robotic Training ◽  
Robotic Assisted ◽  
Open Radical Prostatectomy ◽  
Robotic Assisted Radical Prostatectomy ◽  
The Cost

Abstract Aim To investigate the cost-effectiveness of robotic technology in robotic-assisted radical prostatectomy in comparison with laparoscopic radical prostatectomy and open radical prostatectomy. Methods The British Association of Urology Surgeons database (2014–2016) and Cancer Research UK (2012–2014) were accessed in conjunction with media; keywords included: ‘Da Vinci’, ‘first robotic prostatectomy’, ‘hospital’ to estimate the cost-effectiveness of robotic-assisted radical prostatectomy in the National Health Service. Results Approximately 12/43 (27.9%) centres achieved 150 robotic-assisted radical prostatectomies per year while 26/43 (60.4%) centres have managed to meet 100 robotic-assisted radical prostatectomies per year in 2014–2016. A national mean of 120–130 robotic-assisted radical prostatectomies per year for 2014–2016 was estimated. Conclusion The cost of robotic-assisted radical prostatectomy is adequately justified if a high volume of surgeries (&gt;150) are performed in high volume centres by high volume experienced surgeons per year. This can be achieved by subsidising the cost of robotic technology, centralisation and establishing robotic training centres.

Robotic-assisted surgery for colorectal and hepatopancreatobiliary neoplasms

2021 ◽  
Vol 75 (5) ◽  
pp. 410-416
Author(s):  
Daniel Langer ◽  
Michal Vočka ◽  
Jaroslav Kalvach ◽  
Jaroslav Pažin ◽  
Miroslav Ryska ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Randomized Study ◽  
Radical Resection ◽  
Therapeutic Modality ◽  
Cochrane Library ◽  
Mesorectal Excision ◽  
Gastrointestinal Malignancies ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

Summary: Introduction: The Czech Republic belongs to countries under significant strain due to malignant tumours. Despite the changes introduced in the therapy of gastrointestinal malignancies, radical removal of the tumour holds a crucial position in the mutimodal therapeutic process and is irreplaceable nowadays. From the beginning of the third millennium, minimally invasive surgery of abdominal tumours is being expanded with robotic-assisted procedures. The aim of this paper is to assess the benefits of robotic-assisted surgery in the treatment of colorectal and hepatopancreatobiliary neoplasms and to present the results of a non-randomized study with prospectively collected data from robotically assisted rectal cancer surgeries. Material and method: The authors summarize studies published in the PubMed, EMBASE, Medline and Cochrane Library databases that compare robotic and laparoscopic approaches in the treatment of colorectal and hepatopancreatobiliary malignancies, and present the results of their own non-randomized study. 204 patients with rectal cancer (<15 cm from the anal verge) who underwent robotic-assisted surgery at our department between 1 January 2016 and 31 December 2020 were included in the study. All demographic, clinical and oncological data were prospectively obtained and analysed. The data were analysed using descriptive statistic methods. Results: 204 patients with rectal cancer of whom 138 were men and 66 were women underwent robotic surgery at our department during the five-year period. In 97 (47.5%) cases the disease was dia­gnosed in an advanced stage (stage III and IV of the TNM classification). 18 patients had synchronous liver metastases and 2 patients had pulmonary metastases at the time of the dia­gnosis. The liver-first approach was indicated in 8 (44.4%) patients, two patients underwent a radical resection of liver lesions together with the primary neoplasm in one surgery. Total mesorectal excision was performed in 136 patients with extraperitoneal disease, partial mesorectal excision was performed in 68 cases. 18 complications were documented. Clinically relevant anastomotic leak requiring intervention occurred in 5 (3.6%) cases. One patient died due to decompensation of chronic toxonutritive liver disease. Local recurrence was documented in 6 patients, half of them underwent radical resection. Conclusion: Surgical therapy holds a crucial position in the treatment of colorectal and hepatopancreatobiliary neoplasms and represents the only potentially curative procedure in multimodal therapy. Robotic-assisted therapy has become a routine therapeutic modality for colorectal and hepatopancreatobiliary malignancies worldwide. Da Vinci assisted surgeries prevail in the surgical treatment of rectal cancer at the authors’ workplace as well as at some foreign centres. Compared to open and laparoscopic resections of rectal carcinoma, robotic-assisted operations achieve the same clinical and oncological results with a lower rate of complications. Key words: robotic surgery – colorectal cancer – liver malignancies – pancreatic carcinoma

scholarly journals The Use of Robotic Assisted Surgery; the Current and Future Challenges

2016 ◽  
Vol 3 (1) ◽  
pp. 300-304
Author(s):  
Reza Mafi ◽  
Pouya Mafi ◽  
Marco Malahias
Keyword(s):  
Robotic Surgery ◽  
Science Fiction ◽  
Surgical Procedures ◽  
Armed Forces ◽  
Stanford Research Institute ◽  
Robotic Assisted ◽  
Optimal Outcomes ◽  
Robotic Assisted Surgery ◽  
Future Challenges ◽  
Evolutionary Step

Background: Living with robots has always been regarded as a science fiction theme, however due to rapid advances in technology it is becoming more of a reality. The use of robots in surgery dates back to more than 25 years, and has previously been of great assistance to humans in the fields of Aeronautics and Armed forces. An evolutionary step was made after collaboration between the National Aeronautics and Space Administration (NASA), and the Stanford Research Institute in the field of robotic-assisted surgery. Thereafter, more surgical specialties incorporated this technology in surgical procedures. The objective of this article is to review different applications, challenges, and the future of robotic surgery. Methods: We have used a systematic approach to look at the most relevant published articles regarding robotic-assisted surgery. This review has taken 26 articles into consideration that have met the inclusion criteria of using of robotic- assisted technology in surgical procedures. Conclusion: Robotic surgery is being used in numerous surgical fields such as pediatrics, urology, cardiovascular surgery, gynecology, otolaryngology, general surgery and orthopedics. It has resulted in a reduction in length of stay, post-operative complication and scarring. However, for achieving optimal outcomes, further development in improving the sensory feedback and reducing the lag time during the transmission of long-range telesurgery is required.

scholarly journals Status of Robotic-Assisted Surgery (RAS) in the Department of Defense (DoD)

2019 ◽  
Vol 184 (9-10) ◽  
pp. e412-e416
Author(s):  
Samuel Grasso ◽  
Joshua Dilday ◽  
Brian Yoon ◽  
Avery Walker ◽  
Eric Ahnfeldt
Keyword(s):  
General Surgery ◽  
Department Of Defense ◽  
Cost Effective ◽  
Gynecologic Surgery ◽  
Surgical Specialty ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Time Period ◽  
Surgical Device ◽  
The Military

Abstract Introduction Since inception of robotic-assisted surgery (RAS) in 1999, there has been an exponential rise in RAS in both number and complexity of surgical cases performed. The majority of these cases are gynecologic surgery in nature, with only a quarter of them labeled as general surgery. The purpose of this study is to determine if RAS in the Department of Defense (DoD) mirrors these trends. Methods A total of 6,204 RAS cases from across the DoD were reviewed between 01 January 2015 and 30 September 2017 from every Military Treatment Facility (MTF) that employs a robotic surgical device (various models of the da Vinci robotic surgical system by Intuitive Surgical). Specialty, number, and surgeon were recorded for each case. These end points were also examined for trends overtime and compared to similar civilian data. Results The number of MTFs performing robotic surgery and the number of cases performed increased significantly. An average of 373 cases per quarter-year were performed in 2015, 647 in 2016, and 708 in 2017. The number of RAS cases increased by about 10% every quarter-year during this time period. RAS was most commonly performed by general surgery in 10 of the 14 MTFs examined. Conclusions MTFs implemented RAS much later than the civilian world. However, since its implementation, the frequency of RAS use has increased at a faster rate in the DoD than in the civilian world. Possible reasons for this are a younger pool of surgeons in the military and less demands on cost-effective productivity, allowing these younger surgeons to focus on emerging technology rather than maximizing surgical cost efficiency. General surgery constitutes the majority of RAS cases in the DoD. It is unclear why this difference from the civilian world exists.

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