PS01.070: EVALUATION OF THE EFFECTIVENESS OF ROBOTIC FUNDOPLICATIONS IN THE TREATMENT OF GERD

Abstract Background Surgical treatment is one of the most effective options for treatment of gastroesofageal reflux disease. Laparoscopic approach became is a ‘gold standard’ over the time demonstrating all advantages of minimally invasive techniques over the open procedures. However the utility of robotic antireflux operations still remains controversial. Methods Since the January till the December of 2017 thirty operations were operated on. Mean age was 57,2 (35–76), among them 21 (70%) were female and 9 (30%) were males. Mean BMI was 29,4 (24,1–41,0). Laparoscopic procedures were performed in15 patients (1st group), robotic procedures with DaVinci system were performed in 15 patients of the second group. Chernousov modified Nissen fundoplication was performed in 25 patients, Toupet fundoplication was used for 4 patients, Nissen type was performed in 4 cases. Results The median operative time in laparoscopic group was 125 min (80–200 min), in robotic group - 124 min (90–210 min). There were no statistical differences between two groups (P = 0,93).Blood loss was minimal in both groups. Mean postoperative hospital stay was 4 days (2–7 days) in the 1st group and 4 days (2–6 days) in the second. There were no statistical differences between two groups (P = 0,19). Postoperative course was uneventful in all patients of both groups. Conclusion Robotic antireflux operations are safe and effective in treatment of patients with reflux-esophagitis. There were no statistically significant differences in short-term results of laparoscopic and robotic operations. Disclosure All authors have declared no conflicts of interest.

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Short-term Outcomes of Elective 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea: Does Laparoscopy Have Benefits?

Annals of Coloproctology ◽

10.3393/ac.2019.03.29 ◽

2020 ◽

Vol 36 (1) ◽

pp. 41-47 ◽

Cited By ~ 1

Author(s):

Jun Woo Bong ◽

Yong Sik Yoon ◽

Jong Lyul Lee ◽

Chan Wook Kim ◽

In Ja Park ◽

...

Keyword(s):

Ulcerative Colitis ◽

Postoperative Complications ◽

Restorative Proctocolectomy ◽

Complication Rate ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Bowel Function ◽

Open Group ◽

Open Approach ◽

Short Term

Purpose: This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).Methods: We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.Results: There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.Conclusion: Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.

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Robotic surgery for rectal cancer: Short-term and oncological outcomes for 607 consecutive patients.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.756 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 756-756

Author(s):

Akio Shiomi ◽

Tomohiro Yamaguchi ◽

Hiroyasu Kagawa ◽

Yushi Yamakawa ◽

Akinobu Furutani ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Operative Time ◽

Autonomic Nerve ◽

Relapse Free Survival ◽

Short Term ◽

Free Survival ◽

Oncological Outcomes ◽

Oncological Results ◽

Median Operative Time

756 Background: Conventional laparoscopic surgery (CLS) for rectal cancer has several inherent technical difficulties, including a limited range of motion of the instruments.Robot-assisted laparoscopic surgery (RALS) has some technical advantages over CLS because it improves dexterity with an increased range of movements at the tips of the instruments. The purpose of this study was to evaluate the short-term and oncological outcomes of RALS for rectal cancer, including robotic, autonomic nerve-preserving, lateral lymph node dissection (RALLD), a new, technically challenging procedure. Methods: Between December 2011 and August 2017, 607 consecutive patients underwent RALS for rectal cancer. Surgical outcomes, pathological results, and oncological results were investigated retrospectively. Results: There were 403 males and 204 females; 577 patients had adenocarcinoma, 19 had carcinoid tumor, 8 had GIST, and 2 had other malignant tumor. The types of procedures performed were: 453 anterior resections, 93 intersphincteric resections, and 61 abdominoperineal resections. RALLD was performed in 202 patients (33.3%). Preoperative chemoradiotherapy was performed in 34 patients. The overall median operative time was 257(109-683) min. In cases without RALLD, the median operative time was 217 (109-545) min, while median operative time was 420 (162-683) min with RALLD. None of the cases was converted to an open or laparoscopic procedure.There was no surgical mortality. The overall complication rate for Clavien-Dindo classification grade III-IV was 3.0%. The oncological results for 279 patients with primary rectal adenocarcinoma, operated before December 2014 was also investigated (Stage I/II/III 115/48/116). The 5-year overall survival was 96.6%, the 3-year relapse free survival was 88.3%, and 3-year local relapse free survival was 98.5%. The 3-year RFS of pStage I/II/III was 96.2/89.6/79.6% respectively. Conclusions: RALS for rectal cancer is a feasible procedure with low morbidity and a low conversion rate, and acceptable oncological results.

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A retrospective study on laparoscopic appendectomy versus open appendectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20191127 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1144

Author(s):

P. Senthil Kumar ◽

S. Edwin Kin’s Raj ◽

Saranya Nagalingam

Keyword(s):

Retrospective Study ◽

Acute Appendicitis ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Operative Time ◽

Open Appendectomy ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Daily Activities ◽

Early Return

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Open appendectomy is the “gold standard” for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a retrospective study.Methods: The study was done as a retrospective study among 387 patients diagnosed with appendicitis for a period of 18 months in the Dept of General Surgery. All patients included were 16 years and above and followed up for 3 weeks. In this study, 130 patients diagnosed as acute appendicitis - underwent open appendectomy and 257 patients diagnosed as sub-acute cases of appendicitis - underwent laparoscopic appendectomy. These two groups (open & laparoscopic) were compared for operative time, length of hospital stay, postoperative pain, complication rate, early return to normal activity.Results: Laparoscopic appendectomy was associated with a shorter hospital stay (around 4.5 days), with a less need for analgesia and with an early return to daily activities (around 11.5 days). Operative time was significantly shorter in the open group (35 mins), when compared with laparoscopic group (around 59 mins). Total number of complications was less in the Laparoscopic group with a significantly lower incidence of post-op pain and complications.Conclusions: The laparoscopic approach is a safe and efficient operative procedure and it provides clinically beneficial advantages over open appendectomy (including shorter hospital stay, an early return to daily activities and less post-op complications).

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Laparoscopic approach for pancreato-splenic abscess from disseminated melioidosis: Surgical outcome and review of literature

International Journal of Case Reports ◽

10.28933/ijcr-2021-08-1505 ◽

2021 ◽

pp. 241

Author(s):

Keyword(s):

Operative Time ◽

Case Reports ◽

Demographic Data ◽

Splenic Abscess ◽

Laparoscopic Approach ◽

Systemic Infection ◽

Management Options ◽

Distal Pancreatosplenectomy ◽

Complications And Mortality ◽

Median Operative Time

Melioidosis is a severe systemic infection caused by Burkholderia pseudomallei. It commonly affects the lungs, liver and kidneys. Pancreatic and splenic abscess from melioidosis is rare, with few reports in the literature. We present a series of 4 patients with disseminated melioidosis of pancreas and spleen who required surgical intervention. A MEDLINE database review was conducted. Relevant publications were evaluated and demographic data, clinical, radiological findings as well as management options were collected. We found 10 case reports describing this clinical condition. In our series, median age was 57. Median operative time 260 minutes. All four patients failed trial of antibiotic therapy and required surgery. Three underwent distal pancreatosplenectomy and one underwent splenectomy alone. Laparoscopic distal pancreatosplenectomy was successful in two patients. Median length of stay 11.5 days. No post-operative complications and mortality reported. Surgery is indicated in failed medical therapy and laparoscopic approach is safe and feasible.

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Laparoscopic vs open gastrectomy- An updated metaanalysis of randomised control trials for short term outcomes

10.1101/2020.04.12.20062562 ◽

2020 ◽

Author(s):

Bhavin Vasavada ◽

Hardik Patel

Keyword(s):

Gastric Cancer ◽

Blood Loss ◽

Operative Time ◽

Laparoscopic Group ◽

Open Gastrectomy ◽

Systemic Review ◽

Wound Complications ◽

Short Term ◽

Significant Difference ◽

Randomised Control Trials

AbstractIntroductionAim of this metaanalysis was to compare short term outcomes of laparoscopic and open gastrectomy for gastric cancer.Material and methodsEMBASE, MEDLINE, PubMed and the Cochrane Database were searched for randomised control trials comparing outcomes in patients undergoing laparoscopic gastrectomies with those patients undergoing open gastrectomies. The primary outcome was 30 day morbidity and mortality. Secondary outcomes studied included length of stay, blood loss, d2gastrectomies, lymphnode retrieval, operative time, distal gastrectomy, wound complications and intraabdominal complications Systemic review and Metaanalysis were done according to MOOSE and PRISMA guidelines.ResultsMorbidity was significantly low in laparoscopic group(P=0.004).There was no significant difference between mortality between the two groups. (P=0.989). There less wound complications in laparoscpic group, no difference intra-abdominal complications in both the groups. Operative time was significantly higher in laparoscopic group. (P< 0.001) wmd 56.904. Hospital stay was similar in laparoscopic group. (P=0.305) wmd –0.533 days. Blood loss was significantly lesser in laparoscopic group.(p <0.001). Laparoscopic group patients had less number of lymph node retrieval compared to laparoscopic group.(p< 0.001). Laparoscopic group also contained similar advanced staged gastric cancer than open gastrectomies.ConclusionsLaparoscopic gastrectomies were associated with better short term outcomes.

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Robotic-Assisted versus Conventional Laparoscopic Approach for Rectal Cancer Surgery, First Egyptian Academic Center Experience, RCT

Minimally Invasive Surgery ◽

10.1155/2018/5836562 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 3

Author(s):

Yasser Debakey ◽

Ashraf Zaghloul ◽

Ahmed Farag ◽

Ahmed Mahmoud ◽

Inas Elattar

Keyword(s):

Rectal Cancer ◽

Rectal Surgery ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Distal Margin ◽

Complication Rates ◽

Safe Procedure ◽

Short Term ◽

Robotic Assisted ◽

Estimated Blood Loss

Background. Undoubtedly, robotic systems have largely penetrated the surgical field. For any new operative approach to become an accepted alternative to conventional methods, it must be proved safe and result in comparable outcomes. The purpose of this study is to compare the short-term operative as well as oncologic outcomes of robotic-assisted and laparoscopic rectal cancer resections. Methods. This is a prospective randomized clinical trial conducted on patients with rectal cancer undergoing either robotic-assisted or laparoscopic surgery from April 2015 till February 2017. Patients’ demographics, operative parameters, and short-term clinical and oncological outcomes were analyzed. Results. Fifty-seven patients underwent permuted block randomization. Of these patients, 28 were assigned to undergo robotic-assisted rectal surgery and 29 to laparoscopic rectal surgery. After exclusion of 12 patients following randomization, 45 patients were included in the analysis. No significant differences exist between both groups in terms of age, gender, BMI, ASA score, clinical stage, and rate of receiving upfront chemoradiation. Estimated blood loss was evidently lower in the robotic than in the laparoscopic group (median: 200 versus 325 ml, p= 0.050). A significantly more distal margin is achieved in the robotic than in the laparoscopic group (median: 2.8 versus 1.8, p< 0.001). Although the circumferential radial margin (CRM) was complete in 18 patients (85.7%) in the robotic group in contrast to 15 patients (62.5%) in the laparoscopic group, it did not differ statistically (p=0.079). The overall postoperative complication rates were similar between the two groups. Conclusion. To our knowledge, this is the first prospective randomized trial of robotic rectal surgery in the Middle East and Northern Africa region. Our early experience indicates that robotic rectal surgery is a feasible and safe procedure. It is not inferior to standard laparoscopy in terms of oncologic radicality and surgical complications. Organization number is IORG0003381. IRB number is IRB00004025.

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Bypass en Y-de-Roux sobre una funduplicatura de Nissen

Revista Argentina de Cirugía ◽

10.25132/raac.v111.n1.1394.es ◽

2019 ◽

Vol 111 (2) ◽

pp. 95-98

Author(s):

Matías J. Turchi ◽

◽

Felipe E. Fiolo ◽

María Tosti ◽

José I. Paladini ◽

...

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

Gastric Bypass ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Operative Time ◽

Nissen Fundoplication ◽

Laparoscopic Approach ◽

Laparoscopic Rygb ◽

Laparoscopic Nissen

Roux-en-Y gastric bypass (RYGB) effectively treats both obesity and gastroesophageal reflux disease (GERD). Unfortunately, some patients finally present for bariatric surgery have previously undergone Nissen fundoplication due to GERD. Conversion to EYGB after Nissen fundoplication is safe and effective, but is associated with greater morbidity and longer operative time and hospital stay. A 50-year-old female patient with a body mass index (BMI) of 40.4 kg/m2 was evaluated for bariatric surgery. She had a history laparoscopic Nissen fundoplication seven years before. We report a case of laparoscopic take-down of Nissen fundoplication and conversion to RYGB. A previous fundoplication is not a contraindication for laparoscopic RYGB. These procedures should be performed by well-trained surgeons and laparoscopic approach should be the method of choice.

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O-B02 Robotic versus Laparoscopic Roux-en-Y Gastric Bypass: A comparison of short-term outcomes and weight loss

British Journal of Surgery ◽

10.1093/bjs/znab429.001 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Mohammed Hamdan ◽

Gianfranco Messina ◽

Eleanor Duck ◽

Aniruddh Shenoy ◽

Gurpreet Singh Gill ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Operative Time ◽

Current Evidence ◽

Short Term ◽

Demographic Differences ◽

Term Outcome ◽

Short Term Outcome ◽

Outcome Differences ◽

Median Operative Time

Abstract Background The benefits of robotic over laparoscopic surgery for Roux-en-Y gastric bypass (RYGB) are debatable, with current evidence suggesting no significant differences in short-term outcomes. This study compares short-term outcomes and excess weight loss (EWL) % difference between these two techniques. Methods A retrospective study of patients undergoing RYGB between January 2016 and November 2020 at a single centre. Demographic, peri-operative and EWL% data were analysed. Results 424 RYGB procedures were performed by three surgeons including 77 robotic (RRYGB) and 347 laparoscopic (LRYGB) operations. The first 8 RRYGB were excluded being early in the learning curve and the operative technique was modified afterwards. There were no statistically significant demographic differences. The median operative time was 179 (151 – 195) and 149 (123 -171) minutes in the RRYGB and LRYGB groups respectively (P < 0.001). There were no statistically significant differences between both groups in complications, length of stay, 30-day readmission and EWL% at 6 and 12 months. The EWL% at 2 years was 88.5 (+/-19.1) and 66.6 (+/-29.8) in the RRYGB and LRYGB groups respectively (P = 0.003). Conclusions RRYGB increases the operative time with no significant short-term outcome differences. The EWL% was higher at 2 years, probably due to a narrower hand-sewn gastro-jejunal anastomosis.

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Laparoscopic Surgery for Gastric Cancer: The European Point of View

Journal of Oncology ◽

10.1155/2019/8738502 ◽

2019 ◽

Vol 2019 ◽

pp. 1-11 ◽

Cited By ~ 4

Author(s):

Mickael Chevallay ◽

Minoa Jung ◽

Felix Berlth ◽

Chon Seung-Hun ◽

Philippe Morel ◽

...

Keyword(s):

Gastric Cancer ◽

Odds Ratio ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Reoperation Rate ◽

Mean Difference ◽

Open Group ◽

Open Gastrectomy ◽

Short Term

Objective. Multiple Asian studies have proved the feasibility of laparoscopic approach for surgical treatment of gastric cancer. The difference between Asian and European patients could limit their application in Europe. We reviewed the literature for European studies comparing open gastrectomy with laparoscopic approach in the treatment of gastric cancer. Method. We searched the keywords gastric cancer and laparoscopy in MEDLINE and EMBASE. We included all studies published between 1990 and 2016 and conducted in Europe. Result. We found 1 randomized and 13 cohort studies which compared laparoscopic with open gastrectomy. We found no mean difference in the number of lymph nodes harvested between laparoscopic and open group (mean difference: -0.49; 95% CI: -2.42; 1.44, p=0.62) and no difference of short-term or long-term mortality (short-term odds ratio: 0.74, p=0.47; long-term odds ratio: 0.65, p=0.11). We found a longer operative time in the laparoscopic group (mean difference: 35.75 minutes, p<0.01) but lesser reoperation rate than the open group (odds ratio: 1.55 p=0.01). Conclusion. European based population studies found results comparable with their Asian counterpart. In the current state of evidence, minimally invasive surgery for gastric cancer is safe and can achieve the same oncological results.

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