scholarly journals Make New Friends But Keep the Old: Minimally Invasive Surgery Training in Gynecologic Oncology Fellowship Programs

2015 ◽  
Vol 25 (6) ◽  
pp. 1115-1120 ◽  
Author(s):  
Kari L. Ring ◽  
Pedro T. Ramirez ◽  
Lesley B. Conrad ◽  
William Burke ◽  
R. Wendel Naumann ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Objective Assessment ◽  
Gynecologic Oncology ◽  
Fellowship Training ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Fellowship Programs

ObjectivesTo evaluate the role of minimally invasive surgery (MIS) in gynecologic oncology fellowship training and fellows’ predictions of their use of MIS in their future practice.MethodsAll fellows-in-training in American Board of Obstetrics and Gynecology–approved training programs were surveyed in 2012 through an online or mailed-paper survey. Data were analyzed and compared to results of a similar 2007 survey.ResultsOf 172 fellows, 69 (40%) responded. Ninety-nine percent of respondents (n = 68) indicated that MIS was either very important or important in gynecologic oncology, a proportion essentially unchanged from 2007 (100%). Compared to 2007, greater proportions of fellows considered laparoscopic radical hysterectomy and node dissection for cervical cancer (87% vs 54%; P < 0.0001) and trachelectomy and staging for cervical cancer (83% vs 32%; P < 0.0001) appropriate for MIS. Of the respondents, 92% believed that maximum or some emphasis should be placed on robotic-assisted surgery and 89% on traditional laparoscopy during fellowship training. Ten percent rated their fellowship training in laparoendoscopic single-site surgery as very poor; 44% said that the question was not applicable. Most respondents (60%) in 2012 performed at least 11 procedures per month, whereas most respondents (45%) in 2007 performed 6 to 10 procedures per month (P = 0.005). All respondents at institutions where robotic surgery was used were allowed to operate at the robotic console, and 63% of respondents reported that in robotic-assisted surgery cases when a fellow sat at the robot, the fellow performed more than 50% of the case at the console.ConclusionsThese findings indicate that MIS in gynecologic oncology is here to stay. Fellowship programs should develop a systematic approach to training in MIS and in individual MIS platforms as they become more prevalent. Fellowship programs should also develop and apply an objective assessment of minimum proficiency in MIS to ensure that programs are adequately preparing trainees.

scholarly journals Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology

2015 ◽  
Vol 25 (6) ◽  
pp. 1121-1127 ◽  
Author(s):  
Lesley B. Conrad ◽  
Pedro T. Ramirez ◽  
William Burke ◽  
R. Wendel Naumann ◽  
Kari L. Ring ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Minimally Invasive Surgery ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Single Port ◽  
Gynecologic Oncology ◽  
Pelvic Lymphadenectomy ◽  
Single Port Laparoscopy

ObjectivesTo evaluate the current patterns of use of minimally invasive surgical procedures, including traditional, robotic-assisted, and single-port laparoscopy, by Society of Gynecologic Oncology (SGO) members and to compare the results to those of our 2004 and 2007 surveys.MethodsThe Society of Gynecologic Oncology members were surveyed through an online or mailed-paper survey. Data were analyzed and compared with results of our prior surveys.ResultsFour hundred six (32%) of 1279 SGO members responded. Eighty-three percent of respondents (n = 337) performed traditional laparoscopic surgery (compared with 84% in 2004 and 91% in 2007). Ninety-seven percent of respondents performed robotic surgery (compared with 27% in 2007). When respondents were asked to indicate procedures that they performed with the robot but not with traditional laparoscopy, 75% indicated radical hysterectomy and pelvic lymphadenectomy for cervical cancer. Overall, 70% of respondents indicated that hysterectomy and staging for uterine cancer was the procedure they most commonly performed with a minimally invasive approach. Only 17% of respondents who performed minimally invasive surgery performed single-port laparoscopy, and only 5% of respondents indicated that single-port laparoscopy has an important or very important role in the field.ConclusionsSince our prior surveys, we found a significant increase in the overall use and indications for robotic surgery. Radical hysterectomy or trachelectomy and pelvic lymphadenectomy for cervical cancer and total hysterectomy and staging for endometrial cancer were procedures found to be significantly more appropriate for the robotic platform in comparison to traditional laparoscopy. The indications for laparoscopy have expanded beyond endometrial cancer staging to include surgical management of early-stage cervical and ovarian cancers, but the use of single-port laparoscopy remains limited.

scholarly journals Tactile Sensing for Minimally Invasive Surgery: Conventional Methods and Potential Emerging Tactile Technologies

2022 ◽  
Vol 8 ◽  
Author(s):  
Wael Othman ◽  
Zhi-Han A. Lai ◽  
Carlos Abril ◽  
Juan S. Barajas-Gamboa ◽  
Ricard Corcelles ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Emerging Technologies ◽  
Surgical Instruments ◽  
Force Sensing ◽  
Tactile Sensing ◽  
Robotic Assisted ◽  
Surgical Tools ◽  
Robotic Assisted Surgery

As opposed to open surgery procedures, minimally invasive surgery (MIS) utilizes small skin incisions to insert a camera and surgical instruments. MIS has numerous advantages such as reduced postoperative pain, shorter hospital stay, faster recovery time, and reduced learning curve for surgical trainees. MIS comprises surgical approaches, including laparoscopic surgery, endoscopic surgery, and robotic-assisted surgery. Despite the advantages that MIS provides to patients and surgeons, it remains limited by the lost sense of touch due to the indirect contact with tissues under operation, especially in robotic-assisted surgery. Surgeons, without haptic feedback, could unintentionally apply excessive forces that may cause tissue damage. Therefore, incorporating tactile sensation into MIS tools has become an interesting research topic. Designing, fabricating, and integrating force sensors onto different locations on the surgical tools are currently under development by several companies and research groups. In this context, electrical force sensing modality, including piezoelectric, resistive, and capacitive sensors, is the most conventionally considered approach to measure the grasping force, manipulation force, torque, and tissue compliance. For instance, piezoelectric sensors exhibit high sensitivity and accuracy, but the drawbacks of thermal sensitivity and the inability to detect static loads constrain their adoption in MIS tools. Optical-based tactile sensing is another conventional approach that facilitates electrically passive force sensing compatible with magnetic resonance imaging. Estimations of applied loadings are calculated from the induced changes in the intensity, wavelength, or phase of light transmitted through optical fibers. Nonetheless, new emerging technologies are also evoking a high potential of contributions to the field of smart surgical tools. The recent development of flexible, highly sensitive tactile microfluidic-based sensors has become an emerging field in tactile sensing, which contributed to wearable electronics and smart-skin applications. Another emerging technology is imaging-based tactile sensing that achieved superior multi-axial force measurements by implementing image sensors with high pixel densities and frame rates to track visual changes on a sensing surface. This article aims to review the literature on MIS tactile sensing technologies in terms of working principles, design requirements, and specifications. Moreover, this work highlights and discusses the promising potential of a few emerging technologies towards establishing low-cost, high-performance MIS force sensing.

Evidence and Recommendations Regarding Urologic Laparoscopic and Robotic-Assisted Surgery in times of COVID-19

2020 ◽  
Vol 80 (3) ◽  
pp. 1-6
Author(s):  
Eduardo Alberto González-Bonilla ◽  
Jesús Emmanuel Rosas-Nava ◽  
Juan Eduardo Sánchez-Núñez ◽  
Mario Iván Doria-Lozano ◽  
Víctor Enrique Corona-Montes ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Patient Care ◽  
Invasive Surgery ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery ◽  
Patient At Risk ◽  
Underlying Pathology

On March 11, 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic and has created an impact like no other on health systems worldwide. A restructuring in the priority of patient care has currently taken place that is based on the patient’s underlying pathology.  Urology services are no exception, postponing all the elective surgeries that can be delayed without putting the patient at risk. A surgical protocol has been adopted during the pandemic that attempts to reduce the amount of time the operating room is in use, as well as the risk for postoperative complications, so that hospital stay can be reduced.   In such a setting, minimally invasive surgery, such as laparoscopic and robotic-assisted surgery, can play a beneficial role in treating oncologic pathologies that cannot be deferred. Based on the best evidence that has currently been published and the guidelines of international associations, this paper summarizes the recommendations regarding urologic laparoscopic and robotic-assisted surgery in times of COVID-19.

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