scholarly journals Comparison of robot-assisted surgery, laparoscopic-assisted surgery, and open surgery for the treatment of colorectal cancer

Medicine ◽  
2018 ◽  
Vol 97 (34) ◽  
pp. e11817 ◽  
Author(s):  
Shihou Sheng ◽  
Tiancheng Zhao ◽  
Xu Wang
2021 ◽  
Vol 10 (4) ◽  
pp. 589
Author(s):  
Mariusz G. Fleszar ◽  
Paulina Fortuna ◽  
Marek Zawadzki ◽  
Paweł Hodurek ◽  
Iwona Bednarz-Misa ◽  
...  

Excessive endocrine response to trauma negatively affects patients’ well-being. Cortisol dynamics following robot-assisted colorectal surgery are unknown. We aimed at determining the impact of cancer pathology and surgery-related factors on baseline cortisol levels and analyzed its time-profile in colorectal cancer patients undergoing open or robot-assisted surgery. Cortisol levels were measured using liquid chromatography quadrupole time-of-flight mass spectrometry. Baseline cortisol was not associated with any patient- or disease-related factors. Post-surgery cortisol increased by 36% at 8 h and returned to baseline on postoperative day three. The cortisol time profile was significantly affected by surgery type, estimated blood loss, and length of surgery. Baseline-adjusted cortisol increase was greater in females at hour 8 and in both females and patients from open surgery group at hour 24. Solely in the open surgery group, cortisol dynamics paralleled changes in interleukin (IL)-1β, IL-10, IL-1ra, IL-7, IL-8 and tumor necrosis factor (TNF)-α but did not correlate with changes in IL-6 or interferon (IFN)-γ at any time-point. Cortisol co-examined with C-reactive protein was predictive of surgical site infections (SSI) with high accuracy. In conclusion, patient’s sex and surgery invasiveness affect cortisol dynamics. Surgery-induced elevation can be reduced by minimally invasive robot-assisted procedures. Cortisol and C-reactive protein as SSI biomarkers might be of value in the evaluation of safety of early discharge of patients.


2010 ◽  
Vol 31 (8) ◽  
pp. 822-827 ◽  
Author(s):  
Elizabeth D. Hermsen ◽  
Tim Hinze ◽  
Harlan Sayles ◽  
Lee Sholtz ◽  
Mark E. Rupp

Objective.Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.Design.Retrospective cohort study.Setting.A 689-bed academic medical center.Patients.All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.Methods.SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.Results.Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81–11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79–30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68–70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68–69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5–10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.Conclusions.Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.


2020 ◽  
Vol 7 (2) ◽  
pp. 74-78
Author(s):  
Baki Ekci ◽  
Gokhan Agturk

The use of tools and machines in the field of medicine is very old, although the use of robots datesback to several decades. The purpose of using machinery and robots in the industry is to reduceproduction costs in the industry. Unlike machines, robots are energy-driven mechanical systemsdesigned to perform learned operations and movements in a much safer faster and more economicalway. In the medical sector, robots used outside operations are used to automate certain tasks. Butthe surgical robots are controlled by the surgeons and used to facilitate the surgeons' work. In otherwords, they do not move except for the surgeon’s control and do not perform an automated procedureand they do not have artificial intelligence now. In this context, it is more appropriate to use the termrobotic-assisted surgical equipment, robot-assisted minimally invasive surgery or roboticallyassisted surgical devices rather than using the word “robot”. In short, robots used in surgeries aremachines designed to perform more complex, thinner, more precise tasks. In this review, we will beevaluating the robot, the different medical assistants and robotic surgery, the da Vinci robot, and thedifferences between the open surgery, laparoscopic surgery, and robot-assisted surgery.


2016 ◽  
Vol 30 (12) ◽  
pp. 5601-5614 ◽  
Author(s):  
Xuan Zhang ◽  
ZhengQiang Wei ◽  
MengJun Bie ◽  
XuDong Peng ◽  
Cheng Chen

2012 ◽  
Vol 26 (7) ◽  
pp. 871-877 ◽  
Author(s):  
Courtney K. Rowe ◽  
Michael W. Pierce ◽  
Katherine C. Tecci ◽  
Constance S. Houck ◽  
James Mandell ◽  
...  

2018 ◽  
Vol 27 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Tina Fransgaard ◽  
Ismail Pinar ◽  
Lau Caspar Thygesen ◽  
Ismail Gögenur

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Peter van Dam ◽  
Jan Hauspy ◽  
Luc Verkinderen ◽  
Xuan Bich Trinh ◽  
Pieter-Jan van Dam ◽  
...  

The exponential use of robotic surgery is not the result of evidence-based benefits but mainly driven by the manufacturers, patients and enthusiastic surgeons. The present review of the literature shows that robot-assisted surgery is consistently more expensive than video-laparoscopy and in many cases open surgery. The average additional variable cost for gynecological procedures was about 1600 USD, rising to more than 3000 USD when the amortized cost of the robot itself was included. Generally most robotic and laparoscopic procedures have less short-term morbidity, blood loss, intensive care unit, and hospital stay than open surgery. Up to now no major consistent differences have been found between robot-assisted and classic video-assisted procedures for these factors. No comparative data are available on long-term morbidity and oncologic outcome after open, robotic, and laparoscopic gynecologic surgery. It seems that currently only for very complex surgical procedures, such as cardiac surgery, the costs of robotics can be competitive to open surgical procedures. In order to stay viable, robotic programs will need to pay for themselves on a per case basis and the costs of robotic surgery will have to be reduced.


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