Robotic Central Hepatectomy for the Treatment of Gallbladder Carcinoma. Outcomes of Minimally Invasive Approach

2021 ◽  
pp. 000313482110474
Author(s):  
Iswanto Sucandy ◽  
Furrukh Jabbar ◽  
Cameron Syblis ◽  
Kaitlyn Crespo ◽  
Sharona Ross ◽  
...  
Keyword(s):  
Gallbladder Carcinoma ◽  
Intraoperative Complications ◽  
Bile Leak ◽  
Robotic Approach ◽  
Robotic Technology ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Operative Duration ◽  
Estimated Blood Loss ◽  
Central Hepatectomy

Gallbladder cancer (GBC) is an uncommon but very aggressive malignancy with poor prognosis. Concerns for oncological inferiority related to the technical difficulties in performing laparoscopic portal lymphadenectomy discourage many surgeons to undertake this operation minimally invasively. With wide application of robotic technology to solve limitations of conventional laparoscopy, we describe our initial outcomes of robotic central hepatectomy and portal lymphadenectomy for gallbladder carcinoma in 15 consecutive patients. Data were presented as median (mean ± SD). Patients were 70 (73 ± 10.9) years old with BMI of 26 (26 ± 3.6) kg/m2. Tumor size was 3(4 ± 1.9) cm. Operative duration was 222 (237 ± 85.7) minutes and estimated blood loss was 200 (222 ± 135.4) mL. There were no intraoperative complications and complete resection (R0) was obtained in nearly all patients. Postoperative complications were seen in two patients (bile leak (n = 1) and respiratory failure (n = 1)). Length of stay was 3 (4 ± 4.0) days without 30-day mortality. Robotic approach is safe and effective for the treatment of GBC.

THE Big Deal: An Institution's Experience with Robotic Transhiatal Esophagectomy

2019 ◽  
Vol 85 (9) ◽  
pp. 1061-1065
Author(s):  
Jack Wecowski ◽  
Sharona B. Ross ◽  
Michalina F. Jadick ◽  
Ashley Justice ◽  
Iswanto Sucandy ◽  
...  
Keyword(s):  
Blood Loss ◽  
Length Of Hospital Stay ◽  
Transhiatal Esophagectomy ◽  
Site Infection ◽  
Robotic Approach ◽  
Robotic Platform ◽  
Operative Duration ◽  
Estimated Blood Loss ◽  
High Level ◽  
Robotic Application

As minimally invasive operations evolve, it is imperative to evaluate the advantages and risks involved. The aim of our study was to evaluate our institution's experience in incorporating a robotic platform for transhiatal esophagectomy (THE). Patients undergoing robotic THE were prospectively followed. Data are presented as median (mean ± SD). Forty-five patients were of 67 (67 ± 6.9) years and BMI 26 (27 ± 5.5) kg/m2. Nine per cent of operations were converted to “open,” but none in the last 25 operations. Operative duration of robotic THE was 334 (364 ± 108.8) minutes and estimated blood loss was 200 (217 ± 144.0) mL, which decreased with time ( P = 0.017). Length of stay was 8 (12 ± 11.1) days. Twenty per cent had respiratory failure requiring intubation that resolved, 4 per cent developed pneumonia, 11 per cent developed a surgical site infection, 2 per cent developed renal insufficiency, and 2 per cent developed a UTI. Two per cent (one patient) died within 30 days postoperatively, because of cardiac arrest. Our experience with robotic THE promotes robotic application because we endeavor to achieve high-level proficiency. With experience, we improved estimated blood loss and converted fewer transhiatal esophagectomies to “open.” Our length of hospital stay seems long but reflects the ill-health of patients, as does the variety of complications. Our data support the evolving future of THE, which will integrally include a robotic approach.

scholarly journals PRIMARY ABANDON-OF-THE-SAC (PAS) TECHNIQUE: PRELIMINARY RESULTS OF A NOVEL MINIMALLY INVASIVE APPROACH FOR INGUINOSCROTAL HERNIA REPAIR

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Alexander Charles MORRELL ◽  
Andre Luiz Gioia MORRELL ◽  
Flavio MALCHER ◽  
Allan Gioia MORRELL ◽  
Alexander Charles MORRELL-JUNIOR
Keyword(s):  
Minimally Invasive ◽  
Average Length ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Site Infections ◽  
Postoperative Outcomes ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Preliminary Results ◽  
Average Length Of Stay

ABSTRACT Background: Laparoscopic best approach of repairing inguinoscrotal hernias are still debatable. Incorrect handling of the distal sac can possibly result in damage to cord structures and negative postoperative outcomes as ischemic orquitis or inguinal neuralgia. Aim: To describe a new technique for a minimally invasive approach to inguinoscrotal hernias and to analyze the preliminary results of patients undergoing the procedure. Methods: A review of a prospectively maintained database was conducted in patients who underwent minimally invasive repair using the “primary abandon-of-the-sac” (PAS) technique for inguinoscrotal hernias. Patient´s demographics, as well as intraoperative variables and postoperative outcomes were also analyzed. Results: Twenty-six male were submitted to this modified procedure. Mean age of the case series was 53.8 years (range 34-77) and body mass index was 26.8 kg/m2 (range 20.8-34.2). There were no intraoperative complications or conversion. Average length of stay was one day. No surgical site infections, pseudo hydrocele or neuralgia were reported after the procedure and two patients presented seroma. No inguinal hernia recurrence was verified during the mean 21.4 months of follow up. Conclusion: The described technique is safe, feasible and reproducible, with good postoperative results.

Laparoendoscopic Single-Site (LESS) versus Robotic “Redo” Hiatal Hernia Repair with Fundoplication: Which Approach is Better?

2019 ◽  
Vol 85 (9) ◽  
pp. 978-984
Author(s):  
Andres Giovannetti ◽  
Danielle Craigg ◽  
Miguel Castro ◽  
Sharona Ross ◽  
Iswanto Sucandy ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Single Site ◽  
Hiatal Hernia Repair ◽  
Type I ◽  
Robotic Approach ◽  
Operative Duration ◽  
Laparoendoscopic Single Site ◽  
Institutional Review ◽  
Estimated Blood Loss ◽  
Antireflux Operations

Only a small percentage of patients fail laparoscopic fundoplications undertaken for gastroesophageal reflux disease. But because many laparoscopic fundoplications have been undertaken, surgeons frequently encounter patients in need of “redo” operations. This study was undertaken to evaluate the robotic approach versus laparoendoscopic single-site (LESS) approach for redo fundoplications. With an Institutional Review Board approval, 64 patients undergoing LESS (n = 32) or robotic (n = 32) redo antireflux operations were prospectively followed up. Data are presented as median (mean + SD). For LESS versus robotic redo operations, the operative duration was 145 (143 ± 33.5) versus 196 (208 ± 76.7) minutes ( P < 0.01), estimated blood loss was 50 (80 ± 92.1) versus 20 (43 ± 57.1) mL ( P = 0.07), and length of stay was 1 (3 ± 5.4) versus 1 (2 ± 1.9) day ( P = 0.57); 1 LESS operation was converted to “open.” Operative duration was longer for men ( P = 0.01). Postoperative complications were not more frequent after Nissen (n = 36) or Toupet (n = 28) fundoplication, regardless of the approach. When matched by BMI, operative duration was prolonged by a large Type I to IV hiatal hernia ( P = 0.01). Symptoms improved dramatically and were similar with both approaches, and patient satisfaction was high. Robotic redo antireflux operations take longer than LESS operations. LESS and robotic redo antireflux operations are both safe and offer significant and similar amelioration of symptoms after failed fundoplications.

Is robotic technology facilitating the minimally invasive approach to partial nephrectomy?

2011 ◽  
Vol 109 (5) ◽  
pp. 760-768 ◽  
Author(s):  
Harveer S. Dev ◽  
Prasanna Sooriakumaran ◽  
Jens-Uwe Stolzenburg ◽  
Christopher J. Anderson
Keyword(s):  
Minimally Invasive ◽  
Partial Nephrectomy ◽  
Robotic Technology ◽  
Minimally Invasive Approach ◽  
Invasive Approach

scholarly journals Comparing Robot-Assisted Laparoscopic Pyeloplasty vs. Laparoscopic Pyeloplasty in Infants Aged 12 Months or Less

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuenshan Sammi Wong ◽  
Kristine Kit Yi Pang ◽  
Yuk Him Tam
Keyword(s):  
Minimally Invasive ◽  
Intraoperative Complications ◽  
Linear Regression Analysis ◽  
Hospital Length Of Stay ◽  
Success Rates ◽  
Laparoscopic Pyeloplasty ◽  
Minimally Invasive Approach ◽  
Robot Assisted ◽  
Analgesic Requirement ◽  
Invasive Approach

Objective: To investigate the outcomes of minimally invasive approach to infants with ureteropelvic junction (UPJ) obstruction by comparing the two surgical modalities of robot-assisted laparoscopic pyeloplasty (RALP) and laparoscopic pyeloplasty (LP).Methods: We conducted a retrospective review of all consecutive infants aged ≤12 months who underwent either LP or RALP in a single institution over the period of 2008–Jul 2020. We included primary pyeloplasty cases that were performed by or under the supervision of the same surgeon.Results: Forty-six infants (LP = 22; RALP = 24) were included with medians of age and body weight at 6 months (2–12months) and 8.0 kg (5.4–10 kg), respectively. There was no difference between the two groups in the patients' demographics and pre-operative characteristics. All infants underwent LP or RALP successfully without conversion to open surgery. None had intraoperative complications. Operative time (OT) was 242 min (SD = 59) in LP, compared with 225 min (SD = 39) of RALP (p = 0.25). Linear regression analysis showed a significant trend of decrease in OT with increasing case experience of RALP(p = 0.005). No difference was noted in the post-operative analgesic requirement. RALP was associated with a shorter hospital length of stay than LP (3 vs. 3.8 days; p = 0.009). 4/22(18%) LP and 3/24(13%) RALP developed post-operative complications (p = 0.59), mostly minor and stent-related. The success rates were 20/22 (91%) in LP and 23/24 (96%) in RALP (p = 0.49).Conclusions: Pyeloplasty by minimally invasive approach is safe and effective in the infant population. RALP may have superiority over LP in infants with its faster recovery and a more manageable learning curve to acquire the skills.

Minimally Invasive Approach for Wilms Tumor Treatment in a Small Child - A Case Report

Urology ◽  
2020 ◽  
Author(s):  
Alexandre Azevedo Ziomkowski ◽  
João Rafael Silva Simões Estrela ◽  
Nilo Jorge Carvalho Leão Barretto ◽  
Nilo César Leão Barretto
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Wilms Tumor ◽  
Small Child ◽  
Tumor Treatment ◽  
Minimally Invasive Approach ◽  
Invasive Approach

A Minimally Invasive Approach for Treatment of Cholesterol Granuloma of the Petrous Apex

2019 ◽  
Author(s):  
Brandon Lucke-Wold ◽  
Maya Fleseriu ◽  
Haley Calcagno ◽  
Timothy Smith ◽  
Joshua Levy ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Petrous Apex ◽  
Cholesterol Granuloma ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

2013 ◽  
Vol 16 (5) ◽  
pp. E295-E297 ◽  
Author(s):  
Joseph Lamelas ◽  
Christos Mihos ◽  
Orlando Santana
Keyword(s):  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Rational Approach ◽  
Functional Mitral Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Technical Details ◽  
Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

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