Robotic-Assisted Complex Pulmonary Resection: Sleeve Lobectomy for Cancer

The use of robotic assistance for complex pulmonary resections such as segmentectomy and sleeve lobectomy has steadily increased in recent years. These operations are technically challenging as they require fine dissection and suturing, which is often difficult to perform using traditional minimally invasive techniques. Robotic surgery is well-suited for complex pulmonary surgery given its specific advantages related to superior optics and precise tissue manipulation and dissection. Herein we describe our technique for robotic-assisted complex pulmonary surgery with a specific focus on right upper sleeve lobectomy for cancer, including associated video case demonstration. The principles discussed are generalizable to other complex lung and tracheobronchial operations and highlight the benefits of the robotic platform.

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Robotic oesophago-gastric cancer surgery

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.supp1.23 ◽

2018 ◽

Vol 100 (6_sup) ◽

pp. 27-35 ◽

Cited By ~ 1

Author(s):

YA Qureshi ◽

B Mohammadi

Keyword(s):

Gastric Cancer ◽

Robotic Surgery ◽

Postoperative Complications ◽

Minimally Invasive ◽

Cancer Surgery ◽

Minimally Invasive Techniques ◽

Gastric Cancer Surgery ◽

Complications Rate ◽

Invasive Techniques

A postoperative complications rate of nearly 50% has compelled oesophago-gastric practice to adopt minimally invasive techniques such as robotic surgery

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16. Minimally invasive techniques for urinary incontinence: laparoscopic/robotic-assisted Burch colposuspension (urethropexy)

Minimally Invasive Surgery in Gynecological Practice ◽

10.1515/9783110535204-016 ◽

2020 ◽

pp. 163-169

Keyword(s):

Urinary Incontinence ◽

Minimally Invasive ◽

Minimally Invasive Techniques ◽

Burch Colposuspension ◽

Robotic Assisted ◽

Invasive Techniques

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How I do it: robotic-assisted Ivor Lewis esophagectomy

Diseases of the Esophagus ◽

10.1093/dote/doaa070 ◽

2020 ◽

Vol 33 (Supplement_2) ◽

Author(s):

Christopher A Heid ◽

Victor Lopez ◽

Kemp Kernstine

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Techniques ◽

Ivor Lewis ◽

Robotic Assisted ◽

Surgical Technology ◽

Ivor Lewis Esophagectomy ◽

Improved Outcomes ◽

Invasive Techniques

SUMMARY Advances in minimally invasive techniques, including robotic surgical technology, have led to improved outcomes in esophagectomy. In this article, we detail our approach to the robotic Ivor Lewis esophagectomy.

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Robotic Surgery in Inflammatory Bowel Disease

Current Drug Targets ◽

10.2174/1389450121999200820125918 ◽

2020 ◽

Vol 22 (1) ◽

pp. 112-116

Author(s):

Jacopo Crippa ◽

Michele Carvello ◽

Paulo Gustavo Kotze ◽

Antonino Spinelli

Keyword(s):

Inflammatory Bowel Disease ◽

Robotic Surgery ◽

Minimally Invasive ◽

Bowel Disease ◽

Series Data ◽

Minimally Invasive Techniques ◽

Conversion To Open Surgery ◽

Inflammatory Bowel ◽

Invasive Techniques ◽

The Impact

Background: Surgery is considered a cornerstone of inflammatory bowel disease (IBD) treatment. In the last years, robotic surgery has seen an increase in adoption rates for both benign and malignant diseases. Objective: This work aims to review the current applications of robotic surgery in IBD. Discussion and Conclusion: Minimally-invasive techniques have been applied to the treatment of IBD for more than 20 years. Investments in surgical digital and robotic platforms are increasingly arising, with an estimate of getting doubled within the next 5 years. Robotic surgery represents the newest technology available to reduce the impact of surgery on patients affected by IBD, and may theoretically be even more effective than other minimally-invasive techniques given the lower rate of conversion to open surgery as compared to laparoscopy according to many large retrospective series. Data on robotic surgery applied to IBD are still scarce and initial experiences in high-volume centers from retrospective series suggested that robotic surgery may achieve similar results when compared to laparoscopy. A new wave of robotics incorporating artificial intelligence is awaited to empower the capability of IBD surgeon in terms of intraoperative decision-making beyond technical skill enhancement.

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411 LEARNING CURVES IN MINIMALLY INVASIVE ESOPHAGECTOMY: A SYSTEMATIC REVIEW

Diseases of the Esophagus ◽

10.1093/dote/doaa087.103 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

P Prasad ◽

L Wallace ◽

M Navidi ◽

S Wahed ◽

A Immanuel ◽

...

Keyword(s):

Minimally Invasive ◽

Learning Curve ◽

Minimally Invasive Esophagectomy ◽

Learning Curves ◽

Minimally Invasive Techniques ◽

Robotic Assisted ◽

Invasive Esophagectomy ◽

Training Programmes ◽

Meta Analyses ◽

Invasive Techniques

Abstract Minimally invasive techniques are being increasingly used in the treatment of esophageal cancer. The learning curve for minimally invasive esophagectomy (MIE) is variable and can have an impact upon training delivered within residency and fellowship programmes. The aims of this review are to critically appraise current literature on the learning curve for MIE, identify what parameter(s) is used to quantify achieving competence and determine if there is evidence of resultant impact on surgical training. Methods A search of the major reference databases (MEDLINE, EMBASE, Cochrane) was performed with no time limits up to the date of the search (February 2020). Results were screened in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and study quality assessed using the Newcastle-Ottawa Scale for cohort studies. Results Twenty-one studies comprising 2720 patients were included- 17 studies reported on a combination of thoracoscopic, hybrid and total MIE, 3 studies reported robotic assisted alone and 1 study evaluated robotic assisted and thoracoscopic esophagectomy. 3 studies used a cumulative sum (CUSUM) analysis to define learning, 1 study used CUSUM and another parameter and 17 studies used one or more parameters. Quantification of surgical competence was variable and ranged from 12–80 cases for robotic surgery and 12–60 cases for other modes of MIE. One study reported trainees achieving MIE skills quicker if mentoring surgeons had attained proficiency on the learning curve. Conclusion Learning curves in MIE remain ill-defined with limited evidence on impact upon training received by residents and fellows. Additionally, the parameters used to define achievement of surgical competency is heterogenous. As minimally invasive techniques are increasingly adopted, specific standards to help define competence need to be identified and agreed on. This could help in designing training programmes and improve the rate of achieving competency.

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

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000567 ◽

2018 ◽

Vol 13 (6) ◽

pp. 438-444 ◽

Cited By ~ 8

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.

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Minimally Invasive Techniques: Transoral Robotic Surgery and Photodynamic Therapy

Contemporary Oral Oncology ◽

10.1007/978-3-319-43854-2_14 ◽

2017 ◽

pp. 297-300

Author(s):

Hassan Arshad

Keyword(s):

Photodynamic Therapy ◽

Robotic Surgery ◽

Minimally Invasive ◽

Transoral Robotic Surgery ◽

Minimally Invasive Techniques ◽

Invasive Techniques

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Robotic repair of incarcerated morgagni hernia in an adult on the acute care surgery service

Revista de la Facultad de Ciencias Médicas de Córdoba ◽

10.31053/1853.0605.v78.n1.28299 ◽

2021 ◽

Vol 78 (1) ◽

pp. 91-94

Author(s):

Robert Cubas ◽

Manuel Garcia ◽

Kaushik Mukherjee

Keyword(s):

Robotic Surgery ◽

Minimally Invasive ◽

Acute Care ◽

Surgical Care ◽

Acute Care Surgery ◽

Minimally Invasive Techniques ◽

Composite Mesh ◽

Morgagni Hernia ◽

Care Surgery ◽

Invasive Techniques

Introduction: Morgagni hernia is a relatively uncommon anterior diaphragmatic defect, particularly in adults. We describe the case of a patient who presented with an incarcerated Morgagni hernia and was repaired by an Acute Care Surgery service.Description: The patient is a 29 year old male who presented with a picture of bowel obstruction. CT scan revealed a Morgagni hernia with incarcerated stomach and colon. He was taken to the operating room for robotic repair. The hernia was reduced. The defect measured 10 x 7cm, a composite mesh was interposed, and sutured in place. The patient was discharged on postoperative day 5 and has done well at 1 year follow up.Conclusion: Robotic surgery offer the chance to apply minimally invasive techniques for urgent surgical care. This is the first reported case of an incarcerated Morgagni hernia repaired urgently using robotic techniques, and performed by acute care surgeons.

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