Comparison of robot-assisted surgery, laparoscopic-assisted surgery, and conventional open surgery for the treatment of gastric cancer： A network meta-analysis

Aim. To compare the clinical efficacies between laparoscopic and conventional open surgery in lateral lymph node dissection (LLND) for advanced rectal cancer. Methods. We comprehensively searched PubMed, Embase, Cochrane Library, CNKI, and Wanfang Data and performed a cumulative meta-analysis. According to inclusion criteria and exclusion criteria, all eligible randomized controlled trials (RCTs) or retrospective or prospective comparative studies assessing the two techniques were included, and then a meta-analysis was performed by using RevMan 5.3 software to assess the difference in clinical and oncological outcomes between the two treatment approaches. Results. Eight studies involving a total of 892 patients were finally selected, with 394 cases in the laparoscopic surgery group and 498 cases in the traditional open surgery group. Compared with the traditional open group, the laparoscopic group had a longer operative time (WMD=81.56, 95% CI (2.09, 142.03), P=0.008), but less intraoperative blood loss (WMD=−452.18, 95% CI (-652.23, -252.13), P<0.00001), shorter postoperative hospital stay (WMD=−5.30, 95% CI (-8.42, -2.18), P=0.0009), and higher R0 resection rate (OR=2.17, 95% CI (1.14, 4.15), P=0.02). There was no significant difference in the incidence of surgical complications between the two groups (OR=0.52, 95% CI (0.26, 1.07), P=0.08). Lateral lymph node harvest, lateral lymph node metastasis, local recurrence, 3-year overall survival, and 3-year disease-free survival did not differ significantly between the two approaches (P>0.05). Conclusion. Laparoscopic LLND has a similar efficacy in oncological outcomes and postoperative complications to the conventional open surgery, with the advantages of reduced intraoperative blood loss, shorter postoperative hospital stay, and higher R0 resection rate, and tumor radical cure is similar to traditional open surgery. Laparoscopic LLND is a safe and feasible surgical approach, and it may be used as a standard procedure in LLND for advanced rectal cancer.

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Incidence of Surgical Site Infection Associated with Robotic Surgery

Infection Control and Hospital Epidemiology ◽

10.1086/654006 ◽

2010 ◽

Vol 31 (8) ◽

pp. 822-827 ◽

Cited By ~ 9

Author(s):

Elizabeth D. Hermsen ◽

Tim Hinze ◽

Harlan Sayles ◽

Lee Sholtz ◽

Mark E. Rupp

Keyword(s):

Surgical Site Infection ◽

Open Surgery ◽

Small Sample Size ◽

Academic Medical Center ◽

Small Sample ◽

Site Infection ◽

National Data ◽

Robot Assisted ◽

Surgical Duration ◽

Robot Assisted Surgery

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.

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Totally laparoscopic versus laparoscopic-assisted total gastrectomy for upper and middle gastric cancer: a single-unit experience of 253 cases with meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-016-0860-2 ◽

2016 ◽

Vol 14 (1) ◽

Cited By ~ 17

Author(s):

Ke Chen ◽

Yu Pan ◽

Jia-Qin Cai ◽

Di Wu ◽

Jia-Fei Yan ◽

...

Keyword(s):

Gastric Cancer ◽

Total Gastrectomy ◽

Single Unit ◽

Meta Analysis ◽

Laparoscopic Assisted ◽

Totally Laparoscopic

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SURGEON AND THE MACHINE – ROBOTS IN SURGERY

Journal of Surgical Sciences ◽

10.33695/jss.v7i2.355 ◽

2020 ◽

Vol 7 (2) ◽

pp. 74-78

Author(s):

Baki Ekci ◽

Gokhan Agturk

Keyword(s):

Open Surgery ◽

Da Vinci ◽

Robot Assisted ◽

Surgical Robots ◽

Da Vinci Robot ◽

Surgical Equipment ◽

Medical Assistants ◽

Surgical Devices ◽

Medical Sector ◽

Robot Assisted Surgery

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.

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