scholarly journals Present Challenges of Robotics in Gynecology

2021 ◽  
Author(s):  
Pranjal H. Desai ◽  
Ryan J. Gillentine
Keyword(s):  
Laparoscopic Surgery ◽  
Learning Curve ◽  
Business Strategy ◽  
Team Building ◽  
Maintenance Cost ◽  
Culture Of Safety ◽  
Conventional Laparoscopic ◽  
Da Vinci Robotic System ◽  
Building Culture ◽  
Laparoscopic Techniques

Hysterectomy is one of the most common operations performed in gynecology. In the last decade and a half, the da Vinci robotic system has gained widespread acceptance in gynecology due to enhanced visualization and excellent dexterity compared to conventional laparoscopic techniques. The rapid adoption of the technology comes with unique challenges. Excluding initial acquisition cost and maintenance cost, surgery performed robotically is expensive than laparoscopic surgery. Higher cost on each case questions many about the viability of the robotic platform. Several hospitals have successfully established the robotic program, but many are reluctant to acquire expensive technology, and some are rolling back on their decision due to various reasons. This chapter expands on those challenges, mainly needs assessment, team building, culture of safety, learning curve, business strategy, and return of investment.

scholarly journals Pediatric Robotic-Assisted Laparoscopy: A Description of the Principle Procedures

2006 ◽  
Vol 6 ◽  
pp. 2581-2588 ◽  
Author(s):  
Carlo Passerotti ◽  
Craig A. Peters
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Robotic Assistance ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Robotic Assisted ◽  
Conventional Laparoscopic ◽  
Robotic Devices ◽  
Robotic Assisted Laparoscopy

The advent of clinically useful robotic devices to facilitate reconstructive laparoscopic surgery in pediatric urology opens new doors to minimally invasive procedures. Previously limited by the challenge of delicate suturing and reconstruction using conventional laparoscopic instruments, robotic assistance offers a more rapid climb up the learning curve. Initial procedures that have been safely and efficaciously performed with robotic assistance include nephrectomy, partial nephrectomy, pyeloplasty, and antireflux surgeries. These techniques and their outcomes will be reviewed, as well as some of the challenges still posed by this methodology.

scholarly journals Two-port access for laparoscopic surgery for endometrial cancer using conventional laparoscopic instruments

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kuan-Ju Huang ◽  
Ying-Xuan Li ◽  
Bor-Ching Sheu ◽  
Wen-Chun Chang
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Learning Curve ◽  
Surgical Techniques ◽  
Operation Time ◽  
Single Incision Laparoscopic Surgery ◽  
Conventional Laparoscopic ◽  
Laparoscopic Instruments ◽  
Port Access ◽  
Baseline Characteristics

AbstractMinimally invasive surgery is the first-line management for endometrial cancer. The role of 2-port access laparoscopy (TPA) has been underestimated. Compared to conventional laparoscopic surgery (CL), TPA is associated with smaller total incision size and less postoperative pain. Compared to single-incision laparoscopic surgery, no specific instruments and surgical techniques are needed. This study primarily evaluated the surgical and pathologic outcomes of TPA with conventional instruments, and additionally evaluated the surgeon’s learning curve. Consecutive patients who underwent TPA and CL for endometrial cancer between 2015 and 2019 were included. Baseline characteristics were recorded. In total, 148 patients (TPA, 89; CL, 59) were identified. The baseline characteristics were similar, except for a greater proportion of patients in the CL group receiving para-aortic lymph node dissection (5.62% vs. 35.59%, P < 0.01). The mean operation time was significantly less in the TPA group (152.09 vs. 187.15 min; P < 0.01). Both the groups had comparable 5-year progression-free survival (TPA, 86.68%) and 5-year overall survival rates (TPA, 93.24%). Analysis of the learning curve showed that the operation time decreased after 3–4 procedures. TPA using conventional laparoscopic instruments for endometrial cancer is feasible and is easily accessible to patients and surgeons.

scholarly journals A learning curve in using organ retractor for single-incision laparoscopic right colectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshio Shiraishi ◽  
Tetsuro Tominaga ◽  
Takashi Nonaka ◽  
Kiyoaki Hamada ◽  
Masato Araki ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Learning Curve ◽  
Single Incision ◽  
Operation Time ◽  
Perioperative Outcomes ◽  
Single Incision Laparoscopic Surgery ◽  
Right Colon ◽  
Right Colon Cancer

AbstractSingle-incision laparoscopic surgery (SILS) has the potential to improve perioperative outcomes, including less postoperative pain, shorter operation time, less blood loss, and shorter hospital stay. However, SILS is technically difficult and needs a longer learning curve. Between April 2016 and September 2019, a total of 198 patients with clinical stage I/II right colon cancer underwent curative resection. In the case of the SILS approach, an organ retractor was usually used to overcome SILS-specific restrictions. The patients were divided into two groups by surgical approach: the SILS with organ retractor group (SILS-O, n = 33) and the conventional laparoscopic surgery group (LAC, n = 165). Clinical T status was significantly higher in the LAC group (p = 0.016). Operation time was shorter and blood loss was lower in the SILS-O group compared to the LAC group (117 vs. 197 min, p = 0.027; 10 vs. 25 mL, p = 0.024, respectively). In the SILS-O group, surgical outcomes including operation time, blood loss, number of retrieved lymph nodes, and postoperative complications were not significantly different between those performed by experts and by non-experts. Longer operation time (p = 0.041) was significantly associated with complications on univariate and multivariate analyses (odds ratio 2.514, 95%CI 1.047–6.035, p = 0.039). SILS-O was safe and feasible for right colon cancer. There is a potential to shorten the learning curve of SILS using an organ retractor.

Laparoscopic surgery for gastro-oesophageal reflux: Beyond the learning curve

1996 ◽  
Vol 83 (9) ◽  
pp. 1284-1287 ◽  
Author(s):  
D. I. Watson ◽  
G. G. Jamieson ◽  
R. J. Baigrie ◽  
G. Mathew ◽  
P. G. Devitt ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Learning Curve ◽  
Oesophageal Reflux
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