Intelligent Surgery最新文献

{"title":"Application of da Vinci surgery in hepatectomy","authors":"Shiliu Lu ,&nbsp;Guandou Yuan ,&nbsp;Biao Lei ,&nbsp;Bin Chen ,&nbsp;Bangyu Lu ,&nbsp;Shuiping Yu ,&nbsp;Songqing He","doi":"10.1016/j.isurg.2022.09.001","DOIUrl":"10.1016/j.isurg.2022.09.001","url":null,"abstract":"<div><p>The first laparoscopic hepatectomy was performed over 30 years ago, and its safety and short-term and long-term outcomes are comparable to those of traditional laparotomy. Minimally invasive surgery is important for liver surgery. However, due to the limitations of its instruments and technology, laparoscopic surgery still has certain challenges in the field of liver resection, which is also an important reason for the relatively slow implementation of laparoscopic liver resection. The advent of the da Vinci robotic surgical system has helped to overcome the shortcomings of laparoscopy, such as the difficulty in exposing some special liver segments and performing sutures and reconstruction. Based on the experience of the authors’ surgical team, this paper explores the application value and breakthrough of the da Vinci robot in minimally invasive hepatectomy from the aspects of perioperative evaluation, lesion localization, bleeding control, surgical approaches, and precautions for complications.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 6-11"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000813/pdfft?md5=2437829efadfeab78230cb0faf7f9da2&pid=1-s2.0-S2666676622000813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80588129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic liver resection from exploration to maturity—single center experience","authors":"Ben Ma ,&nbsp;Shurui Wu ,&nbsp;Rong Liu,&nbsp;Minggen Hu","doi":"10.1016/j.isurg.2022.09.002","DOIUrl":"10.1016/j.isurg.2022.09.002","url":null,"abstract":"<div><p>By 2022, more than 2000 cases of robotic liver surgeries have been completed in our medical center. Based on the large number of robotic operation experience, recommendations on how to perform robotic liver resection were summarized in this paper. Robotic hepatectomy is a safe and feasible technique. Firstly, a patterned trocar placement scheme and individualized adjustment method are established. Secondly, an improved intracorporeal Pringle maneuver is founded. Thirdly, with reasonable combined use of three-dimensional reconstruction, indocyanine green (ICG) fluorescent staining, intraoperative ultra-sound image and intrahepatic/extrahepatic landmarks, an ideal hepatectomy plane would be more likely obtained. In this paper, robotic liver surgeries are divided into three types according to the difficulty of learning and a safe and feasible advanced learning process is proposed. Experiences in this paper may provide some help to those centers planning to carry out robotic liver surgery.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 20-25"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622001120/pdfft?md5=797d43d34e3c23ea03bd52bc857a2ecc&pid=1-s2.0-S2666676622001120-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78741913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted transvaginal natural orifice transluminal endoscopic surgery for a 32-year-old patient with early-stage endometrial carcinoma: A case report (with video)","authors":"Yanna Liu,&nbsp;Li Sun,&nbsp;Keyao Chen,&nbsp;Heyang Xu,&nbsp;Yu Guo","doi":"10.1016/j.isurg.2022.08.004","DOIUrl":"10.1016/j.isurg.2022.08.004","url":null,"abstract":"<div><p>Robot-assisted transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for patients with early-stage endometrial carcinoma has not been reported previously. The following case report is a robot-assisted vNOTES for a 32-year-old female with early-stage endometrial carcinom.We successfully performed hysterectomy and bilateral salpingectomy with sentinel lymph node mapping,spending 165 minutes and estimated blood loss was 50mL. No significant postoperative adverse events were observed. The good perioperative outcome indicated it is a safe and feasible procedure. Various techniques used for successful completion of the surgery, are described in detail in the following report.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"5 ","pages":"Pages 16-19"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000795/pdfft?md5=30d4cb5af7ce8b3733e6a134c36daf65&pid=1-s2.0-S2666676622000795-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74886236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic transvaginal NOTES: A step-by-step approach to surgical technique","authors":"Brooke Thigpen ,&nbsp;Jing Sun ,&nbsp;Xiaoming Guan","doi":"10.1016/j.isurg.2022.06.002","DOIUrl":"10.1016/j.isurg.2022.06.002","url":null,"abstract":"","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000588/pdfft?md5=614c7bf8749d86e5e1107249927db1b9&pid=1-s2.0-S2666676622000588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74265517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suture technique and material selection in Da Vinci robotic biliary reconstruction surgery","authors":"Hao Zou,&nbsp;Chengzhan Zhu,&nbsp;Mengling Ji,&nbsp;Zejiang Xu,&nbsp;Chuandong Sun","doi":"10.1016/j.isurg.2022.08.001","DOIUrl":"10.1016/j.isurg.2022.08.001","url":null,"abstract":"<div><p>Roux-en-Y hepaticojejunostomy is an important component of robotic biliary reconstruction surgery. High-quality hepaticojejunostomy is inseparable from a number of key factors.These factors include the incision of bile duct stump, the handling of the bowel, anastomosis method selection, and selection of anastomotic threads, etc. More attention should be paid to the improvement of biliary reconstruction techniques in the direction of refinement and homogeneity.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 9-11"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000680/pdfft?md5=4cf1a426e653d5ebf248c82de493c258&pid=1-s2.0-S2666676622000680-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84488382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in the application of robotic single-site laparoscopy in gynecology","authors":"Yanyan Liu,&nbsp;Jiaqiang Xiong,&nbsp;Yurou Chen,&nbsp;Yuexiong Yi,&nbsp;Wei Zhang","doi":"10.1016/j.isurg.2022.08.002","DOIUrl":"10.1016/j.isurg.2022.08.002","url":null,"abstract":"<div><p>With the recognition of the significant advantages of minimizing surgical trauma, laparoscopic single site surgery with robotic system has attracted more and more attention from surgeons because of its higher accuracy, stable vision and excellent ergonomics. Since gynecological surgery involves the female pelvic cavity, transumbilical or transvaginal natural cavity robotic laparoscopic single site surgery presents many advantages and possibilities. However, R-LESS in gynecological surgery is at the early stage of development and the specific advantages are still controversial. Here, we provided an overview of the application advancement of robotic single-site laparoscopic surgery in gynecology, and described indications and technique, highlighting the potential development direction and possibilities in the future.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 12-17"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000692/pdfft?md5=3dce001184834b0a6d4fd1c58bf295a2&pid=1-s2.0-S2666676622000692-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76620534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical analysis of da Vinci procedure volumes of 2021 in the Chinese Mainland","authors":"Ruihua Xue,&nbsp;Rong Liu","doi":"10.1016/j.isurg.2022.06.003","DOIUrl":"10.1016/j.isurg.2022.06.003","url":null,"abstract":"<div><h3>Objective</h3><p>To calculate the number of da Vinci surgical procedures in the Chinese mainland in 2021.</p></div><div><h3>Methods</h3><p>Based on the statistics on the number of da Vinci surgery of 2021 in the Chinese mainland, we analyzed the surgical volumes according to the classification of hospital, single robotic surgical system, specialty, and surgical team.</p></div><div><h3>Results</h3><p>The number of installed da Vinci surgical system in the Chinese mainland has exceeded 260, and more than 89,000 robotic procedures were performed in 2021, an 87.8% increase compared with that of the previous year. A total of 53 hospitals performed more than 600 da Vinci robotic procedures; 56 robotic systems distributed in 46 hospitals completed more than 600 procedures in 2021; and 64 surgical teams in various specialties completed more than 260 da Vinci surgeries.</p></div><div><h3>Conclusion</h3><p>A high volume of da Vinci surgical procedures were performed in the Chinese mainland in 2021 with an estimated growth rate.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 18-22"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000679/pdfft?md5=55d86668486c09dd5eba9fdb70d92791&pid=1-s2.0-S2666676622000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82783097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Da Vinci robotic assisted pancreaticoduodenectomy with superior mesenteric vein resection and reconstruction","authors":"Zheng Li ,&nbsp;Wensheng Liu ,&nbsp;Qifeng Zhuo ,&nbsp;Mengqi Liu ,&nbsp;Yihua Shi ,&nbsp;Wenyan Xu ,&nbsp;Shunrong Ji ,&nbsp;Xianjun Yu ,&nbsp;Xiaowu Xu","doi":"10.1016/j.isurg.2022.08.003","DOIUrl":"10.1016/j.isurg.2022.08.003","url":null,"abstract":"<div><p>This study demonstrated Da Vinci robot assisted pancreaticoduodenectomy with superior mesenteric vein (SMV) resection and reconstruction. The patient was diagnosed with pancreatic head cancer preoperatively. After anesthesia, trocars were placed by “six-hole method”, and then constant pressure pneumoperitoneum was established. The first step was to remove the gallbladder, open the gastrocolonic ligament, and expose the pancreas and surrounding tissues. After making a Kocher incision, we dissected duodenum, inferior vena cava and uncinate process of pancreas, and then cleaned lymph nodes in groups 13 and 16A. After the stomach was severed using linear stapler, the right gastric artery was dissected and ligated. In this case, the adhesion around the pancreas and common hepatic artery was serious, so the pancreas was transected firstly. The gastroduodenal artery was dissected from the upper edge of the pancreas, and the lymph nodes in groups 7, 8, 9 and 12 were cleaned to expose the common bile duct and portal vein. The common bile duct was transected above the confluence plane of the cystic duct. After opening the colonic mesentery on the left side of the superior mesenteric artery (SMA), the jejunum was severed with a linear cutting obturator. The uncinate process was treated through the middle artery approach; the inferior pancreaticoduodenal artery was severed and lymph nodes were cleaned to the root of SMA and celiac trunk. The tumor and part of the invaded SMV were removed and end-to-end SMV anastomosis was performed. The proper hepatic artery was wrapped with the round hepatic ligament. To protect the stump of gastroduodenal artery, we padded the round hepatic ligament below the pancreaticoduodenal anastomosis. The modified Blumgart method was used for pancreaticointestinal duct to mucosal anastomosis. 4-0 ​V-Lock suture was used for continuous suture of posterior wall and anterior wall respectively, and finally gastrointestinal side-to-side anastomosis was performed. The operation time was 360 ​min and the intraoperative bleeding was 200 ​mL. The patient was discharged 7 days after operation.</p></div>","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"4 ","pages":"Pages 23-26"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000709/pdfft?md5=191b79317919b60984d012b832a27459&pid=1-s2.0-S2666676622000709-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87089982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted laparoscopic surgery in gynecologic oncology","authors":"Henrik Falconer","doi":"10.1016/j.isurg.2022.05.004","DOIUrl":"10.1016/j.isurg.2022.05.004","url":null,"abstract":"","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"3 ","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000485/pdfft?md5=9eed1c8f26a4977c79a185ede066683e&pid=1-s2.0-S2666676622000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72744742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic assisted vaginal natural orifice transluminal endoscopic surgery high uterosacral ligament suspension (NOTES-HUS) for uterine prolapse with and without uterine preservation","authors":"Juan Liu ,&nbsp;Zhenkun Guan ,&nbsp;Liping Tang ,&nbsp;Xiaoming Guan","doi":"10.1016/j.isurg.2022.05.003","DOIUrl":"10.1016/j.isurg.2022.05.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Study objective&lt;/h3&gt;&lt;p&gt;To demonstrate stepwise techniques for the successful use of the robotic-assisted transvaginal natural orifice transluminal endoscopy surgery high uterosacral ligament suspension (RvNOTES-HUS) technique for pelvic organ prolapse with and without uterine preservation.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;Stepwise demonstration with narrated video footage (Canadian Task Force classification III).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;p&gt;An academic tertiary care hospital. Case 1: A 62-year-old G0P0 with a symptomatic stage Ⅱ anterior vaginal prolapse and Stage Ⅱ uterine prolapse. The preoperative vaginal length was measured at 9 ​cm. Case 2: A 42-year-old G3P2 with a symptomatic fibroid uterus with stage Ⅱ anterior vaginal prolapse and Stage Ⅱ uterine prolapse. The preoperative vaginal length was measured at 8 ​cm.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;p&gt;Since the approval of the robotic platforms in gynecologic surgery by the Food and Drug Administration in 2005,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; robotic assisted surgery has been proliferating in the treatment of benign gynecological diseases including sacrocolpopexy, hysterectomy, myomectomy and endometriosis resection.&lt;span&gt;2&lt;/span&gt;, &lt;span&gt;3&lt;/span&gt;, &lt;span&gt;4&lt;/span&gt;, &lt;span&gt;5&lt;/span&gt; In recent years, publications have demonstrated the feasibility and safety of traditional laparoscopic assisted high uterosacral ligament suspension for pelvic organ prolapse with long term follow up.&lt;span&gt;6&lt;/span&gt;, &lt;span&gt;7&lt;/span&gt;, &lt;span&gt;8&lt;/span&gt; However, robotic assisted RvNOTES-HUS has yet to be investigated in a publication. Utilizing the RvNOTES-HUS technique with or without uterine preservation operations greatly reduces the difficulty of intraperitoneal suture for the surgeon and postoperative pain for the patient. Nevertheless, this approach may be technically challenging.&lt;/p&gt;&lt;p&gt;For patients requesting uterine preservation, posterior colpotomy is required to place the port. Contrasting with hysterectomy, after the uterine removal the port was placed through the vaginal cuff; the remaining steps show great similarities. The succeeding techniques were adopted to perform RvNOTES-HUS: the bilateral uterosacral ligaments were tagged with sutures prior to the vNOTES port placement, highlighting the ureters, plucking the tagged uterosacral ligament to aid in identifying the high uterosacral ligament, elevating the uterosacral ligament while suturing, and pulling on the suture post-placement to determine the correct location.&lt;/p&gt;&lt;p&gt;The results were as follows:&lt;/p&gt;&lt;p&gt;Case 1: The procedure was successfully performed with a postoperative vaginal length of 8 ​cm. Her pain level was 4/10 in the first week, 2/10 in the second week, 0/10 in the third week, 0/10 in the fourth week. Postoperative pelvic organ prolapse quantification was stage 0.&lt;/p&gt;&lt;p&gt;Case 2: The procedure was successfully performed with a postoperative vaginal length of 7 ​cm. She had one day of post-operative pain. Postoperative pelvic organ prolapse q","PeriodicalId":100683,"journal":{"name":"Intelligent Surgery","volume":"3 ","pages":"Pages 14-15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666676622000473/pdfft?md5=e39cb7d90ff9c0901dd75bc9c7c9c672&pid=1-s2.0-S2666676622000473-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76092277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}