JSLS : Journal of the Society of Laparoendoscopic Surgeons最新文献

{"title":"Factors Associated with Mortality after Percutaneous Endoscopic Gastrostomy.","authors":"Diego Laurentino Lima,&nbsp;Luiz Eduardo Correia Miranda,&nbsp;Raquel Nogueira Cordeiro Laurentino Lima,&nbsp;Gustavo Romero-Velez,&nbsp;Ryan Chin,&nbsp;Phillip P Shadduck,&nbsp;Prashanth Sreeramoju","doi":"10.4293/JSLS.2023.00005","DOIUrl":"https://doi.org/10.4293/JSLS.2023.00005","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous endoscopic gastrostomy (PEG) is a common procedure performed world-wide on patients with different comorbidities, with many indications and overall low morbidity. However, studies showed an elevated early mortality in patients undergoing PEG placement. In this systematic review, we review the factors associated with early mortality after PEG.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The methodological index for nonrandomized studies (MINORS) score system was used to perform qualitative assessment of all included studies. Recommendations were summarized for predefined key items.</p><p><strong>Results: </strong>The search found 283 articles. A refined total of 21 studies were included; 20 studies cohort studies and 1 case-control study. For the cohort studies, MINORS score ranged from 7 to 12 out of 16. The single case-control study scored 17 out of 24. The number of study patients ranged from 272 to 181,196. Thirty-day mortality rate varied from 2.4% to 23.5%. Albumin, age, body mass index, C-reactive protein, diabetes mellitus, and dementia were the most frequently associated factors to early mortality in patients undergoing PEG placement. Five studies reported procedure related deaths. Infection was the most commonly reported complication of PEG placement.</p><p><strong>Conclusions: </strong>PEG tube insertion is a fast, safe and effective procedure, but is not free of complications and can have a high early mortality rate as demonstrated in this review. Patient selection should be a key factor and the identification of factors associated with early mortality is important in the elaboration of a protocol to benefit patients.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/85/e2023.00005.PMC10256279.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Body Mass Index on Patients' Outcomes Following Robotic Distal Pancreatectomy and Splenectomy.","authors":"Harel Jacoby,&nbsp;Sharona Ross,&nbsp;Iswanto Sucandy,&nbsp;Cameron Syblis,&nbsp;Kaitlyn Crespo,&nbsp;Prakash Vasanthakumar,&nbsp;Michael Trotto,&nbsp;Alexander Rosemurgy","doi":"10.4293/JSLS.2022.00046","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00046","url":null,"abstract":"<p><strong>Background and objectives: </strong>Obesity has increased over the past decade, yet the correlation among body mass index (BMI), surgical outcomes, and the robotic platform are not well established. This study was undertaken to measure the impact of elevated BMI on outcomes after robotic distal pancreatectomy and splenectomy.</p><p><strong>Methods: </strong>We prospectively followed patients who underwent robotic distal pancreatectomy and splenectomy. Regression analysis was utilized to identify significant relationships with BMI. For illustrative purposes, the data are presented as median (mean ± SD). Significance was determined at p ≤ 0.05.</p><p><strong>Results: </strong>A total of 122 patients underwent robotic distal pancreatectomy and splenectomy. Median age was 68 (64 ± 13.3), 52% were women, and BMI was 28 (29 ± 6.1) kg/m². One patient was underweight (< 18.5 kg/m²), 31 had normal weight (18.5-24.9 kg/m²), 43 were overweight (25-29.9 kg/m²), and 47 were obese (≥ 30 kg/m²). BMI was inversely correlated with age (p = 0.05) but there was no correlation with sex (p = 0.72). There were no statistically significant relationships between BMI and operative duration (p = 0.36), estimated blood loss (p = 0.42), intraoperative complications (p = 0.64), and conversion to open approach (p = 0.74). Major morbidity (p = 0.47), clinically relevant postoperative pancreatic fistula (p = 0.45), length of stay (p = 0.71), lymph nodes harvested (p = 0.79), tumor size (p = 0.26), and 30-day mortality (p = 0.31) were related to BMI.</p><p><strong>Conclusion: </strong>BMI has no significant effect on patients undergoing robotic distal pancreatectomy and splenectomy. BMI greater than 30 kg/m² should not defer proceeding with robotic distal pancreatectomy with splenectomy. Limited empirical evidence exists in the literature regarding patients with a BMI greater than 30 kg/m², and thus any proposed operative intervention should invoke sufficient planning and preparation.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/3e/e2022.00046.PMC10256280.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9623738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gynecology Resident Experience with Office Hysteroscopy Training.","authors":"Lindsey Michel,&nbsp;Scott Chudnoff","doi":"10.4293/JSLS.2023.00009","DOIUrl":"10.4293/JSLS.2023.00009","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopy is the gold standard for evaluating intrauterine pathology. The majority of physicians currently perform hysteroscopy in the operating room. Lack of training has been cited as a barrier to performing office hysteroscopy; however, resident training in office hysteroscopy has not yet been evaluated.</p><p><strong>Methods: </strong>A prospective cross-sectional survey was performed. A validated 17 question survey tool was sent to 297 program directors of Accreditation Council for Graduate Medical Education accredited obstetrics and gynecology residency programs for distribution to their residents. The survey utilized a Likert scale to assess resident interest in learning office hysteroscopy, satisfaction in training, and perceived self-efficacy to perform office hysteroscopy independently upon graduation.</p><p><strong>Results: </strong>Two hundred and ninety-three obstetrics and gynecology residents responded. Of the respondents, 26.3% reported receiving training in office hysteroscopy. There was no statistically significant difference in training among postgraduate years or program regions. A greater proportion of male residents received training when compared to female residents (42.9% vs. 24.2%, <i>p </i>=<i> </i>0.019). Ninety-four percent of residents reported interest in learning office hysteroscopy. Satisfaction with hysteroscopy training in the operating room versus the office was 91.1% vs. 11.3% respectively. Of the fourth-year residents, 17.4% felt they could perform office hysteroscopy independently upon graduation and 14.5% reported feeling comfortable performing the procedure.</p><p><strong>Conclusions: </strong>Residency training in office hysteroscopy is lacking and residents are unprepared to perform the procedure after graduation. Enhanced residency training in office hysteroscopy would likely improve resident comfort and ability to perform office hysteroscopy in practice.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10371772/pdf/e2023.00009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Surgical Technical Skills and Clinical Outcomes: A Systematic Literature Review and Meta-Analysis.","authors":"Michael S Woods,&nbsp;Joshua N Liberman,&nbsp;Pinyao Rui,&nbsp;Emily Wiggins,&nbsp;Joan White,&nbsp;Bruce Ramshaw,&nbsp;Jonah J Stulberg","doi":"10.4293/JSLS.2022.00076","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00076","url":null,"abstract":"<p><strong>Background: </strong>A systematic literature review and meta-analysis was conducted to assess the association between intraoperative surgical skill and clinical outcomes.</p><p><strong>Methods: </strong>Peer-reviewed, original research articles published through August 31, 2021 were identified from PubMed and Embase. From the 1,513 potential articles, seven met eligibility requirements, reporting on 151 surgeons and 17,932 procedures. All included retrospective assessment of operative videos. Associations between surgical skill and outcomes were assessed by pooling odds ratios (OR) using random-effects models with the inverse variance method. Eligible studies included pancreaticoduodenectomy, gastric bypass, laparoscopic gastrectomy, prostatectomy, colorectal, and hemicolectomy procedures.</p><p><strong>Results: </strong>Meta-analytic pooling identified significant associations between the highest vs. lowest quartile of surgical skill and reoperation (OR: 0.44; 95% confidence interval [CI]: 0.23, 0.83), hemorrhage (OR: 0.66; 95% CI, 0.65, 0.68), obstruction (OR: 0.33; 95% CI, 0.30, 0.35), and any medical complication (OR: 0.23, 95% CI, 0.19, 0.27). Nonsignificant inverse associations were noted between skill and readmission, emergency department visit, mortality, leak, infection, venous thromboembolism, and cardiac and pulmonary complications.</p><p><strong>Conclusions: </strong>Overall, surgeon technical skill appears to predict clinical outcomes. However, there are surprisingly few articles that evaluate this association. The authors recommend a thoughtful approach for the development of a comprehensive surgical quality infrastructure that could significantly reduce the challenges identified by this study.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/ca/e2022.00076.PMC9913064.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Over-the-Scope-Clips Can Be Fired Safely Over a Guidewire: Proof of Concept in an Ex-Vivo Porcine Model.","authors":"Colin G DeLong,&nbsp;Alexander T Liu,&nbsp;Joshua S Winder,&nbsp;Eric M Pauli","doi":"10.4293/JSLS.2022.00069","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00069","url":null,"abstract":"<p><strong>Background and objectives: </strong>To assist in achieving optimal position when deploying over-the-scope (OTS)-clips, the concept of cannulating the defect with a guidewire, backloading the endoscope onto the wire, and firing the OTS-clip over the wire with subsequent wire removal has been demonstrated. The safety of this technique has not been evaluated.</p><p><strong>Methods: </strong>An ex-vivo porcine foregut model was utilized. Biopsy punches were used to create 3-mm diameter full-thickness gastrointestinal tract defects through which a guidewire was threaded. An endoscope was backloaded over the wire and OTS-clips (OVESCO, Tuebingen, Germany) were fired over the mucosal defect and wire. The wire was removed through the endoscope and the removal difficulty was graded using a Likert scale. This process was repeated for each unique combination of nine OTS-clip types, two wire types, four wire angles, and three tissue types. Statistical analysis included <i>t</i> test and ANOVA.</p><p><strong>Results: </strong>Two hundred sixteen OTS-clip firings with wire removal attempts were performed with the following Likert score breakdown: 1 - No difficulty (80.6%), 2 - mild difficulty (16.2%), 3 - moderate difficulty (2.3%), 4 - extreme difficulty (0.9%), and 5 - unable to remove (0%). Statistically significant differences were noted in removal difficulty between OTS-clip sizes (p < 0.05). No differences were identified between clip teeth types, wire types, tissue types, and wire angles (p > 0.05).</p><p><strong>Conclusion: </strong>In this ex-vivo model, the guidewire was successfully removed through the endoscope in all cases. This technique can be employed to facilitate OTS-clip closure of gastrointestinal tract defects, but further study is indicated before wide clinical implementation.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/d4/e2022.00069.PMC9913066.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9233571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Outcomes-Focused Analysis of Laparoscopic and Open Surgery in a Nigerian Hospital.","authors":"Katherine E Smiley,&nbsp;Funmilola Wuraola,&nbsp;Bolanle O Mojibola,&nbsp;Adewale Aderounmu,&nbsp;Raymond R Price,&nbsp;Adewale O Adisa","doi":"10.4293/JSLS.2022.00081","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00081","url":null,"abstract":"<p><strong>Background/objectives: </strong>The benefits of laparoscopic surgery such as swifter recovery and fewer wound complications, elude much of the developing world. Nigeria, a lower middle-income country, is the most populous sub-Saharan nation; an excellent model for studying the impact of laparoscopy in resource-constrained environments. The Department of Surgery at the Obafemi Awolowo University Teaching Hospital and the University of Utah's Center for Global Surgery present a study of laparoscopic surgery cases in sub-Saharan Africa.</p><p><strong>Methods: </strong>A retrospective chart review of 261 patients compared open and laparoscopic surgical outcomes for three common general surgery procedures: open versus laparoscopic cholecystectomy and appendectomy, and open laparotomy versus diagnostic laparoscopy for biopsy of intra-abdominal mass. The primary outcome was total length of stay (LOS); secondary outcomes included wound complications, analgesia and antibiotic use, time to oral intake, and patient charges.</p><p><strong>Results: </strong>Total LOS for laparoscopic surgery was significantly shorter compared to analogous open procedures (4.7 vs 11.5 days). Postoperative LOS was also shorter (2.6 vs 8.2 days). There were no differences in wound complications. Median charges to patients were lower for laparoscopic versus open procedures ($184 vs $217 USD).</p><p><strong>Conclusions: </strong>The introduction of laparoscopy allows for significantly shorter LOS and equivalent wound complications in the context of a sub-Saharan teaching hospital. Concerns regarding higher costs of care for patients do not appear to be a significant issue. Further work is needed to evaluate costs to the hospital system as a whole, including procurement and maintenance of laparoscopic equipment.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/10/e2022.00081.PMC9859654.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9286770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bowel Endometriosis Management by Colorectal Resection: Laparoscopic Surgical Technique & Outcome.","authors":"Dipak Limbachiya,&nbsp;Rajnish Tiwari,&nbsp;Rashmi Kumari,&nbsp;Manoj Agrawal","doi":"10.4293/JSLS.2022.00075","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00075","url":null,"abstract":"<p><strong>Background and objectives: </strong>Bowel deep infiltrating endometriosis (DIE) management by colorectal resection is a complex procedure. The purpose of the present study is to delineate a meticulous approach to the assessment of the patient, step-wise surgical technique, pre, and postoperative care, and its short-term and long-term outcomes.</p><p><strong>Methods: </strong>This is a single-center retrospective study done on patients of bowel DIE managed by colorectal resection between January 1, 2019 to June 30, 2021.</p><p><strong>Results: </strong>There was a significant improvement in the symptomatology of patients post-surgery. Our surgical technique is feasible with acceptable short-term and long-term outcomes.</p><p><strong>Conclusion: </strong>Bowel DIE management can be proficiently executed with a proper diagnostic approach, appropriate surgical expertise with exhaustive pelvic anatomy knowledge especially concerning autonomic nerve plexus.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/96/e2022.00075.PMC9859653.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9286767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Digital Three-Dimensional Reality Models on Patient Counseling for Renal Masses.","authors":"Michael McDonald,&nbsp;Joseph D Shirk","doi":"10.4293/JSLS.2022.00084","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00084","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patient counseling for treatment of renal masses is complex. It can be difficult for patients to understand their disease and make treatment decisions when being shown standard black-and-white, two-dimensional computed tomography scans or magnetic resonance images. In a telehealth setting, the patient-physician interaction can be even more challenging. We sought to determine the impact of using digital three-dimensional (3D) models during consultation visits for patients with renal masses.</p><p><strong>Methods: </strong>Forty-seven patients participating in a consultation visit for renal masses, both in-person and virtual, were shown a digital 3D model comprised of their kidney, renal mass, and key adjacent structures as part of their counseling. Patients then completed a five-question survey to assess the impact of the 3D model on their visit, with a sixth question administered to telehealth patients.</p><p><strong>Results: </strong>Thirty-five patients undergoing telehealth visits and 12 patients seen in-person were shown the digital 3D model and surveyed. Survey results were universally positive, with all Likert scores > 4.7 (1 - 5 scale). There were no differences between the telehealth and in-person groups. Patients noted the digital 3D model made telehealth visits as effective as in-person visits (average Likert score 4.94).</p><p><strong>Conclusion: </strong>Counseling for patients with renal masses can be augmented with patient-specific digital 3D models, leading to increased provider loyalty, lower levels of patient anxiety, and better understanding and shared decision making.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/e8/e2022.00084.PMC9913065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Cholangiography in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis.","authors":"Catherine Hall,&nbsp;Slesha Amatya,&nbsp;Ramesh Shanmugasundaram,&nbsp;Ngee-Soon Lau,&nbsp;Edwin Beenen,&nbsp;Sivakumar Gananadha","doi":"10.4293/JSLS.2022.00093","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00093","url":null,"abstract":"<p><strong>Background/objectives: </strong>Routine intraoperative cholangiography (IOC) for laparoscopic cholecystectomy (LC) remains controversial. The primary outcomes of this meta-analysis were detection rates of choledocholithiasis, bile duct injuries (BDI), and missed stones in LCs.</p><p><strong>Methods: </strong>A systematic literature search was conducted for the time period January 1, 1990 to July 31, 2022. Some studies reported LCs with conversion to open therefore subgroup analysis in BDI rates was performed for studies which included LCs with and without conversion to open. Studies including primary open cholecystectomies were excluded. I² statistics were used for heterogeneity analysis.</p><p><strong>Results: </strong>Fourteen studies involving 440659 patients were included. In studies comparing routine and selective IOC policies in LC, 61.1% of patients underwent routine IOC; 38.9% underwent selective IOC. In studies comparing IOC to no IOC in LC, 17.3% of patients had IOC; 82.7% did not. Between the selective and routine IOC groups there was no difference in choledocholithiasis detection rate (odds ratio [OR] = 1.33, p = 0.20, 95% confidence interval [CI] = 0.86 - 2.04), no difference in the rate of missed stones (OR = 1.59, p = 0.58; 95% CI = 0.31 - 8.29), and no difference in BDI rates in selective compared to routine IOC (OR = 0.92, p = 0.92; 95% CI = 0.20 - 4.22). There was no difference in the BDI detection rates in LC with and without IOC (OR = 1.12, p = 0.77; 95% CI = 0.52 - 2.38).</p><p><strong>Conclusion: </strong>This is the largest meta-analysis on this topic to date. There was no statistically significant difference in choledocholithiasis detection, missed stones, or BDI rates in the analyzed groups.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/2f/e2022.00093.PMC10009875.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9287259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Assisted Transplant Nephrectomy: Case Series and Training Model for Improving Adoption.","authors":"Michael McCabe,&nbsp;Thomas Osinski,&nbsp;Randeep Kashyap,&nbsp;Jeremy Taylor,&nbsp;Nathan Schuler,&nbsp;Lauren Shepard,&nbsp;Ahmed Ghazi,&nbsp;Katie Helbig,&nbsp;M Katherine Dokus,&nbsp;Amit Nair,&nbsp;Karen Pineda-Solis,&nbsp;Mark Orloff,&nbsp;Guan Wu","doi":"10.4293/JSLS.2022.00079","DOIUrl":"https://doi.org/10.4293/JSLS.2022.00079","url":null,"abstract":"<p><strong>Introduction: </strong>Open transplant nephrectomy for failed renal allograft is an invasive procedure associated with significant perioperative morbidity and mortality. Minimally invasive surgical approaches have improved a variety of patient outcomes for many surgeries. Thus, robotic assisted transplant nephrectomy (RATN) potentially offers significant patient benefit. Although previously reported, there remains a paucity of data on RATN outcomes and techniques.</p><p><strong>Methods: </strong>Four perfused, high-fidelity hydrogel models were created using previously described techniques and used for simulated RATN. Subsequently performed institutional cases were included for analysis. Intra- and postoperative variables along with patient demographics were retrospectively obtained through parsing of patient records.</p><p><strong>Results: </strong>Simulated nephrectomy time was 67.33 minutes (35.75 - 98.91). Five patients underwent RATN. There were four male and one female patients. The average age was 47 years. The most common indication was abdominal pain secondary to rejection (3/5). Mean blood loss was 188 mL; mean operative time was 243 minutes, and mean length of stay was 4.5 days. Intraoperatively there were two incidences of small cystotomies. One patient was readmitted within 30 days for intraabdominal abscess.</p><p><strong>Conclusion: </strong>This study adds to the growing literature around RATN, demonstrating the feasibility of the technique and reporting good outcomes for this cohort.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913067/pdf/e2022.00079.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10778630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}