Journal of Robotic Surgery最新文献_第8页

Robot-assisted microsurgery: a single-center experience of 100 cases. 机器人辅助显微外科手术：100例单中心经验。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-17 DOI: 10.1007/s11701-024-02175-3

F Struebing, A Boecker, F Vollbach, J Weigel, U Kneser, A K Bigdeli, E Gazyakan

{"title":"Robot-assisted microsurgery: a single-center experience of 100 cases.","authors":"F Struebing, A Boecker, F Vollbach, J Weigel, U Kneser, A K Bigdeli, E Gazyakan","doi":"10.1007/s11701-024-02175-3","DOIUrl":"https://doi.org/10.1007/s11701-024-02175-3","url":null,"abstract":"The adoption of robot-assisted microsurgery (RAMS) is a cutting-edge advancement in the realm of microsurgery. The Symani Surgical System is CE approved and has recently gained FDA approval. It provides tremor elimination, motion scaling and improved ergonomics. This study reports on the first 100 consecutive cases of RAMS at a high-volume academic center, representing the largest series to date, and assesses its clinical application and efficacy. A prospective database captured all RAMS cases at a single institution between February 2023 and April 2024. Parameters recorded included patient demographics, surgical details, and outcomes. Surgeons completed a comprehensive 12 h training program to ensure adept use of the system. One-hundred patients with a mean age of 54 yrs were identified, predominantly male (66%). RAMS was performed in a wide range of procedures, notably free flaps (73%), nerve surgery (20%), and lymphovenous anastomoses (LVA) (6%). 159 anastomoses and coaptations were performed. Major complications occurred in 12 cases (12%). There were two complete free flap losses (2.7% of free flaps) and one partial free flap loss (1.4%). LVAs had significantly longer times per stitch than other types of anastomoses (p < 0.01). RAMS presents a viable alternative to traditional microsurgery with a commendable safety profile, marked by a 3% conversion rate to conventional techniques and complication rates that align with current literature. While challenges such as longer anastomosis times and higher costs exist, the results affirm the feasibility of RAMS in a high-volume microsurgical center.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"28"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Virtual reality simulations in robotic surgery training: a systematic review and meta-analysis. 机器人手术训练中的虚拟现实模拟：系统回顾和荟萃分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-17 DOI: 10.1007/s11701-024-02187-z

Kazuho Kawashima, Francis Nader, Justin W Collins, Ali Esmaeili

{"title":"Virtual reality simulations in robotic surgery training: a systematic review and meta-analysis.","authors":"Kazuho Kawashima, Francis Nader, Justin W Collins, Ali Esmaeili","doi":"10.1007/s11701-024-02187-z","DOIUrl":"10.1007/s11701-024-02187-z","url":null,"abstract":"Objective: To compare VR simulations with other training methods regarding improvements in objective assessment scores and task completion times.Method: A database search was conducted on 20 May 2024 across Central, MEDLINE, EMBASE, Web of Science, and Scopus. Included were randomised controlled trials comparing VR simulations to other training methods, assessing objective scores and task times. The Risk of Bias-2 tool was used for bias assessment.Results: Eighteen studies were included. VR significantly improved objective scores (n = 339, SMD 1.04, 95% CI 0.40-1.69, P = 0.002) and reduced task completion times (n = 357, SMD of -1.08, 95% CI of as - 2.05 to - 0.12, P = 0.03) compared to no additional training. VR was as effective as dry lab training for improving scores (n = 213, SMD -0.47, 95% CI - 1.34 to 0.41, P = 0.30) and task times (n = 98, SMD - 0.37, 95% CI - 1.51 to 0.78, P = 0.53). However, one study found wet lab training significantly reduced task times compared to VR (n = 20, SMD of 1.7, 95% CI of 0.65-2.76, P = 0.002). No significant differences were found when VR alone was compared to VR with expert advice.Conclusion: VR is more effective than no additional training and is as effective as dry lab training in robotic skill acquisitions. Therefore, VR is effective in enhancing robotic surgery skills and warrants an expanded role in surgical training programmes.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"29"},"PeriodicalIF":2.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tampa difficulty score: a scoring system for difficulty of robotic pancreaticoduodenectomy. 坦帕难度评分：机器人胰十二指肠切除术难度评分系统。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-16 DOI: 10.1007/s11701-024-02189-x

Sharona B Ross, Michelle M Dugan, Iswanto Sucandy, Maria Christodoulou, Tara Menon Pattilachan, Sneha Saravanan, Shlomi Rayman, Harel Jacoby, Alexander Rosemurgy

{"title":"Tampa difficulty score: a scoring system for difficulty of robotic pancreaticoduodenectomy.","authors":"Sharona B Ross, Michelle M Dugan, Iswanto Sucandy, Maria Christodoulou, Tara Menon Pattilachan, Sneha Saravanan, Shlomi Rayman, Harel Jacoby, Alexander Rosemurgy","doi":"10.1007/s11701-024-02189-x","DOIUrl":"https://doi.org/10.1007/s11701-024-02189-x","url":null,"abstract":"Robotic platforms are increasingly utilized in surgery, offering unique technical advantages, though there is a scarcity of difficulty scoring systems (DSS) for these procedures. DSS aids in understanding operative complexities and enhancing preoperative planning. With IRB approval, data were collected on 200 consecutive adult patients who underwent robotic pancreaticoduodenectomy at a high-volume institution from 2019 to 2022. Linear regression was employed on clinical variables to analyze operative time and estimated blood loss as markers of surgical complexity. Weighted scoring system was developed using significant linear coefficient values, and an ANOVA analysis created the difficulty-level grouping system. Significant variables affecting operative time and/or EBL included: history of alcoholism, preoperative endoscopic intervention, tumor size, nodal disease on preoperative imaging, pancreatic duct dilation. These factors created the DSS ranging from 0 to 33. Group 1 (0-8, n = 9), Group 2 (9-20, n = 145), Group 3 (21-26, n = 37), and Group 4 (27-33, n = 9) showed significant differences in age, history of alcoholism, preoperative jaundice, tumor size, nodal disease, and operative metrics. Our novel DSS for robotic pancreaticoduodenectomy effectively predicts intraoperative challenges and aids in preoperative planning. Future steps include validating the system internally and externally.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"27"},"PeriodicalIF":2.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Robotic trans-abdominal retromuscular hernia repair for medium-sized midline hernias: midterm outcomes and surgical site occurrence (SSO) analysis in 120 patients. 机器人经腹肌肉后疝修复中型中线疝：120例患者的中期结果和手术部位发生（SSO）分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-16 DOI: 10.1007/s11701-024-02184-2

Luca Ferraro, Giampaolo Formisano, Adelona Salaj, Simona Giuratrabocchetta, Wanda Petz, Francesco Toti, Paolo Pietro Bianchi

{"title":"Robotic trans-abdominal retromuscular hernia repair for medium-sized midline hernias: midterm outcomes and surgical site occurrence (SSO) analysis in 120 patients.","authors":"Luca Ferraro, Giampaolo Formisano, Adelona Salaj, Simona Giuratrabocchetta, Wanda Petz, Francesco Toti, Paolo Pietro Bianchi","doi":"10.1007/s11701-024-02184-2","DOIUrl":"10.1007/s11701-024-02184-2","url":null,"abstract":"Robotic surgery has become a popular method for treating ventral hernias due to its promising peri-operative outcomes. However, the long-term results of this approach are still unclear. In this study, 120 patients underwent robotic trans-abdominal retromuscular mesh placement (r-TARM) with a mean follow-up period of 18.1 months. This study aims to evaluate the feasibility of the robotic approach reporting peri-operative and midterm outcomes. Additionally, we examined possible risk factors that may contribute to the development of surgical site occurrences (SSOs). Between January 2021 and September 2023, 120 patients underwent r-TARM for midline hernias, including 39 primary, 71 incisional, and 10 recurrent cases. A retrospective analysis was performed. A logistic regression model was used to identify possible patient risk factors for SSO development. The average operative time was 153.5 ± 47.2 min, and there were no open or laparoscopic approach conversions. The mean length of hospital stay was 1.9 ± 0.9 days. We observed SSO in 16 patients (13.3%). One patient (0.8%) required angiographic embolization due to post-operative parietal bleeding. The mean follow-up time was 18.1 ± 7.8 months, and we observed hernia recurrence in only one (0.8%) patient. The logistic regression model did not identify any possible risk factors for SSO. r-TARM is a safe and effective method for treating ventral hernias not requiring posterior component separation. Our results indicate that patient and hernia characteristics were not predictive of SSO. Midterm outcomes are encouraging, though longer follow-up is needed.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"26"},"PeriodicalIF":2.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Very long-term outcomes of robotic mesh sacrocolpopexy for pelvic organ prolapse repair. 用于盆腔器官脱垂修复的机器人网片骶骨整形术的长期疗效。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-13 DOI: 10.1007/s11701-024-02185-1

Sonia Guérin, Evan Suzman, Feras Alhalabi, Kevin Lutz, Philippe Zimmern

{"title":"Very long-term outcomes of robotic mesh sacrocolpopexy for pelvic organ prolapse repair.","authors":"Sonia Guérin, Evan Suzman, Feras Alhalabi, Kevin Lutz, Philippe Zimmern","doi":"10.1007/s11701-024-02185-1","DOIUrl":"https://doi.org/10.1007/s11701-024-02185-1","url":null,"abstract":"To assess the very long-term functional outcomes and complications of robot-assisted sacrocolpopexy (RASC) at our institution where this robotic technology for pelvic organ prolapse (POP) repair has been available since 2006. A retrospective review of a cohort of women who underwent a RASC was performed by an investigator not involved in the clinical care of these patients. Women with no electronic medical record follow-up in the last 2 years were contacted by telephone. The primary outcome was RASC success defined as (1) no self-report of vaginal bulge, (2) no prolapse beyond the hymen (POP-Q > 0), and (3) no retreatment for prolapse (surgery, pessary). Postoperative symptomatic urinary incontinence (UI), anorectal dysfunction, dyspareunia and any late complication were secondary outcomes. Of 100 women who underwent RASC between 2007 and 2018, 79 patients with a median age of 66 years (IQR 58-71) were included. Median follow-up was 69 months (28-117), with a last visit more than 5 years postoperatively in 48 patients and more than 10 years in 19 patients. A total of 59 patients (75%) met the definition of success. A bothersome vaginal bulge was reported in 18 patients (23%), prolapse beyond the hymen was observed in 12 patients (16%), and further surgery for POP was performed in 9 patients (12%). Twenty-three patients reported postoperative UI (32%) and 21 reported postoperative anorectal dysfunction (39%). RASC provided good long-term results with an unpredictable risk of recurrence independent of the timeline.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"25"},"PeriodicalIF":2.2,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review and meta-analysis comparing the short-term efficacy of the KangDuo surgical robot with the da Vinci robotic system in radical prostatectomy. 一项比较康多手术机器人与达芬奇机器人系统在根治性前列腺切除术中的短期疗效的系统综述和荟萃分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-12 DOI: 10.1007/s11701-024-02188-y

Zhi-Kai Dai, Jun-Min Wang, Qi-Min Zhang, Ping Liang, Ting-Ting Zhou, Tai-Ping Leng, Liang Wang, Yao-Yu Zhang, Jian-Wei Zhang, You-Guang Zhao, Sha-Dan Li

{"title":"A systematic review and meta-analysis comparing the short-term efficacy of the KangDuo surgical robot with the da Vinci robotic system in radical prostatectomy.","authors":"Zhi-Kai Dai, Jun-Min Wang, Qi-Min Zhang, Ping Liang, Ting-Ting Zhou, Tai-Ping Leng, Liang Wang, Yao-Yu Zhang, Jian-Wei Zhang, You-Guang Zhao, Sha-Dan Li","doi":"10.1007/s11701-024-02188-y","DOIUrl":"10.1007/s11701-024-02188-y","url":null,"abstract":"To determine the efficacy and adverse consequences between KangDuo and Da Vincii surgical robotic systems in facilitating radical prostatectomy. All the papers, that were included in the current analysis, were identified with PubMed, Embase, and the Cochrane Library through October 1, 2024. To make the comparison easier, only the English-language articles have been used for the analysis and only those focusing on comparing the use of the KangDuo and da Vinci robotic systems in radical prostatectomy were used. There are several avenues of bias when considering articles to include, when selecting the articles for this study to adopt the RCTs and cohort studies and excluding the others, the bias selection targeted was minimal. For the systematic review, 1 cohort study was found as well as 2 RCTs were found that involved 150 adult patients assigned to undergo urological surgery. Of those, 76 patients operated by the Kang Duo robotic system, and the remaining 74 patients operated by the Da Vinci system. In conclusion from this study, it was noted that though there was an increase in the operative time used in the KangDuo system, the estimated blood loss, number of days needed to stay in hospital, and the incidences of postoperative complications were comparable to the other system. Compared to the da Vinci robotic system, the KangDuo robotic system, while associated with longer operative times for radical prostatectomy, showed no significant difference in perioperative or short-term outcomes. In addition, the KangDuo system is more cost-effective and easier to implement in developing countries or other regions. However, further high-quality studies are needed to confirm these findings.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"21"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perceptions and attitudes regarding robotic total hip arthroplasty: a patient stakeholder survey. 对机器人全髋关节置换术的看法和态度：一项患者利益相关者调查。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-12 DOI: 10.1007/s11701-024-02172-6

Hassaan Abdel Khalik, Asher Selznick, Kamal Bali, Yasaman Amini, Isabelle Tate, Thomas J Wood

{"title":"Perceptions and attitudes regarding robotic total hip arthroplasty: a patient stakeholder survey.","authors":"Hassaan Abdel Khalik, Asher Selznick, Kamal Bali, Yasaman Amini, Isabelle Tate, Thomas J Wood","doi":"10.1007/s11701-024-02172-6","DOIUrl":"https://doi.org/10.1007/s11701-024-02172-6","url":null,"abstract":"To describe the attitudes and preferences of patients pertaining to robotic-assisted total hip arthroplasty (RA-THA) with the long-term objective of designing a prospective randomized-controlled trial (RCT) to evaluate the efficacy of RA-THA compared to conventional technique. A cross-sectional survey of patients attending an outpatient high-volume academic arthroplasty clinic chosen was administered from December 2023 to May 2024. The survey comprised 31 items including patient demographic, patient reported factors of significance and perceptions surrounding RA-THA. Ninety-seven patients completed the survey with a mean age of 67.5 ± 9.1 years and with 63% of patients being female. The majority of respondents were not at all familiar with RA-THA (69%). Common perceptions of RA-THA compared to conventional technique included a smaller incision (41%), lower chance of developing infection (47%), shorter length of surgery (41%), less blood loss (41%), lower cost (22%), shorter length of stay (30%), more precise implant positioning (46.8%), lower post-operative pain (29%), and lower post-operative complications (36%). Very important outcomes to be assessed in future investigations included post-operative range of motion (91%), implant longevity (91%), dislocation risk (90%), post-operative pain (89%), and infection risk (87%). Patient familiarity with robotic-assisted total hip arthroplasty is low. Patient perceptions regarding RA-THA compared to conventional technique are favorable, despite limited evidence to date. Important factors to be assessed in future RCTs include range of motion, implant longevity, dislocation risk, and infection risk. Findings of this study can inform a clinically relevant RCT assessing RA-THA compared to conventional technique.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"22"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Complete hepatic caudate lobe resection: is robotic approach safe? Report from experienced centers. 完全肝尾状叶切除术：机器人入路安全吗？由经验丰富的中心报告。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-12 DOI: 10.1007/s11701-024-02162-8

Greta Donisi, Emanuele Doria, Gemma Bosch, Fernando Burdio, Celine De Meyere, Mathieu D'Hondt, Fabrizio Di Benedetto, Rosalinda Filippo, Annarita Libia, Victor Lopez-Lopez, Paolo Magistri, Riccardo Memeo, Patricia Sanchez-Velazquez, Marcello Giuseppe Spampinato, Ricardo Robles-Campos, Iswanto Sucandy, Benedetto Ielpo

{"title":"Complete hepatic caudate lobe resection: is robotic approach safe? Report from experienced centers.","authors":"Greta Donisi, Emanuele Doria, Gemma Bosch, Fernando Burdio, Celine De Meyere, Mathieu D'Hondt, Fabrizio Di Benedetto, Rosalinda Filippo, Annarita Libia, Victor Lopez-Lopez, Paolo Magistri, Riccardo Memeo, Patricia Sanchez-Velazquez, Marcello Giuseppe Spampinato, Ricardo Robles-Campos, Iswanto Sucandy, Benedetto Ielpo","doi":"10.1007/s11701-024-02162-8","DOIUrl":"10.1007/s11701-024-02162-8","url":null,"abstract":"Minimally invasive liver surgery has become widely accepted as a safe and effective approach, especially with experienced surgeons. Robotic hepatectomy may offer significant benefits in challenging procedures like caudate lobe resection. The caudate lobe's intricate anatomy and deep-seated location make its resection particularly challenging, with limited reports on minimally invasive techniques. The aim of this study was to assess the feasibility and safety of robotic isolated complete caudectomy and to provide a detailed description of the different technical approaches available. This retrospective multicenter study was conducted across eight experienced hepatobiliary robotic surgery centers between June 2020 and March 2024. All patients who underwent elective RICC during this period were included. Data were prospectively collected and retrospectively analyzed, focusing on demographics, intraoperative variables, postoperative outcomes, and histopathological results. The primary outcome was the feasibility and safety of the robotic approach. The study included 42 patients. The median (IQR) operative time was 180 (125-245) min, with a median estimated blood loss of 30 (0-100) ml. There were no conversions to open surgery and only one severe complication (Clavien-Dindo ≥ 3) occurred. No postoperative mortality was observed, and all resections for malignant lesions achieved R0 margins. The median time to flatus was 1 (1-1) day, time to solid diet was 1 (1-2) days, and the median length of stay was 3 (2-4) days. RICC is a feasible and safe procedure, demonstrating significant benefits in operative efficiency and patient recovery. However, further research with larger, prospective multicenter studies is necessary to confirm these findings and assess long-term outcomes.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"23"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Understanding fundamental differences in symptomatic outcomes of hiatal versus paraoesophageal hernia robotic repairs. 了解裂孔疝与食管旁疝机器人修复的症状结果的根本差异。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-12 DOI: 10.1007/s11701-024-02182-4

Arham Aslam, Michal Hubka, Joel Sternbach, Madhan Kuppusamy

{"title":"Understanding fundamental differences in symptomatic outcomes of hiatal versus paraoesophageal hernia robotic repairs.","authors":"Arham Aslam, Michal Hubka, Joel Sternbach, Madhan Kuppusamy","doi":"10.1007/s11701-024-02182-4","DOIUrl":"https://doi.org/10.1007/s11701-024-02182-4","url":null,"abstract":"Hiatal hernia (HH), or type I paraoesophageal hernias (PEH), can commonly be grouped along with types II-IV PEHs. The fundamental operation performed for repair is similar for all types. We question whether the clinical outcomes following surgical repair differ. The objective of this study is to determine the differences in clinical outcomes when comparing robotic-assisted surgical repair of HH versus types II-IV PEHs. This is a retrospective study analyzing 602 consecutive patients that underwent robotic-assisted repair of a PEH between August 2018 and June 2024. Data were retrieved from an IRB-approved database (IRB21-014). Tertiary referral center. Eligibility criteria included patients with objective findings of a PEH on diagnostic testing. 184 patients were excluded due to: emergent operation, repeat operations, conversion to open operation, patients pending follow-up, and patients lost to follow up. Patient demographics were consistent with a population-based sample. All patients underwent robotic-assisted laparoscopic PEH repair with a fundoplication using the Da Vinci Xi robotic system (Intuitive Surgical, Sunnyvale, CA). No mesh implantation was used. The primary study outcome was post-operative symptomatic improvement when comparing HH repairs versus types II-IV PEH repairs. Secondary outcomes included other perioperative outcomes. The hypothesis was formulated before data collection started. Patients in the HH cohort showed significant reflux symptom improvement postoperatively (98% vs 12.2%, p < 0.01). PEH patients also showed similar improvements in reflux symptoms (84.8% vs 25%, p < 0.01). Symptomatic improvement of dysphagia was found to be significant only in the PEH cohort (54% vs 17.8%, p < 0.01). HHs and PEHs are two distinct entities that present with different symptoms; however, the fundamental operation is similar. Symptomatic outcomes differ between the two patient populations, even with the same surgical management.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"24"},"PeriodicalIF":2.2,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An institutional analysis of hospital readmission following a robotic pancreaticoduodenectomy. 机器人胰十二指肠切除术后再入院的机构分析。

IF 2.2 3区医学

Journal of Robotic Surgery Pub Date : 2024-12-11 DOI: 10.1007/s11701-024-02186-0

Denis Gratsianskiy, Dharti Patel, Iswanto Sucandy, Tara M Pattilachan, Maria Christodoulou, Alexander Rosemurgy, Sharona B Ross

{"title":"An institutional analysis of hospital readmission following a robotic pancreaticoduodenectomy.","authors":"Denis Gratsianskiy, Dharti Patel, Iswanto Sucandy, Tara M Pattilachan, Maria Christodoulou, Alexander Rosemurgy, Sharona B Ross","doi":"10.1007/s11701-024-02186-0","DOIUrl":"https://doi.org/10.1007/s11701-024-02186-0","url":null,"abstract":"This study sought to identify the primary reasons for hospital readmissions and examine patient outcomes and associated costs following readmission after robotic pancreaticoduodenectomy. We conducted a retrospective analysis of 435 patients who underwent robotic pancreaticoduodenectomy between 2012 and 2024. Readmitted patients within 30 days post-surgery were compared to non-readmitted patients using Student's t-test and Fisher's exact test. Data are presented as median (mean ± SD). In the study cohort, 86 patients (20%) were readmitted within 30 days after surgery. No significant differences were found in patient demographics or outcomes. The most common causes for readmission included insufficient patient education (n = 18), infection (n = 16), and gastrointestinal bleeding (n = 13). The readmitted cohort had significantly higher costs at $40,452 (± 30,724) compared to $31,438 (± 31,546.2) for non-readmitted patients (p < 0.001). Median survival was similar between the two groups (36 vs. 34 months, p = 0.88). Although some readmissions are inevitable, this study provides compelling evidence that inadequate patient education is a primary contributor to increased healthcare costs. The lack of sufficient education appears to have no mitigating effect on patient outcomes. Implementing a proactive, thorough patient education approach, combined with improved emergency department awareness, presents a promising strategy for reducing costly readmissions.","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"20"},"PeriodicalIF":2.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0