Anouk Verhellen, Shirley A. Elprama, Thierry Scheerlinck, Fiene Van Aerschot, Johnny Duerinck, Frederick Van Gestel, Taylor Frantz, Bart Jansen, Jef Vandemeulebroucke, An Jacobs
{"title":"Exploring technology acceptance of head-mounted device-based augmented reality surgical navigation in orthopaedic surgery","authors":"Anouk Verhellen, Shirley A. Elprama, Thierry Scheerlinck, Fiene Van Aerschot, Johnny Duerinck, Frederick Van Gestel, Taylor Frantz, Bart Jansen, Jef Vandemeulebroucke, An Jacobs","doi":"10.1002/rcs.2585","DOIUrl":"10.1002/rcs.2585","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study used the Unified Theory of Acceptance and Use of Technology (UTAUT) to investigate the acceptance of HMD-based AR surgical navigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An experiment was conducted in which participants drilled 12 predefined holes using freehand drilling, proprioceptive control, and AR assistance. Technology acceptance was assessed through a survey and non-participant observations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants' intention to use AR correlated (<i>p</i> < 0.05) with social influence (Spearman's rho (rs) = 0.599), perceived performance improvement (rs = 0.592) and attitude towards AR (rs = 0.542).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While most participants acknowledged the potential of AR, they also highlighted persistent barriers to adoption, such as issues related to user-friendliness, time efficiency and device discomfort. To overcome these challenges, future AR surgical navigation systems should focus on enhancing surgical performance while minimising disruptions to workflows and operating times. Engaging orthopaedic surgeons in the development process can facilitate the creation of tailored solutions and accelerate adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223089","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}
Pietro Anoldo, Michele Manigrasso, Anna D’Amore, Mario Musella, Giovanni Domenico De Palma, Marco Milone
{"title":"Dual docking technique for robotic repair of simultaneous inguinal and umbilical hernia: A preliminary single center experience","authors":"Pietro Anoldo, Michele Manigrasso, Anna D’Amore, Mario Musella, Giovanni Domenico De Palma, Marco Milone","doi":"10.1002/rcs.2586","DOIUrl":"10.1002/rcs.2586","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to assess clinical results in terms of intraoperative outcomes, recovery and recurrence of our robotic technique for the treatment of patients affected by simultaneous inguinal and umbilical hernia, providing technical details to facilitate multiquadrant surgery in robotic hernia repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from patients affected by simultaneous primary inguinal and umbilical hernia who underwent robotic repair with our dual docking technique was retrospectively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were included. No intraoperative complications occurred. All patients achieved complete mobilisation within 7 h. The mean length of hospital stay was 21.6 h, with five patients discharged on the same day of surgery. There was no major complication and no recurrence within the median follow-up period of 673 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This surgical technique shows optimal postoperative outcomes, such as early mobilisation and short length of stay. Our study provides an aid to surgeons performing multiquadrant robotic surgery for the treatment of abdominal hernias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oncological and functional outcome of robotic-assisted radical cystectomy with total intracorporeal stentless J-pouch neobladder reconstruction","authors":"Hao Xiang Chen, Chi-Ping Huang","doi":"10.1002/rcs.2583","DOIUrl":"10.1002/rcs.2583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted radical cystectomy (RARC) with neobladder reconstruction has gained popularity in recent years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of 17 consecutive patients who underwent RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent by a single experienced surgeon to evaluate perioperative, oncological and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up duration was 32.8 months (range: 17.4–59.0 months), and the 2-year disease-free survival rate was 88.2%. Five out of 12 patients were totally continent, and none required more than one pad per day. The overall complication rate was 41.2%, and hydronephrosis was the most common adverse event. The renal function remained stable, and no long-term renal function impairment was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study suggests that RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent is a safe and feasible option for the treatment of muscle-invasive bladder cancer, with good oncological and functional outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175433","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}
Xiaoqiang Shi, Hainan Guo, Chao Zhu, Guanglin Qiu, Ting Liang, Jie Lian, Yanfei Ma, Shufeng Wang, Xuqi Li
{"title":"Mixed reality in primary retroperitoneal tumour surgery: Evaluation of preoperative and intraoperative application value","authors":"Xiaoqiang Shi, Hainan Guo, Chao Zhu, Guanglin Qiu, Ting Liang, Jie Lian, Yanfei Ma, Shufeng Wang, Xuqi Li","doi":"10.1002/rcs.2584","DOIUrl":"10.1002/rcs.2584","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170755","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}
Davor Stamenovic, P. Schiller, I. Karampinis, C. Galata, E. D. Roessner
{"title":"Uniportal robotic assisted surgery for anatomical lung resection—First German experience","authors":"Davor Stamenovic, P. Schiller, I. Karampinis, C. Galata, E. D. Roessner","doi":"10.1002/rcs.2580","DOIUrl":"10.1002/rcs.2580","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uniportal robotic-assisted thoracic surgery (uRATS) has emerged as a promising technique with potential advantages over multiportal approaches. This study aims to evaluate our initial outcomes of uRATS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Five patients underwent anatomic lung resections with systematic nodal dissection through a uniportal robotic approach by one surgeon. The results were compared to the results of the first five uniportal video-assisted thoracic surgery (uVATS) anatomical resections performed by the same surgeon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No adverse events occurred during the uRATS-procedures. Comparable surgical outcomes were observed between uRATS and uVATS, including hospital stays, complication rates, and blood loss. The average procedural time was slightly but non-significantly longer in the uRATS-group. Average pain-scores were lower in the uRATS group. One patient in each group experienced major postoperative complications, with one case of in-hospital mortality in the uRATS-group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The outcomes of uRATS/uVATS were comparable, highlighting the potential and the feasibility of this technique. Prospective studies comparing the learning curves, complication rate and hospital-stay are required in order to justify the superiority of robotics over uVATS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian B. Ong, Graham B. J. Buchan, Alexander J. Acuña, Christian J. Hecht, Yasuhiro Homma, Roshan P. Shah, Atul F. Kamath
{"title":"Cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty system: A Markov analysis","authors":"Christian B. Ong, Graham B. J. Buchan, Alexander J. Acuña, Christian J. Hecht, Yasuhiro Homma, Roshan P. Shah, Atul F. Kamath","doi":"10.1002/rcs.2582","DOIUrl":"10.1002/rcs.2582","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to assess the cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty (RA-THA) system compared to a manual unassisted technique (mTHA) up to 5 years post-operatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Markov model was constructed to compare the cost-effectiveness of RA-THA and mTHA. Cost-effectiveness was defined as an Incremental Cost-Effectiveness Ratio (ICER) <$50 000 or $100 000 per Quality Adjusted Life Year (QALY).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RA-THA patients experienced lower costs compared to mTHA patients at 1 year ($20 865.12 ± 9897.52 vs. $21 660.86 ± 9909.15; <i>p</i> < 0.001) and 5 years ($23 124.57 ± 10 045.48 vs. $25 756.42 ± 10 091.84; <i>p</i> < 0.001) post-operatively. RA-THA patients also accrued more QALYs (1-year: 0.901 ± 0.117 vs. 0.888 ± 0.114; <i>p</i> < 0.001; 5-years: 4.455 ± 0.563 vs. 4.384 ± 0.537 <i>p</i> < 0.001). Overall, RA-THA was cost-effective (1-year ICER: $−61 210.77; 5-year ICER: $−37 068.31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The novel, fluoroscopy-based RA-THA system demonstrated cost-effectiveness when compared to manual unassisted THA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165096","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}
Meltem Kurt Pehlivanoğlu, Eren Cem Ay, Ayşe Gül Eker, Nur Banu Albayrak, Nevcihan Duru, Ahmet Serdar Mutluer, Tolga Turan Dündar, İhsan Doğan
{"title":"A new surgical path planning framework for neurosurgery","authors":"Meltem Kurt Pehlivanoğlu, Eren Cem Ay, Ayşe Gül Eker, Nur Banu Albayrak, Nevcihan Duru, Ahmet Serdar Mutluer, Tolga Turan Dündar, İhsan Doğan","doi":"10.1002/rcs.2576","DOIUrl":"10.1002/rcs.2576","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite using a variety of path-finding algorithms that use tracts, the most significant advancement in this study is considering the values of all brain areas by doing atlas-based segmentation for a more precise search. Our motivation comes from the literature’s shortcomings in designing and implementing path-planning methods. Since planning paths with curvatures is a complex problem that requires considering many surgical and physiological constraints, most path-planning strategies focus on straight paths. There is also a lack of studies that focus on the complete structure of the brain with the tracks, veins, and segmented areas. Instrument dependence is another inadequacy of the methods proposed in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study is to design a new surgical path planning framework that helps to plan the surgical path independently of the instrument, considers the entire structure of the brain, and allows curvilinear surgical paths. Thus, neurosurgeons can generate patient-specific possible optimal surgical pathways before the neurosurgical procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>The proposed framework includes different path-finding algorithms (Dijkstra, A*, and their aggressive variants) that find optimal paths by taking the risk scores (surgeons assessed all the segmented regions, considering the extent of damage. In this evaluation, scores ranged from “0 to 10,” with the most critical areas receiving a score of “10,” while the least possible affected areas were assigned a score of \"0\") for sensitive brain areas into consideration. For the tract image processing the framework includes fractional anisotropy (FA), relative anisotropy (RA), spherical measure (SM), and linear measure (LM) methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This is the first paper to handle tracts and atlas-based segmentation of the human brain altogether under a framework for surgical path planning. The framework has a dynamic structure that gives the flexibility to add different path-finding algorithms and generate different widths of surgical pathways. Moreover, surgeons can update the score table to guarantee minimally invasive surgery. The output file format of all the extracted surgical paths is NRRD, so it can be easily visualised, analysed, or processed over the third part software tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 ","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kush Savsani, Katrina Hansen-Artache, Anjelica Alfonso, Seung Lee, Bryce Hatfield, Daisuke Imai, Aamir Khan, Amit Sharma, Irfan Saeed, Vinay Kumaran, Adrian Cotterell, Marlon Levy, David A. Bruno
{"title":"Robotic hepatectomy and cholecystectomy in the management of intraductal papillary mucinous neoplasm of the biliary tract: A case report and literature review","authors":"Kush Savsani, Katrina Hansen-Artache, Anjelica Alfonso, Seung Lee, Bryce Hatfield, Daisuke Imai, Aamir Khan, Amit Sharma, Irfan Saeed, Vinay Kumaran, Adrian Cotterell, Marlon Levy, David A. Bruno","doi":"10.1002/rcs.2575","DOIUrl":"10.1002/rcs.2575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the Western Hemisphere, Intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B) is a rare lesion with uncertain aetiology. This report outlines a scarcely documented instance of IPMN-B treated using robotic hepatectomy and cholecystectomy supplemented with intraoperative imagery aimed at informing future robotic procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A healthy person with acute cholangitis symptoms underwent diagnostic imaging followed by successful robotic hepatectomy and cholecystectomy. Pathological examination confirmed IPMN-B.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient was consulted regarding the proposed procedure of robotic left hepatectomy, cholecystectomy, and potential hepaticojejunostomy, to which she provided consent. Subsequent surgical intervention resulted in clear margins for malignancy, and the patient recovered without complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This case emphasises the importance of early diagnosis and intervention in managing IPMN. The use of a robotic approach, specifically through robotic left hepatectomy combined with cholecystectomy, offers minimally invasive surgery that provides exceptional visualisation and precise control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruijian Huang, Yue Xiao, Feng Jiang, Yanfei Chen, Cunhua Su, Jifang Zhou, Tianchi Yang
{"title":"Elevated respiratory complications following robotic-assisted lobectomy: A national cohort analysis of 26,140 cases","authors":"Ruijian Huang, Yue Xiao, Feng Jiang, Yanfei Chen, Cunhua Su, Jifang Zhou, Tianchi Yang","doi":"10.1002/rcs.2581","DOIUrl":"10.1002/rcs.2581","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted lobectomy (RL) is increasingly used nationally, but little comparative data exist on its safety compared with open lobectomy (OL) or video-assisted lobectomy (VL). This study aimed to estimate the risk of perioperative complications for RL, VL, or OL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Admissions were identified from the hospital administrative data collected between 2015 and 2019. Propensity score matching and inverse probabilistic weighting were used to account for selection bias. Logistic and quantile regression models were applied to determine perioperative outcome differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 26,140 cases of which 5337 (20.4%), 12,680 (48.5%), and 8123 (31.1%) underwent RL, VL, and OL. RL and VL were associated with lower complication rates, shorter lengths of stay, and fewer mortality risks. RL was associated with significantly elevated risks for perioperative respiratory complications (adjusted odds ratio 1.10, <i>p</i> = 0.010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Relatively low rates of perioperative complications for VL and RL, and higher respiratory complication rates in RL are concerning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164585","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}
Guangjun Hu, Weidong Shao, Zhuo Chen, Bixi Li, Bo Xu
{"title":"Deep neuromuscular block attenuates intra-abdominal pressure and inflammation and improves post-operative cognition in prostate cancer patients following robotic-assisted radical prostatectomy","authors":"Guangjun Hu, Weidong Shao, Zhuo Chen, Bixi Li, Bo Xu","doi":"10.1002/rcs.2565","DOIUrl":"10.1002/rcs.2565","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Whether neuromuscular block (NMB) affects Intra-abdominal pressure (IAP) and cognition in Prostate cancer (PC) patients with Robotic-assisted laparoscopic radical prostatectomy (RALRP) remains unclear. Here we aimed to compare the effects of deep and moderate NMB on the IAP, inflammation, and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Moderate neuromuscular block (MNMB) group (<i>N</i> = 44) and Deep neuromuscular block (DNMB) group (<i>N</i> = 47) were recruited. Intra-abdominal pressure was adjusted to meet RALRP requirements. The expression of pro-inflammatory factors was measured by ELISA. MMSE scores were recorded before the operation, 1 day and 1 week after the operation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant decreases in IAP (<i>p</i> < 0.001) and IL-1β, IL-6, TNF-a, and S-100β (<i>p</i> ≤ 0.01) expressions were found in the DNMB group. The MMSE score in the DNMB group was higher than that in the MNMB group on day one (<i>p</i> = 0.046). The incidence of nausea and vomiting was lower in the DNMB group than that in the MNMB group (<i>p</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DNMB reduces IAP and inflammation and improves post-operative cognitive functions in PC patients with RALRP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180600","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}