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robotic surgery: An Effective Treatment Option for Epiphrenic Diverticulum Associated with Nutcracker Esophagus

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Surgical Science 2024年第1期15卷 1-6页

作者： Augusto Tinoco Gilberto Carvalho Leonardo Tinoco Ana Paula Quintão Department of Digestive surgery Hospital S&#227o Jos&#233 do Ava&#237 Itaperuna Brazil

Background: Epiphrenic Diverticulum is frequently associated with esophageal motility disorders, such as nutcrackers esophagus. The diagnosis is usually made using imaging studies such as a Barium esophagogram, and esophageal manometry. Surgical treatment options for epiphrenic diverticulum and EN include diverticulectomy and wide myotomy. Aim: The resection of three epiphrenic diverticula and extensive myotomy were performed by robotic thoracoscopy uneventfully. Case presentation: A 65-year-old female complaining of dysphagia for solid foods, Chest pain and regurgitation. Esophagogastroduodenoscopy (EDG) with difficulty in advancing the endoscope at 25 cm and demonstrating an ED, no hiatal hernia and normal stomach and duodenum. Barium Esophagogram showed multiple diverticula and tortuosity throughout the esophagus. Conclusion: With robotic surgery, surgeons can perform highly precise operations with enhanced 3D vision and control. Through this cutting-edge approach, the treatment of ED associated with EN can be drastically changed, promising better outcomes for patients.

关键词： robotic surgery Myotomy Nutcracker Esophagus Epiphrenic Diverticulum

robotic surgery in elderly patients with colorectal cancer: Review of the current literature

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World Journal of Gastrointestinal surgery 2023年第6期15卷 1040-1047页

作者： Nan Zun Teo James Chi Yong Ngu Department of General surgery Changi General HospitalSingapore 529889Singapore

With an ageing global population,we will see an increasing number of elderly patients with colorectal cancer(CRC)requiring ***,it should be recognized that the elderly are a heterogenous group,with varying physiological and functional *** traditionally viewed to be associated with frailty,comorbidities,and a higher risk of post operative morbidity,the advancements in minimally invasive surgery(MIS)and improvements in perioperative care have allowed CRC surgery to be safe and feasible in the elderly-chronological age alone should therefore not strictly be an exclusion criterion for curative ***,as a form of MIS,laparoscopic assisted colorectal surgery(LACS)has the inherent disadvantages of:(1)Dependence on a trained assistant for retraction and laparoscope control;(2)The loss of wristed movement with reduced dexterity and suboptimal ergonomics;(3)A lack of intuitive movement due to the levering effect of trocars;and(4)An amplification of physiological *** a technical evolution of LACS,robotic assisted colorectal surgery was introduced to overcome these *** this minireview,we examine the evidence for robotic surgery in the elderly with CRC.

关键词： robotic surgery Minimally invasive surgery Colorectal cancer Elderly Geriatric Frailty

robotic4all project:Results of a hands-on robotic surgery training program

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Laparoscopic, Endoscopic and robotic surgery 2023年第1期6卷 1-8页

作者： Mario Rui Gonçalves Jose Novo de Matos Antonio Oliveira Ricardo Marinho Irene Cadime Palmira Carlos Alves Salvador Morales-Conde Miguel Castelo-Branco Faculty of Health Sciences University of Beira InteriorCovilha 6200-506Portugal Centro Hospitalar Universitario Lisboa Central Hospital de Sao JoseLisboa 1150-199Portugal Centro Hospitalar de Tras-os-Montes e Alto Douro Vila Real 5000-508Portugal Centro Hospitalar de Leiria Hospital de Santo AndreLeiria 2410-197Portugal Centro de Investigaçao em Psicologia Escola de Psicologia-Universidade do MinhoBraga 4710-057Portugal Departamento de Estudos Curriculares e Tecnologia Educativa Instituto de Educaçao-Universidade do MinhoCampus de GualtarBraga 4710-093Portugal Unit of Innovation in Minimally Invasive surgery University Hospital Virgen del RocioUniversity of SevillaSeville 41013Spain

Objective Although robotic surgery adoption and its indications are growing worldwide,for multiple factors,including costs,there is a lack of training and *** aim was to study the impact of a robotic introduction training program on gesture performance,such as suturing,in robot-naive *** Using the DaVinci robot,a 2-hour program was based on virtual reality and anatomical model *** participants performed 3 repetitions of virtual reality exercises on the virtual simulator,and then performed and were assessed on 2 tests,ie robot and laparoscopic training *** the course,the participants were surveyed for this training *** Twenty-seven residents and surgeons were enrolled in the training *** only 2 hours of training,all of the participants were able to complete the training program,thus learning generic and specific skills in robotic *** virtual reality exercise,the scores of the 3 exercises increased significantly with every repetition(probotic performance independent of laparoscopic *** Surgeons are interested and seek training in robotic *** implemented the first hands-on robotic surgery training program in Portugal and participants considered it was important and adequate for its *** participants,even without robotic experience,lear

关键词： Simulation Education Laparoscopic suture Laparoscopy robotic surgery

robotic surgery of the Mediastinum: A Review

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World Journal of Cardiovascular surgery 2022年第3期12卷 70-84页

作者： Farid Gharagozloo Center for Advanced Thoracic surgery Global Robotics Institute Adventhealth Celebration University of Central Florida Orlando USA

Background: The mediastinum is a complex anatomical region which contains many vital structures. Many aspects of mediastinal surgery, like that for other anatomic regions, have evolved from a maximally invasive approach involving a median sternotomy, anterior mediastinotomy, mediastinoscopy or thoracotomy, to a minimally invasive video-assisted approach. robotic surgery is presently the most advanced form of minimally invasive surgery. Methods: We reviewed our experience with a robotic approach to mediastinal pathology. In addition, an extensive search was conducted using PubMed, in order to extract references for the application of robotics to surgical conditions of the mediastinum. Results: The first robotic procedure by our group was a mediastinal procedure in 2003. In the past eighteen years, 203 patients have undergone robotic surgery for mediastinal pathology. There were 119 procedures for the Anterior Mediastinum, 33 procedures for the Middle Mediastinum, and 51 procedures for the Posterior Mediastinum. 78 patients underwent robotic thymectomy using a left-sided approach. 43/78 (55%) patients underwent radical thymectomy for Myasthenia Gravis. Thymoma was histologically identified in 32% of patients with Myasthenia Gravis. In patients with thymoma, there was no tumor recurrence. In patients with Myasthenia Gravis, the overall improvement rate after robotic radical complete thymectomy was 91% (39/43). Following robotic surgery for the mediastinal disease, the median hospitalization was 3 days, major complications occurred in 0.9% of patients and there was no mortality. Conclusion: With the advent of robotic surgery, many of the current surgical approaches to diseases of the mediastinum will likely be replaced over time by robotic surgery. When applied to the mediastinum, robotics has a number of benefits when compared to conventional Video-Assisted Thoracic surgery (VATS) including three-dimensional visualization, magnification of the operative field, precise

关键词： Mediastinum robotic surgery Anterior Mediastinal Mass Posterior Mediastinal Mass

robotic surgery in giant multilocular cystadenoma of the prostate:A rare case report

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World Journal of Clinical Cases 2020年第18期8卷 4215-4222页

作者： Le-Wei Fan Ying-Hsu Chang I-Hung Shao Kuei-Fang Wu See-Tong Pang Division of Urology Department of SurgeryChang Gung Memorial HospitalTaoyuan 333Taiwan Department of Pathology Chang Gung Memorial HospitalTaoyuan 333Taiwan

BACKGROUND Giant multilocular cystadenoma(GMC)of the prostate gland is a very rare benign *** the benign nature has been known,complete surgical excision is the major treatment consensus because of its high recurrence *** report a rare case of GMC with accompanying lower urinary tract symptoms and repeated urine retention initially thought to be symptoms of benign prostatic hyperplasia,which was treated with robot-assisted laparoscopic radical *** SUMMARY A 65-year-old man presented with a 2-year history of lower urinary tract symptoms that had deteriorated gradually within the previous six months,even though he had received treatment with a selective alpha-blocking *** had undergone two transurethral resections of the prostate(TURP)at a local hospital during a 4-mo interval because initial ultrasound imaging and prostatic core needle biopsy showed benign prostate *** the third recurrence,the patient underwent TURP with a green-light laser at our *** diagnosis was a tumor composed of variously sized dilated glandular and cystic structures lined by blended prostatic type epithelia positive for prostate-specific antigen;the final diagnosis was giant multilocular *** resonance imaging showed a large multilocular retrovesical mass 8.0 cm×7.3 cm×6.4 cm,with heterogeneous enhancement.A coexisting malignant part could not be *** the high recurrence rate,risk of coexisting malignancy,and possible sequelae of open surgery for radical excision,the patient decided to undergo robot-assisted radical prostatectomy,with good outcomes at the 2-year *** Robot-assisted surgery for the treatment of prostate GMC provides another choice for simultaneous attention to disease-control and postoperative quality of life.

关键词： Giant multilocular cystadenoma Prostate gland robotic surgery Radical prostatectomy Continence and erectile function Case report

Transoral robotic surgery frontiers

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World Journal of Otorhinolaryngology-Head and Neck surgery 2016年第2期2卷 -页

作者： James R. Bekeny Enver Ozer Department of 0tolaryngology-Head and Neck surgery The 0hio State University Medical Center The James Cancer Hospital and Solove Research Institute Columbus 0H 43210 USA

Transoral robotic surgery is a exciting field that continues to develop and push the boundaries of current procedural ability and challenges historical treatment paradigms. With the first use of a surgical robot in 1985, to the first clinical use of the robot transorally in 2005, there was some lag in adoption of robotic techniques in the head and neck region. However, since 2005 transoral robotic surgery has rapidly gained momentum amongst head and neck surgeons. With FDA approval of the da Vinci robot in 2009, transoral robotic surgery is currently offered as a treatment modality for malignant and nonmalignant disease of the head and neck region. This new technology is being used to reconsider historical treatment paradigms for malignancies of the upper aerodigestive tract due to the fact that minimally invasive surgical access to the oropharynx and larynx has been improved. Along with this enhanced access have come innovative procedures and uses of the technology for multiple facets of head and neck disease. Technology continues to improve and innovation in surgical robotics is expected to continue as more companies attempt to capture this market. This article aims to provide a view at the landscape of transoral robotic surgery and explore the future frontiers.

关键词： robotic surgery

Awake robotic liver surgery:A case report

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World Journal of Gastrointestinal surgery 2023年第12期15卷 2954-2961页

作者： Antonella Delvecchio Gaetano Pavone Maria Conticchio Claudia Piacente Miriam Varvara Valentina Ferraro Matteo Stasi Annachiara Casella Rosalinda Filippo Michele Tedeschi Carmine Pullano Riccardo Inchingolo Vito Delmonte Riccardo Memeo Unit of Hepato-Pancreatic-Biliary surgery “F.Miulli”Regional General HospitalBari 70021Italy Unit of Anesthesia and Perioperative Medicine “F.Miulli”Regional General HospitalBari 70021Italy Villa Pia Hospital Rome 00151Italy Unit of Interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy

BACKGROUND In recent years,minimally invasive liver resection has become a standard of care for liver *** the need to treat increasingly fragile patients,general anesthesia is sometimes avoided due to respiratory ***,surgical treatment with curative intent is abandoned in favor of a less invasive and less radical *** anesthesia has been shown to reduce respiratory complications,especially in elderly patients with pre-existing lung *** SUMMARY A 77-year-old man with hepatitis-C-virus-related chronic liver disease underwent robotic liver resection for hepatocellular *** patient was suffering from hypertension,diabetes and chronic obstructive pulmonary *** National Surgical Quality Improvement Program score for developing pneumonia was 9.2%.We planned a combined spinal–epidural anesthesia with conscious sedation to avoid general *** modification of the standard surgical technique was *** were stable and bleeding was *** postoperative course was *** robotic surgery in locoregional anesthesia with conscious sedation could be considered a safe and suitable approach in specialized centers and in selected patients.

关键词： robotic surgery Awake surgery Liver resection Frail patient Locoregional anesthesia Conscious sedation Case report

The contemporary role of robotics in surgery:A predictive mathematical model on the short-term effectiveness of robotic and laparoscopic surgery

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Laparoscopic, Endoscopic and robotic surgery 2019年第1期2卷 1-7页

作者： Hari G.Dandapani Kenneth Tieu Holy Trinity Episcopal Academy 5625 Holy Trinity DrMelbourneFL 32940USA Health First Viera Hospital 8745 N Wickham RdMelbourneFL 32940USA

Aim:The goal of this research was to create a mathematical model to evaluate the short-term effectiveness of laparoscopic and robotic surgeries and to apply this model to surgeries with laparoscopic and robotic variants to evaluate their *** and methods:A mathematical model was developed in this study to compare the short-term effectiveness of six different surgical procedures:ventral hernia repairs,hysterectomies,lung lobectomies,pancreatectomies,gastric bypass,and *** criteria analyzed to compare these procedures included morbidity rate,readmission rate,mortality rate,cost,length of hospitalization and operative *** criteria were scaled based on their significance when considering a surgery,such that more important criteria,those that directly impact patient health,are more heavily weighted than less important ***:The mathematical model indicated that robotic surgery was the preferred option for lung lobectomies and *** was preferred for all other *** the case of gastric bypass,laparoscopy was heavily preferred,and there was only a marginal preference in laparoscopy for hysterectomies and ventral hernia ***:The mathematical model developed in this research serves as a robust definitive standard that can continue to be utilized to compare robotic and laparoscopic *** new technologies,preferences are likely to change in favor of robotic surgery,and this model can be employed to predict the impact of those advancements.

关键词： robotic surgery Laparoscopic surgery Mathematical model Surgical outcomes Surgical comparison

robotic surgery in colon cancer: current evidence and future perspectives – narrative review

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Artificial Intelligence in Gastrointestinal Endoscopy 2021年第4期2卷 110-116页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Ugo Cioffi Mauro Zago Department of Emergency and robotic surgery A.Manzoni Hospital–ASST LeccoLecco 23900Italy Department of surgery University of MilanMilano 20122Italy

In the last 10 years,surgery has been developing towards minimal invasiveness;therefore,robotic surgery represents the consequent evolution of laparoscopic ***,surgeons’performances have been upgraded by the ergonomic developments of robotic systems,leading to several benefits for *** introduction into the market of the new Da Vinci Xi system has made it possible to perform all types of surgery on the colon,an in selected cases,to combine interventions in other organs or viscera at the same *** of the suprapubic surgical approach may shorten the length of hospital stay for patients who undergo robotic colonic *** this perspective,single-port robotic colectomy,has reduced the number of robotic ports needed,allowing a better anesthetic outcome and faster *** introduction on the market of new surgical robotic systems from multiple manufacturers is bound to change the landscape of robotic surgery and yield high-quality surgical outcomes.

关键词： Colon cancer robotic surgery Colectomy Laparoscopy Surgical outcomes:Robot system