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robotic-assisted microsurgery in andrology: a systematic review

Asian Journal of Andrology 2023年第4期25卷 454-461页

作者： Konstantinos Douroumis Eleftherios Spartalis Konstantinos Stravodimos Panagiotis K Levis Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I Nikiteas Hellenic Minimally Invasive and robotic Surgery(MIRS)Study Group National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 15bGoudiAthens 11527Greece First Department of Urology National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece Second Department of Propaedeutic Surgery National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece

Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to reportits usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases wasconducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with thePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. Thearticles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was ***-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) areencouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates weregreater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition,robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encounteredwith traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy andmicrosurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. Thecurrent evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery tobecome incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systemsare becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.

关键词： andrology male infertility robotic surgical procedures varicocele vasovasostomy

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robotic versus laparoscopic surgery for sporadic benign insulinoma:Short-and long-term outcomes

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 399-405页

作者： Zhu-Zeng Yin Yuan-Xing Gao Zhi-Ming Zhao Ming-Gen Hu Wen-Bo Tang Rong Liu Faculty of Hepato-Pancreato-Biliary Surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China Institute of Hepatobiliary Surgery of Chinese PLA Beijing 100853China Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA Beijing 100853China

Background:Minimally invasive surgery is the optimal treatment for *** present study aimed to compare short-and long-term outcomes of laparoscopic and robotic surgery for sporadic benign ***:A retrospective analysis of patients who underwent laparoscopic or robotic surgery for insulinoma at our center between September 2007 and December 2019 was *** demographic,perioperative and postoperative follow-up results were compared between the laparoscopic and robotic ***:A total of 85 patients were enrolled,including 36 with laparoscopic approach and 49 with robotic *** was the preferred surgical ***-nine patients(69.4%)underwent enucleation;among them,26 and 33 patients underwent laparoscopic and robotic surgery,*** enucleation had a lower conversion rate to laparotomy(0 vs.19.2%,P=0.013),shorter operative time(102.0 vs.145.5 min,P=0.008)and shorter postoperative hospital stay(6.0 vs.8.5 d,P=0.002)than laparoscopic *** were no differences between the groups in terms of intraoperative blood loss,the rates of postoperative pancreatic fistula and *** a median follow-up of 65 months,two patients in the laparoscopic group developed a functional recurrence and none of the patients in the robotic group had a ***:robotic enucleation can reduce the conversion rate to laparotomy and shorten operative time,which might lead to a reduction in postoperative hospital stay.

关键词： robotic surgical procedures Laparoscopy Insulinoma Enucleation Pancreatectomy

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Minimally invasive surgery for upper gastrointestinal cancer: Our experience and review of the literature

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World Journal of Gastroenterology 2016年第19期22卷 4626-4637页

作者： Koichi Suda Masaya Nakauchi Kazuki Inaba Yoshinori Ishida Ichiro Uyama Division of Upper GI Department of Surgery Fujita Health University

Minimally invasive surgery (MIS) for upper gastrointestinal (GI) cancer, characterized by minimal access, has been increasingly performed worldwide. It not only results in better cosmetic outcomes, but also reduces intraoperative blood loss and postoperative pain, leading to faster recovery; however, endoscopically enhanced anatomy and improved hemostasis via positive intracorporeal pressure generated by CO2 insufflation have not contributed to reduction in early postoperative complications or improvement in long-term outcomes. Since 1995, we have been actively using MIS for operable patients with resectable upper GI cancer and have developed stable and robust methodology in conducting totally laparoscopic gastrectomy for advanced gastric cancer and prone thoracoscopic esophagectomy for esophageal cancer using novel technology including da Vinci surgical System (DVSS). We have recently demonstrated that use of DVSS might reduce postoperative local complications including pancreatic fistula after gastrectomy and recurrent laryngeal nerve palsy after esophagectomy. In this article, we present the current status and future perspectives on MIS for gastric and esophageal cancer based on our experience and a review of the literature.

关键词： Stomach neoplasms Esophageal neoplasms Minimally invasive surgical procedures Postoperative complications robotic surgical procedures

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Biochemical recurrence of pathological T2+localized prostate cancer after robotic-assisted radical prostatectomy:A 10-year surveillance

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World Journal of Clinical Cases 2021年第5期9卷 1026-1036页

作者： Che Hseuh Yang Yi Sheng Lin Yen Chuan Ou Wei Chun Weng Li Hua Huang Chin Heng Lu Chao Yu Hsu Min Che Tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung 435403Taiwan

BACKGROUND pT2+prostate cancer(PCa),a term first used in 2004,refers to organ-confined PCa characterized by a positive surgical margin(PSM)without extracapsular *** with a PSM are vulnerable to biochemical recurrence(BCR)following radical prostatectomy(RP);however,whether adjuvant radiotherapy(aRT)is imperative to PSM after RP remains *** study had the longest follow-up on pT2+PCa after robotic-assisted RP since ***,we discussed our viewpoints on pT2+PCa based on real-world *** To conclude a 10-year surveillance on pT2+PCa and compare our results with those of the published *** Forty-eight patients who underwent robotic-assisted RP between 2008 and 2011 were *** serial tests of prostate specific antigen(PSA)≥0.2 ng/mL were defined as *** designed factors were analyzed using statistical tools for BCR *** 9.4 was applied and significance was defined as Probotic-assisted RP in pT2+PCa of worse conditions can provide better BCR-free survival.A surgical technique limiting the PSM in favorable situations is warranted to lower the pT2+PCa BCR *** PSA cut-off value of 19.09 ng/mL is a predictive factor for *** on our experiences and review of the literat

关键词： Prostatectomy/methods robotic surgical procedures Prostatic neoplasms/pathology Prostate-specific antigen/metabolism Margins of excision Retrospective study

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Role of minimally invasive techniques in gastrointestinal surgery:Current status and future perspectives

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 941-952页

作者： Shan-Ping Ye Wei-Quan Zhu Zhi-Xiang Huang Dong-Ning Liu Xiang-Qiong Wen Tai-Yuan Li Department of General Surgery The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina Institute of Digestive Surgery The First Affiliated Hospital of Nanchang UniversityNanchang 330006Jiangxi ProvinceChina Jiangxi Medical College of Nanchang University Nanchang 330006Jiangxi ProvinceChina

In recent years,the incidence of gastrointestinal cancer has remained ***,surgical resection is still the most effective method for treating gastrointestinal ***,radical surgery depends on open ***,traditional open surgery inflicts great trauma and is associated with a slow *** invasive surgery,which aims to reduce postoperative complications and accelerate postoperative recovery,has been rapidly developed in the last two decades;it is increasingly used in the field of gastrointestinal surgery and widely used in early-stage gastrointestinal ***,many operations for gastrointestinal cancer treatment are still performed by open *** reason for this may be the challenges of minimally invasive technology,especially when operating in narrow spaces,such as within the pelvis or near the upper edge of the ***,some of the current literature has questioned oncologic outcomes after minimally invasive surgery for gastrointestinal ***,the current evidence suggests that minimally invasive techniques are safe and feasible in gastrointestinal cancer surgery,but most of the studies published in this field are retrospective studies and casematched ***-scale randomized prospective studies are needed to further support the application of minimally invasive *** this review,we summarize several common minimally invasive methods used to treat gastrointestinal cancer and discuss the advances in the minimally invasive treatment of gastrointestinal cancer in detail.

关键词： Gastrointestinal neoplasms Laparoscopy Minimally invasive surgical procedures robotic surgical procedures Therapeutics

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Minimally invasive multivisceral resection in rectal cancer:Preparation or Precipitation?

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World Journal of Gastrointestinal Surgery 2024年第11期16卷 3385-3390页

作者： Christian Ramírez Sánchez Sarah Monserrat LomelíMartínez Department of Cardiovascular and Thoracic Surgery Hospital General de OccidenteZapopan 45170Mexico Department of Medical and Life Sciences Centro Universitario de la CiénegaUniversidad de GuadalajaraOcotlán 47810Mexico Master of Public Health Department of Well-being and SustainableCentro Universitario del NorteUniversidad de GuadalajaraColotlán 46200Mexico

Rectal cancer is a malignant neoplasm that constitutes a significant public health challenge due to its high incidence and associated *** this editorial,we comment on the article by Chan et *** recent years,there has been progress in the development of new treatments for initial and metastatic rectal cancer due to introduction of techniques of innovative and minimally-invasive surgery(MIS)such as laparoscopy and robotic ***,only a few studies have ana-lyzed the feasibility,safety,and results of MIS in relation to open surgery,thereby highlighting the promising and superior results of MIS in functional and oncolo-gical *** findings were corroborated by the comparative study of Chan et al which evaluated the feasibility and safety of minimally invasive multivisceral resection(miMVR).A comparison of postoperative outcomes between open MVR and miMVR showed that miMVR presented less blood loss,fewer postoperative complications,and less *** editorial article is focused specifically on analysis of the characteristics of new minimally-invasive surgical techniques in rectal cancer,particularly in advanced *** importance of future research is emphasized by progress in knowledge,training,and clinical practice in the appli-cation of these surgical procedures for the treatment of advanced colorectal cancer.

关键词： Minimally invasive surgical procedures Multivisceral resection Rectal neo-plasms robotic surgical procedures

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Techniques to resect the distal ureter in robotic/laparoscopic nephroureterectomy

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Asian Journal of Urology 2016年第3期3卷 120-125页

作者： Weil R.Lai Benjamin R.Lee Department of Urology Tulane University School of MedicineNew OrleansLAUSA Division of Urology University of Arizona College of MedicineTucsonAZUSA

Treatment of clinically-organ confined high grade urothelial carcinoma of the upper tract has historically comprised open nephroureterectomy,with the distal ureter and bladder cuff mobilized through a separate open pelvic *** decrease morbidity,urologists have increasingly adopted laparoscopy and robotics in performing *** many published series of laparoscopic nephroureterectomy,the distal ureter and bladder cuff are detached from the bladder endoscopically by a variation of the“pluck”technique,with the resulting bladder defect left to heal by prolonged indwelling urethral catheter *** the distal ureter and bladder cuff can be excised laparoscopically,it does require advanced laparoscopic *** the wrist articulation and stereoscopic vision in robotic surgery,robotic nephroureterectomy(RNU)and bladder cuff excision can be performed in antegrade fashion to mimic the open technique together with the ability to intracorporeally close the bladder defect in a watertight,mucosa to mucosa fashion after excising the bladder *** this review,we discuss the published minimally invasive techniques in resecting the distal ureter and bladder cuff during laparoscopic and RNU.

关键词： Transitional cell carcinoma robotic nephroureterectomy Laparoscopy robotic surgical procedures Ureteral neoplasms

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robotic-assisted low anterior resection for rectal cancer shows similar clinical efficacy to laparoscopic surgery: A propensity score matched study

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1558-1570页

作者： Shen-Xiang Long Xin-Ning Wang Shu-Bo Tian Yu-Fang Bi Shen-Shuo Gao Yu Wang Xiao-Bo Guo Department of Gastrointestinal Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Endocrinology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Nursing The People’s Hospital of Zhangqiu AreaJinan 250200Shandong ProvinceChina Medical Center for Gastrointestinal Surgery Weifang People’s HospitalWeifang 261000Shandong ProvinceChina

BACKGROUND Rectal cancer ranks as the second leading cause of cancer-related mortality worldwide,necessitating surgical resection as the sole treatment *** the years,there has been a growing adoption of minimally invasive surgical techni-ques such as robotic and laparoscopic *** surgery represents an innovative modality that effectively addresses the limitations associated with traditional laparoscopic *** previous studies have reported favo-rable perioperative outcomes for robot-assisted radical resection in rectal cancer patients,further evidence regarding its oncological safety is still *** To conduct a comparative analysis of perioperative and oncological outcomes between robot-assisted and laparoscopic-assisted low anterior resection(LALAR)*** The clinical data of 125 patients who underwent robot-assisted low anterior resection(RALAR)and 279 patients who underwent LALAR resection at Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2019 to November 2022 were retrospectively *** performing a 1:1 propensity score matching,the patients were divided into two groups:The RALAR group and the LALAR group(111 cases in each group).Subsequently,a comparison was made between the short-term outcomes within 30 d after surgery and the 3-year survival outcomes of these two *** Compared to the LALAR group,the RALAR group exhibited a significantly earlier time to first flatus[2(2-2)d vs 3(3-3)d,P=0.000],as well as a shorter time to first fluid diet[4(3-4)d vs 5(4-6)d,P=0.001].Additionally,the RALAR group demonstrated reduced postoperative indwelling catheter time[2(1-3)d vs 4(3-5)d,P=0.000]and decreased length of hospital stay after surgery[5(5-7)d vs 7(6-8)d,P=0.009].Moreover,there was an observed increase in total cost of hospitalization for the RALAR group compared to the LALAR group[10777(10780-11850)dollars vs 10550(8766-11715)dollars,P=0.012].No signi

关键词： Rectal cancer robotic surgical procedures Laparoscopy Low anterior resection Clinical efficacy

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Minimally invasive pelvic exenteration for primary or recurrent locally advanced rectal cancer:A glimpse into the future

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1960-1964页

作者： Dimitrios Kehagias Charalampos Lampropoulos Ioannis Kehagias Department of General Surgery General University Hospital of PatrasPatras 26504Greece Intensive Care Unit Saint Andrew’s General HospitalPatras 26335Greece Division of Bariatric and Metabolic Surgery Department of SurgeryUniversity of PatrasPatras 26504Greece

Surgeons have grappled with the treatment of recurrent and T4b locally advanced rectal cancer(LARC)for many *** main objectives are to increase the overall survival and quality of life of the patients and to mitigate postoperative ***,pelvic exenteration(PE)with or without neoadjuvant treatment is a curative treatment when negative resection margins are *** traditional open approach has been favored by many ***,the technological advancements in minimally invasive surgery have radically changed the surgical *** studies have demonstrated promising results in postoperative complications and oncological outcomes after robotic or laparoscopic PE.A recent retrospective study entitled“Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review”was published in the World Journal of Gastrointestinal *** we read this article with great interest,we decided to delve into the latest data regarding the benefits and risks of minimally invasive PE for ***,the small number of suitable patients,limited surgeon experience,and steep learning curve are hindering the establishment of minimally invasive PE.

关键词： Locally advanced rectal cancer Pelvic exenteration Multivisceral resection Minimally invasive surgical procedures robotic surgical procedures

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Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 777-789页

作者： Kai Siang Chan Biquan Liu Ming Ngan Aloysius Tan Kwang Yeong How Kar Yong Wong Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality *** 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on *** LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical *** and/or PE is a major and complex surgery with high post-operative *** invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic *** is a single-center retrospective cohort study from 1st January 2015 to 31st March *** criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic ***-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also *** criteria were patients with systemic metastases with non-resectable *** patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal *** sur-gery was defined based on technical difficulty of surgery(*** PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication ***-gorical values were described as percentages and analysed by the chi-square *** variables were expressed as median(range)and analysed by Mann-Whitney U *** overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table ***-rank test was performed to determine statistical significance between cumulative *** significance was defined as P<*** estimates with li

关键词： Laparoscopy Minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms robotic surgical procedures

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