Results of robotic colorectal surgery at IIIrd surgical department 1st Faculty of Medicine Charles University
Authors:
B. Jíšová; J. Skořepa; J. Pastor; P. Hladík; R. Lischke
Authors‘ workplace:
III. chirurgická klinika 1. LF UK a FN v Motole, Praha
Published in:
Gastroent Hepatol 2023; 77(2): 154-157
Category:
Gastrointestinal Oncology: Review Article
doi:
https://doi.org/10.48095/ccgh2023154
Overview
Introduction: Robotic surgery is a rapidly developing field both in our country and abroad. The beginnings of robotic surgery dated back to the 1980s, but development took place after 2000, especially with the robotic systems from the company Intuitive. In the Czech Republic, the first robotic surgery was performed in October 2005, whereas at our surgical department, it was in June 2018. Robotic surgery techniques are now part of the standard procedures of our workplace. Method: Retrospective analysis of patients from our results database. We included all 150 patients operated between June 2018 to October 2022. Results: The operation technique is almost identical to laparoscopic or open surgery. The difference is so-called docking of the robotic system and the correct placement of the robotic arms. Now in the databases are 150 patients with colon and rectal resection. Most patients underwent rectal resection. 9.4% of the patients had anastomosis leak, which is a figure comparable to foreign literature. The conversion was necessary for 2.4% of patients. The length of hospitalization was reduced to a median of 6 days. Conclusion: Robotic surgery is certainly the future of surgery as such. The advantage over classic operations is a shorter hospitalization period, faster recovery, less painful surgical wounds, fewer wound infections, a lower risk of hernia in the scar and fewer conversions. The disadvantage is certainly the lack of tactile perception and the high purchase price as well as higher costs for the operation.
Keywords:
robotic surgery – colorectal surgery – robotic resection – miniinvasive surgery
Sources
1. Genova P, Pantuso G, Abdalla S et al. Milestones in robotic colorectal surgery development: an historical overview. Mini-invasive Surg 2020; 4: 2. doi: 10.20517/2574-1225.2019.30.
2. Kwoh YS, Hou J, Jonckheere EA et al. A robot with improved absolute positioning accuracy for CT guided stereotactic brain surgery. IEEE Trans Biomed Eng 1988; 35 (2): 153–160. doi: 10.1109/10.1354.
3. Longmore SK, Naik G, Gargiulo GD. Laparoscopic Robotic Surgery: Current Perspective and Future Directions. Robotics 2020; 9 (2): 42. doi: 10.3390/robotics9020042.
4. Veverková L, Čapov I, Vlček P et al. „State of art“ robotická chirurgie. Endoskopie 2010; 19 (1): 17–20.
5. FN Motol. Robotická chirurgie – medicína budoucnosti ve Fakultní nemocnici v Motole dostupná již dnes. 2022 [online]. Dostupné z: https: //www.fnmotol.cz/tiskove-zpravy/roboticka-chirurgie-medicina-budoucnosti-ve-fakultni-nemocnici-v-motole-dostupna-jiz-dnes/.
6. Vining CC, Skowron KB, Hogg ME. Robotic gastrointestinal surgery: learning curve, educational programs and outcomes. Updates Surg 2021; 73 (3): 799–814. doi: 10.1007/s13304-021-00973-0.
7. Panteleimonitis S, Popeskou S, Aradaib M et al. Implementation of robotic rectal surgery training programme: importance of standardisation and structured training. Langenbecks Arch Surg 2018; 403 (6): 749–760. doi: 10.1007/s00423-018-1690-1.
8. Kim CW, Kim CH, Baik SH. Outcomes of Robotic-Assisted Colorectal Surgery Compared with Laparoscopic and Open Surgery: a Systematic Review. J Gastrointest Surg 2014; 18 (4): 816–830. doi: 10.1007/s11605-014-2469-5.
9. İmamoğlu Gİ, Oğuz A, Cimen S et al. The impact of lymph node ratio on overall survival in patients with colorectal cancer. J Cancer Res Ther 2021; 17 (4): 1069–1074. doi: 10.4103/jcrt.JCRT_11_19.
10. Braga M, Vignali A, Gianotti L et al. Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 2002; 236 (6): 759–766. doi: 10.1097/01.SLA.0000036269.60340.AE.
11. Langer D, Vocka M, Kalvach J et al. Roboticky asistovaná léčba zhoubných nádorů kolorekta a hepatopankreatobiliární oblasti. Gastroent Hepatol 2021; 75 (5): 410–416. doi: 10.48095/ccgh2021410
12. Zimmern A, Prasad L, de Souza A et al. Robotic Colon and Rectal Surgery: A Series of 131 Cases. World J Surg 2010; 34 (8): 1954–1958. doi: 10.1007/s00268-010-0591-4.
13. Škrovina M, Macháček M, Martínek L et al. Resekce rekta s totální excizí mezorekta – laparoskopicý versus robotický přístup. Rozhl. Chir 2021; 100 (11): 527–532. doi: 10.33699/PIS.2021. 100.11.527–533.
14. Shogan BD, Carlisle EM, Alverdy JC et al. Do we really know why colorectal anastomoses leak? J Gastrointest Surg 2013; 17 (9): 1698–1707. doi: 10.1007/s11605-013-2227-0.
15. Zarnescu EC, Zarnescu NO, Costea R. Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery. Diagnostics (Basel) 2021; 11 (12): 2382. doi: 10.3390/diagnostics11122382.
16. Bärlehner E, Benhidjeb T, Anders S et al. Laparoscopic resection for rectal cancer: outcomes in 194 patients and review of the literature. Surg Endosc 2005; 19 (6): 757–766. doi: 10.1007/s00464-004-9134-0.
17. Odermatt M, Ahmed J, Panteleimonitis S et al. Prior experience in laparoscopic rectal surgery can minimise the learning curve for robotic rectal resections: a cumulative sum analysis. Surg Endosc 2017; 31 (10): 4067–4076. doi: 10.1007/s00464-017-5453-9.
18. Bokhari MB, Patel CB, Ramos-Valadez DI et al. Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 2011; 25 (3): 855–860. doi: 10.1007/s00464-010-1281-x.
19. Scarpinata R, Aly EH. Does robotic rectal cancer surgery offer improved early postoperative outcomes? Dis Colon Rectum 2013; 56 (2): 253–262. doi: 10.1097/DCR.0b013e3182694595.
20. DeSouza AL, Prasad LM, Marecik SJ et al. Total mesorectal excision for rectal cancer: the potential advantage of robotic assistance. Dis Colon Rectum 2010; 53 (12): 1611–1617. doi: 10.1007/DCR.0b013e3181f22f1f.
Labels
Paediatric gastroenterology Gastroenterology and hepatology SurgeryArticle was published in
Gastroenterology and Hepatology
2023 Issue 2
Most read in this issue
- Autoimmune pancreatitis in childhood
- Ultra-processed food – a threat to liver health
- Neurobiology of liver diseases
- Results of robotic colorectal surgery at IIIrd surgical department 1st Faculty of Medicine Charles University