nach oben

Langenbeck's Archives of Surgery

Erschienen in:

27.09.2017 | REVIEW ARTICLE

Towards standardized robotic surgery in gastrointestinal oncology

verfasst von: Lawrence M. Knab, Amer H. Zureikat, Herbert J. Zeh III, Melissa E. Hogg

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 7/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Minimally invasive techniques have revolutionized the field of surgery over the past several decades. Specifically, robotic surgery is increasingly being used for complex operations, although the appreciable learning curve required to become proficient has deterred many surgeons. We describe how use of a proficiency-based training program can decrease the learning curve and lead to standardized robotic surgery.

Methods

The steps of a proficiency-based robotic training program are described, including (1) a proficiency-based virtual reality simulation curriculum, (2) an inanimate biotissue curriculum, (3) a video library training, (4) intraoperative evaluation, and (5) skill maintenance with ongoing assessment. The learning curve for robotic gastrointestinal surgery is explored, as well as outcomes compared to laparoscopic and open techniques.

Results

The implementation of a proficiency-based robotic training program is feasible. Surgical oncology fellows who participated in the program demonstrated improvement in both the simulation and biotissue curricula. Analyzed as a group, the participants improved in time and errors after the biotissue curriculum.

Conclusions

Published outcomes from robotic gastrointestinal surgery have demonstrated safety, feasibility, and preserved oncologic resections. A proficiency-based robotic curriculum is ideal to enable surgeons to achieve mastery in robotic surgery while minimizing the learning curve required.

Semm K (1988) Pelviscopic appendectomy. Dtsch Med Wochenschr 113(1):3–5. https://doi.org/10.1055/s-2008-1067581 PubMedCrossRef

Reynolds W Jr (2001) The first laparoscopic cholecystectomy. JSLS 5(1):89–94PubMedPubMedCentral

Franklin ME Jr, Rosenthal D, Abrego-Medina D, Dorman JP, Glass JL, Norem R, Diaz A (1996) Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Five-year results. Dis Colon Rectum 39(10 Suppl):S35–S46PubMedCrossRef

Shaligram A, Unnirevi J, Simorov A, Kothari VM, Oleynikov D (2012) How does the robot affect outcomes? A retrospective review of open, laparoscopic, and robotic Heller myotomy for achalasia. Surg Endosc 26(4):1047–1050. https://doi.org/10.1007/s00464-011-1994-5 PubMedCrossRef

Zureikat AH, Postlewait LM, Liu Y, Gillespie TW, Weber SM, Abbott DE, Ahmad SA, Maithel SK, Hogg ME, Zenati M, Cho CS, Salem A, Xia B, Steve J, Nguyen TK, Keshava HB, Chalikonda S, Walsh RM, Talamonti MS, Stocker SJ, Bentrem DJ, Lumpkin S, Kim HJ, Zeh HJ 3rd, Kooby DA (2016) A multi-institutional comparison of perioperative outcomes of robotic and open pancreaticoduodenectomy. Ann Surg 264(4):640–649. https://doi.org/10.1097/SLA.0000000000001869 PubMedCrossRef

McCormack K, Scott NW, Go PM, Ross S, Grant AM, Collaboration EUHT (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785. https://doi.org/10.1002/14651858.CD001785

Gagner M, Pomp A (1994) Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc 8(5):408–410PubMedCrossRef

Cuschieri A (1994) Laparoscopic surgery of the pancreas. J R Coll Surg Edinb 39(3):178–184PubMed

https://www.intuitivesurgical.com/company/faqs.html. Accessed July 21, 2017 2017

10.

Melvin WS, Needleman BJ, Krause KR, Ellison EC (2003) Robotic resection of pancreatic neuroendocrine tumor. J Laparoendosc Adv Surg Tech A 13(1):33–36. https://doi.org/10.1089/109264203321235449 PubMedCrossRef

11.

Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138(7):777–784. https://doi.org/10.1001/archsurg.138.7.777 PubMedCrossRef

12.

Hashizume M, Sugimachi K (2003) Robot-assisted gastric surgery. Surg Clin North Am 83(6):1429–1444. https://doi.org/10.1016/S0039-6109(03)00158-0 PubMedCrossRef

13.

Cuschieri A (2005) Reducing errors in the operating room: surgical proficiency and quality assurance of execution. Surg Endosc 19(8):1022–1027. https://doi.org/10.1007/s00464-005-8110-7 PubMedCrossRef

14.

Smith R, Patel V, Satava R (2014) Fundamentals of robotic surgery: a course of basic robotic surgery skills based upon a 14-society consensus template of outcomes measures and curriculum development. Int J Med Rob 10(3):379–384. https://doi.org/10.1002/rcs.1559 CrossRef

15.

Ahmed K, Khan R, Mottrie A, Lovegrove C, Abaza R, Ahlawat R, Ahlering T, Ahlgren G, Artibani W, Barret E, Cathelineau X, Challacombe B, Coloby P, Khan MS, Hubert J, Michel MS, Montorsi F, Murphy D, Palou J, Patel V, Piechaud PT, Van Poppel H, Rischmann P, Sanchez-Salas R, Siemer S, Stoeckle M, Stolzenburg JU, Terrier JE, Thuroff JW, Vaessen C, Van Der Poel HG, Van Cleynenbreugel B, Volpe A, Wagner C, Wiklund P, Wilson T, Wirth M, Witt J, Dasgupta P (2015) Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts. BJU Int 116(1):93–101. https://doi.org/10.1111/bju.12974 PubMedCrossRef

16.

Hogg ME, Besselink MG, Clavien PA, Fingerhut A, Jeyarajah DR, Kooby DA, Moser AJ, Pitt HA, Varban OA, Vollmer CM, Zeh HJ 3rd, Hansen P, Minimally Invasive Pancreatic Resection Organizing C (2017) Training in minimally invasive pancreatic resections: a paradigm shift away from “See one, Do one, Teach one”. HPB 19(3):234–245. https://doi.org/10.1016/j.hpb.2017.01.016 PubMedCrossRef

17.

Abboudi H, Khan MS, Aboumarzouk O, Guru KA, Challacombe B, Dasgupta P, Ahmed K (2013) Current status of validation for robotic surgery simulators—a systematic review. BJU Int 111(2):194–205. https://doi.org/10.1111/j.1464-410X.2012.11270.x PubMedCrossRef

18.

Hogg ME, Tam V, Zenati M, Novak S, Miller J, Zureikat AH, Zeh HJ 3rd (2017) Mastery-based virtual reality robotic simulation curriculum: the first step toward operative robotic proficiency. J Surg Educ 74(3):477–485. https://doi.org/10.1016/j.jsurg.2016.10.015 PubMedCrossRef

19.

Birkmeyer JD, Finks JF, O'Reilly A, Oerline M, Carlin AM, Nunn AR, Dimick J, Banerjee M, Birkmeyer NJ, Michigan Bariatric Surgery C (2013) Surgical skill and complication rates after bariatric surgery. N Engl J Med 369(15):1434–1442. https://doi.org/10.1056/NEJMsa1300625 PubMedCrossRef

20.

Tam V, Zenati M, Novak S, Chen Y, Zureikat AH, Zeh HJ 3rd, Hogg ME (2017) Robotic pancreatoduodenectomy biotissue curriculum has validity and improves technical performance for surgical oncology fellows. J Surg Educ. https://doi.org/10.1016/j.jsurg.2017.05.016

21.

King JC, Zeh HJ 3rd, Zureikat AH, Celebrezze J, Holtzman MP, Stang ML, Tsung A, Bartlett DL, Hogg ME (2016) Safety in numbers: progressive implementation of a robotics program in an academic surgical oncology practice. Surg Innov 23(4):407–414. https://doi.org/10.1177/1553350616646479 PubMedCrossRef

22.

Hogg ME, Zenati M, Novak S, Chen Y, Jun Y, Steve J, Kowalsky SJ, Bartlett DL, Zureikat AH, Zeh HJ 3rd (2016) Grading of surgeon technical performance predicts postoperative pancreatic fistula for pancreaticoduodenectomy independent of patient-related variables. Ann Surg 264(3):482–491. https://doi.org/10.1097/SLA.0000000000001862 PubMedCrossRef

23.

Gallagher AG, Seymour NE, Jordan-Black JA, Bunting BP, McGlade K, Satava RM (2013) Prospective, randomized assessment of transfer of training (ToT) and transfer effectiveness ratio (TER) of virtual reality simulation training for laparoscopic skill acquisition. Ann Surg 257(6):1025–1031. https://doi.org/10.1097/SLA.0b013e318284f658 PubMedCrossRef

24.

Satava RM (2009) The revolution in medical education—the role of simulation. J Grad Med Educ 1(2):172–175. https://doi.org/10.4300/JGME-D-09-00075.1 PubMedPubMedCentralCrossRef

25.

Lendvay TS, Brand TC, White L, Kowalewski T, Jonnadula S, Mercer LD, Khorsand D, Andros J, Hannaford B, Satava RM (2013) Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study. J Am Coll Surg 216(6):1181–1192. https://doi.org/10.1016/j.jamcollsurg.2013.02.012 PubMedPubMedCentralCrossRef

26.

Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL (2003) Surgeon volume and operative mortality in the United States. N Engl J Med 349(22):2117–2127. https://doi.org/10.1056/NEJMsa035205 PubMedCrossRef

27.

Tseng JF, Pisters PW, Lee JE, Wang H, Gomez HF, Sun CC, Evans DB (2007) The learning curve in pancreatic surgery. Surgery 141(4):456–463. https://doi.org/10.1016/j.surg.2006.09.013 PubMedCrossRef

28.

Fisher WE, Hodges SE, Wu MF, Hilsenbeck SG, Brunicardi FC (2012) Assessment of the learning curve for pancreaticoduodenectomy. Am J Surg 203(6):684–690. https://doi.org/10.1016/j.amjsurg.2011.05.006 PubMedCrossRef

29.

Schmidt CM, Turrini O, Parikh P, House MG, Zyromski NJ, Nakeeb A, Howard TJ, Pitt HA, Lillemoe KD (2010) Effect of hospital volume, surgeon experience, and surgeon volume on patient outcomes after pancreaticoduodenectomy: a single-institution experience. Arch Surg 145(7):634–640. https://doi.org/10.1001/archsurg.2010.118 PubMedCrossRef

30.

Napoli N, Kauffmann EF, Perrone VG, Miccoli M, Brozzetti S, Boggi U (2015) The learning curve in robotic distal pancreatectomy. Updat Surg 67(3):257–264. https://doi.org/10.1007/s13304-015-0299-y CrossRef

31.

Shakir M, Boone BA, Polanco PM, Zenati MS, Hogg ME, Tsung A, Choudry HA, Moser AJ, Bartlett DL, Zeh HJ, Zureikat AH (2015) The learning curve for robotic distal pancreatectomy: an analysis of outcomes of the first 100 consecutive cases at a high-volume pancreatic centre. HPB 17(7):580–586. https://doi.org/10.1111/hpb.12412 PubMedPubMedCentralCrossRef

32.

Boone BA, Zenati M, Hogg ME, Steve J, Moser AJ, Bartlett DL, Zeh HJ, Zureikat AH (2015) Assessment of quality outcomes for robotic pancreaticoduodenectomy: identification of the learning curve. JAMA Surg 150(5):416–422. https://doi.org/10.1001/jamasurg.2015.17 PubMedCrossRef

33.

Chen S, Chen JZ, Zhan Q, Deng XX, Shen BY, Peng CH, Li HW (2015) Robot-assisted laparoscopic versus open pancreaticoduodenectomy: a prospective, matched, mid-term follow-up study. Surg Endosc 29(12):3698–3711. https://doi.org/10.1007/s00464-015-4140-y PubMedCrossRef

34.

Napoli N, Kauffmann EF, Palmeri M, Miccoli M, Costa F, Vistoli F, Amorese G, Boggi U (2016) The learning curve in robotic pancreaticoduodenectomy. Dig Surg 33(4):299–307. https://doi.org/10.1159/000445015 PubMedCrossRef

35.

Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU (2012) Comparison of surgical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: the learning curve of robotic surgery. J Gastric Cancer 12(3):156–163. https://doi.org/10.5230/jgc.2012.12.3.156 PubMedPubMedCentralCrossRef

36.

Park SS, Kim MC, Park MS, Hyung WJ (2012) Rapid adaptation of robotic gastrectomy for gastric cancer by experienced laparoscopic surgeons. Surg Endosc 26(1):60–67. https://doi.org/10.1007/s00464-011-1828-5 PubMedCrossRef

37.

Zhou J, Shi Y, Qian F, Tang B, Hao Y, Zhao Y, Yu P (2015) Cumulative summation analysis of learning curve for robot-assisted gastrectomy in gastric cancer. J Surg Oncol 111(6):760–767. https://doi.org/10.1002/jso.23876 PubMedCrossRef

38.

Sng KK, Hara M, Shin JW, Yoo BE, Yang KS, Kim SH (2013) The multiphasic learning curve for robot-assisted rectal surgery. Surg Endosc 27(9):3297–3307. https://doi.org/10.1007/s00464-013-2909-4 PubMedCrossRef

39.

Jimenez-Rodriguez RM, Diaz-Pavon JM, de la Portilla de Juan F, Prendes-Sillero E, Dussort HC, Padillo J (2013) Learning curve for robotic-assisted laparoscopic rectal cancer surgery. Int J Color Dis 28(6):815–821. https://doi.org/10.1007/s00384-012-1620-6 CrossRef

40.

Kim HJ, Choi GS, Park JS, Park SY (2014) Multidimensional analysis of the learning curve for robotic total mesorectal excision for rectal cancer: lessons from a single surgeon's experience. Dis Colon Rectum 57(9):1066–1074. https://doi.org/10.1097/DCR.0000000000000174 PubMedCrossRef

41.

Melich G, Hong YK, Kim J, Hur H, Baik SH, Kim NK, Sender Liberman A, Min BS (2015) Simultaneous development of laparoscopy and robotics provides acceptable perioperative outcomes and shows robotics to have a faster learning curve and to be overall faster in rectal cancer surgery: analysis of novice MIS surgeon learning curves. Surg Endosc 29(3):558–568. https://doi.org/10.1007/s00464-014-3698-0 PubMedCrossRef

42.

Park EJ, Kim CW, Cho MS, Kim DW, Min BS, Baik SH, Lee KY, Kim NK (2014) Is the learning curve of robotic low anterior resection shorter than laparoscopic low anterior resection for rectal cancer? A comparative analysis of clinicopathologic outcomes between robotic and laparoscopic surgeries. Medicine 93(25):e109. https://doi.org/10.1097/MD.0000000000000109 PubMedPubMedCentralCrossRef

43.

Yamaguchi T, Kinugasa Y, Shiomi A, Sato S, Yamakawa Y, Kagawa H, Tomioka H, Mori K (2015) Learning curve for robotic-assisted surgery for rectal cancer: use of the cumulative sum method. Surg Endosc 29(7):1679–1685. https://doi.org/10.1007/s00464-014-3855-5 PubMedCrossRef

44.

Foo CC, Law WL (2016) The learning curve of robotic-assisted low rectal resection of a novice rectal surgeon. World J Surg 40(2):456–462. https://doi.org/10.1007/s00268-015-3251-x PubMedCrossRef

45.

Chen PD, Wu CY, Hu RH, Chen CN, Yuan RH, Liang JT, Lai HS, Wu YM (2017) Robotic major hepatectomy: is there a learning curve? Surgery 161(3):642–649. https://doi.org/10.1016/j.surg.2016.09.025 PubMedCrossRef

46.

Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23(6):1204–1211. https://doi.org/10.1007/s00464-009-0351-4 PubMedCrossRef

47.

Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45(12):1689–1694; discussion 1695-1686. https://doi.org/10.1097/01.DCR.0000037657.78153.A8 PubMedCrossRef

48.

Park EJ, Kim CW, Cho MS, Baik SH, Kim DW, Min BS, Lee KY, Kim NK (2014) Multidimensional analyses of the learning curve of robotic low anterior resection for rectal cancer: 3-phase learning process comparison. Surg Endosc 28(10):2821–2831. https://doi.org/10.1007/s00464-014-3569-8 PubMedCrossRef

49.

Park JS, Choi GS, Lim KH, Jang YS, Jun SH (2011) S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc 25(1):240–248. https://doi.org/10.1007/s00464-010-1166-z PubMedCrossRef

50.

de Wilde RF, Besselink MG, van der Tweel I, de Hingh IH, van Eijck CH, Dejong CH, Porte RJ, Gouma DJ, Busch OR, Molenaar IQ, Dutch Pancreatic Cancer G (2012) Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality. Br J Surg 99(3):404–410. https://doi.org/10.1002/bjs.8664 PubMedCrossRef

51.

Schroeck FR, de Sousa CA, Kalman RA, Kalia MS, Pierre SA, Haleblian GE, Sun L, Moul JW, Albala DM (2008) Trainees do not negatively impact the institutional learning curve for robotic prostatectomy as characterized by operative time, estimated blood loss, and positive surgical margin rate. Urology 71(4):597–601. https://doi.org/10.1016/j.urology.2007.12.023 PubMedCrossRef

52.

Seamon LG, Fowler JM, Richardson DL, Carlson MJ, Valmadre S, Phillips GS, Cohn DE (2009) A detailed analysis of the learning curve: robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. Gynecol Oncol 114(2):162–167. https://doi.org/10.1016/j.ygyno.2009.04.017 PubMedCrossRef

53.

Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL, Hughes SJ, Lee KK, Moser AJ, Zeh HJ (2013) Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg 257(1):128–132. https://doi.org/10.1097/SLA.0b013e31825fff08 PubMedCrossRef

54.

McMillan MT, Zureikat AH, Hogg ME, Kowalsky SJ, Zeh HJ, Sprys MH, Vollmer CM Jr (2017) A propensity score-matched analysis of robotic vs open pancreatoduodenectomy on incidence of pancreatic fistula. JAMA Surg 152(4):327–335. https://doi.org/10.1001/jamasurg.2016.4755 PubMedCrossRef

55.

Zureikat AH, Moser AJ, Boone BA, Bartlett DL, Zenati M, Zeh HJ 3rd (2013) 250 robotic pancreatic resections: safety and feasibility. Ann Surg 258(4):554–559; discussion 559-562. https://doi.org/10.1097/SLA.0b013e3182a4e87c PubMedPubMedCentral

56.

Anderson C, Ellenhorn J, Hellan M, Pigazzi A (2007) Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc 21(9):1662–1666. https://doi.org/10.1007/s00464-007-9266-0 PubMedCrossRef

57.

Patriti A, Ceccarelli G, Bellochi R, Bartoli A, Spaziani A, Di Zitti L, Casciola L (2008) Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc 22(12):2753–2760. https://doi.org/10.1007/s00464-008-0129-0 PubMedCrossRef

58.

Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH (2009) Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg 249(6):927–932. https://doi.org/10.1097/01.sla.0000351688.64999.73 PubMedCrossRef

59.

Isogaki J, Haruta S, Man IM, Suda K, Kawamura Y, Yoshimura F, Kawabata T, Inaba K, Ishikawa K, Ishida Y, Taniguchi K, Sato S, Kanaya S, Uyama I (2011) Robot-assisted surgery for gastric cancer: experience at our institute. Pathobiology 78(6):328–333. https://doi.org/10.1159/000330172 PubMedCrossRef

60.

D'Annibale A, Pende V, Pernazza G, Monsellato I, Mazzocchi P, Lucandri G, Morpurgo E, Contardo T, Sovernigo G (2011) Full robotic gastrectomy with extended (D2) lymphadenectomy for gastric cancer: surgical technique and preliminary results. J Surg Res 166(2):e113–e120. https://doi.org/10.1016/j.jss.2010.11.881 PubMedCrossRef

61.

Lee HH, Hur H, Jung H, Jeon HM, Park CH, Song KY (2011) Robot-assisted distal gastrectomy for gastric cancer: initial experience. Am J Surg 201(6):841–845. https://doi.org/10.1016/j.amjsurg.2010.05.013 PubMedCrossRef

62.

Tokunaga M, Sugisawa N, Kondo J, Tanizawa Y, Bando E, Kawamura T, Terashima M (2014) Early phase II study of robot-assisted distal gastrectomy with nodal dissection for clinical stage IA gastric cancer. Gastric Cancer 17(3):542–547. https://doi.org/10.1007/s10120-013-0293-3 PubMedCrossRef

63.

Marano A, Choi YY, Hyung WJ, Kim YM, Kim J, Noh SH (2013) Robotic versus laparoscopic versus open gastrectomy: a meta-analysis. J Gastric Cancer 13(3):136–148. https://doi.org/10.5230/jgc.2013.13.3.136 PubMedPubMedCentralCrossRef

64.

Yang SY, Roh KH, Kim YN, Cho M, Lim SH, Son T, Hyung WJ, Kim HI (2017) Surgical outcomes after open, laparoscopic, and robotic gastrectomy for gastric cancer. Ann Surg Oncol. https://doi.org/10.1245/s10434-017-5851-1

65.

Nakauchi M, Suda K, Susumu S, Kadoya S, Inaba K, Ishida Y, Uyama I (2016) Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach: a single institutional retrospective cohort study. Surg Endosc 30(12):5444–5452. https://doi.org/10.1007/s00464-016-4904-z PubMedCrossRef

66.

Coratti A, Fernandes E, Lombardi A, Di Marino M, Annecchiarico M, Felicioni L, Giulianotti PC (2015) Robot-assisted surgery for gastric carcinoma: five years follow-up and beyond: a single western center experience and long-term oncological outcomes. Eur J Surg Oncol 41(8):1106–1113. https://doi.org/10.1016/j.ejso.2015.01.014 PubMedCrossRef

67.

Jimenez Rodriguez RM, Diaz Pavon JM, de La Portilla de Juan F, Prendes Sillero E, Hisnard Cadet Dussort JM, Padillo J (2011) Prospective randomised study: robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection. Cir Esp 89(7):432–438. https://doi.org/10.1016/j.ciresp.2011.01.017 PubMedCrossRef

68.

Yang Y, Wang F, Zhang P, Shi C, Zou Y, Qin H, Ma Y (2012) Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol 19(12):3727–3736. https://doi.org/10.1245/s10434-012-2429-9 PubMedCrossRef

69.

Kwak JM, Kim SH, Kim J, Son DN, Baek SJ, Cho JS (2011) Robotic vs laparoscopic resection of rectal cancer: short-term outcomes of a case-control study. Dis Colon Rectum 54(2):151–156. https://doi.org/10.1007/DCR.0b013e3181fec4fd PubMedCrossRef

70.

Park EJ, Cho MS, Baek SJ, Hur H, Min BS, Baik SH, Lee KY, Kim NK (2015) Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery. Ann Surg 261(1):129–137. https://doi.org/10.1097/SLA.0000000000000613 PubMedCrossRef

71.

Tsung A, Geller DA, Sukato DC, Sabbaghian S, Tohme S, Steel J, Marsh W, Reddy SK, Bartlett DL (2014) Robotic versus laparoscopic hepatectomy: a matched comparison. Ann Surg 259(3):549–555. https://doi.org/10.1097/SLA.0000000000000250 PubMedCrossRef

72.

Packiam V, Bartlett DL, Tohme S, Reddy S, Marsh JW, Geller DA, Tsung A (2012) Minimally invasive liver resection: robotic versus laparoscopic left lateral sectionectomy. J Gastrointest Surg 16(12):2233–2238. https://doi.org/10.1007/s11605-012-2040-1 PubMedPubMedCentralCrossRef

73.

Berber E, Akyildiz HY, Aucejo F, Gunasekaran G, Chalikonda S, Fung J (2010) Robotic versus laparoscopic resection of liver tumours. HPB 12(8):583–586. https://doi.org/10.1111/j.1477-2574.2010.00234.x PubMedPubMedCentralCrossRef

74.

Tranchart H, Ceribelli C, Ferretti S, Dagher I, Patriti A (2014) Traditional versus robot-assisted full laparoscopic liver resection: a matched-pair comparative study. World J Surg 38(11):2904–2909. https://doi.org/10.1007/s00268-014-2679-8 PubMedCrossRef

75.

Troisi RI, Patriti A, Montalti R, Casciola L (2013) Robot assistance in liver surgery: a real advantage over a fully laparoscopic approach? Results of a comparative bi-institutional analysis. Int J Med Rob 9(2):160–166. https://doi.org/10.1002/rcs.1495 CrossRef

76.

Qiu J, Chen S, Chengyou D (2016) A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms. Surg Endosc 30(3):862–875. https://doi.org/10.1007/s00464-015-4306-7 PubMedCrossRef

77.

Chen PD, Wu CY, Hu RH, Chou WH, Lai HS, Liang JT, Lee PH, Wu YM (2017) Robotic versus open hepatectomy for hepatocellular carcinoma: a matched comparison. Ann Surg Oncol 24(4):1021–1028. https://doi.org/10.1245/s10434-016-5638-9 PubMedCrossRef

Titel: Towards standardized robotic surgery in gastrointestinal oncology
verfasst von: Lawrence M. Knab
Amer H. Zureikat
Herbert J. Zeh III
Melissa E. Hogg
Publikationsdatum: 27.09.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Langenbeck's Archives of Surgery / Ausgabe 7/2017
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1623-4

Neu im Fachgebiet Chirurgie

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Towards standardized robotic surgery in gastrointestinal oncology

Abstract

Purpose

Methods

Results

Conclusions

Neu im Fachgebiet Chirurgie

Mehr Frauen im OP – weniger postoperative Komplikationen

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

Klinikreform soll zehntausende Menschenleben retten

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2017

36 th Annual Meeting of the German Association of Endocrine Surgeons (CAEK)

Journal impact factor and methodological quality of surgical randomized controlled trials: an empirical study

Radiation-induced rectovaginal fistulas in locally advanced gynaecological malignancies—new patients, old problem?

Results of surgical treatment for jejunal Crohn’s disease: choice between resection, strictureplasty, and combined treatment

Underestimated risk of cancer in solitary thyroid nodules ≥3 cm reported as benign

Groin hernia diagnostics: dynamic inguinal ultrasound (DIUS)

Update Chirurgie