nach oben

Surgical Endoscopy

Erschienen in:

13.02.2018 | Review

Review of emerging surgical robotic technology

verfasst von: Brian S. Peters, Priscila R. Armijo, Crystal Krause, Songita A. Choudhury, Dmitry Oleynikov

Erschienen in: Surgical Endoscopy | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

The use of laparoscopic and robotic procedures has increased in general surgery. Minimally invasive robotic surgery has made tremendous progress in a relatively short period of time, realizing improvements for both the patient and surgeon. This has led to an increase in the use and development of robotic devices and platforms for general surgery. The purpose of this review is to explore current and emerging surgical robotic technologies in a growing and dynamic environment of research and development.

Methods

This review explores medical and surgical robotic endoscopic surgery and peripheral technologies currently available or in development. The devices discussed here are specific to general surgery, including laparoscopy, colonoscopy, esophagogastroduodenoscopy, and thoracoscopy. Benefits and limitations of each technology were identified and applicable future directions were described.

Results

A number of FDA-approved devices and platforms for robotic surgery were reviewed, including the da Vinci Surgical System, Sensei X Robotic Catheter System, FreeHand 1.2, invendoscopy E200 system, Flex® Robotic System, Senhance, ARES, the Single-Port Instrument Delivery Extended Research (SPIDER), and the NeoGuide Colonoscope. Additionally, platforms were reviewed which have not yet obtained FDA approval including MiroSurge, ViaCath System, SPORT™ Surgical System, SurgiBot, Versius Robotic System, Master and Slave Transluminal Endoscopic Robot, Verb Surgical, Miniature In Vivo Robot, and the Einstein Surgical Robot.

Conclusions

The use and demand for robotic medical and surgical platforms is increasing and new technologies are continually being developed. New technologies are increasingly implemented to improve on the capabilities of previously established systems. Future studies are needed to further evaluate the strengths and weaknesses of each robotic surgical device and platform in the operating suite.

Kumar A, Yadav N, Singh S, Chauhan N (2016) Minimally invasive (endoscopic-computer assisted) surgery: technique and review. Ann Maxillofac Surg 6:159CrossRefPubMedPubMedCentral

Walker AS, Steele SR (2016) The future of robotic instruments in colon and rectal surgery, vol 27. Elsevier, Amsterdam, pp 144–149

Oleynikov D (2008) Robotic surgery. Surg Clin North Am 88:1121–1130. https://doi.org/10.1016/j.suc.2008.05.012 CrossRefPubMed

Rassweiler JJ, Teber D (2016) Advances in laparoscopic surgery in urology. Nat Rev Urol 13:387–399. https://doi.org/10.1038/nrurol.2016.70 CrossRefPubMed

Simorov A, Otte RS, Kopietz CM, Oleynikov D (2012) Review of surgical robotics user interface: what is the best way to control robotic surgery? Surg Endosc 26:2117–2125. https://doi.org/10.1007/s00464-012-2182-y CrossRefPubMed

DACH Medical Group—English (2017). https://www.dach-medical-group.com/en. Accessed 20 Dec 2017

Rivera-Serrano CM, Johnson P, Zubiate B, Kuenzler R, Choset H, Zenati M, Tully S, Duvvuri U (2012) A transoral highly flexible robot. Laryngoscope 122:1067–1071CrossRefPubMed

World’s First Use of Miniaturized Robot in Human Surgery—Virtual Incision Corporation (2017). https://www.virtualincision.com/fim-surgery/. Accessed 20 Dec 2017

van den Bedem LJM (2010) Realization of a demonstrator slave for robotic minimally invasive surgery. Doctoral degree 22-09-2010; Department of Mechanical Engineering; Supervisors: M. Steinbuch and I.A.M.J. Broeders; Co-promotor: P.C.J.N. Rosielle; Eindhoven: Technische Universiteit Eindhoven. https://doi.org/10.6100/IR684835

10.

Hanly EJ, Talamini MA (2004) Robotic abdominal surgery. Am J Surg 188:19–26CrossRef

11.

Armijo PR, Pagkratis S, Boilesen E, Tanner T, Oleynikov D (2017) Growth in robotic-assisted procedures is from conversion of laparoscopic procedures and not from open surgeons’ conversion: a study of trends and costs. Surg Endosc. https://doi.org/10.1007/s00464-017-5908-z

12.

Tsui C, Klein R, Garabrant M (2013) Minimally invasive surgery: national trends in adoption and future directions for hospital strategy. Surg Endosc 27:2253–2257. https://doi.org/10.1007/s00464-013-2973-9 CrossRefPubMed

13.

Alli VV, Yang J, Xu J, Bates AT, Pryor AD, Talamini MA, Telem DA (2017) Nineteen-year trends in incidence and indications for laparoscopic cholecystectomy: the NY State experience. Surg Endosc 31:1651–1658. https://doi.org/10.1007/s00464-016-5154-9 CrossRefPubMed

14.

Rodriguez-Sanjuan JC, Gomez-Ruiz M, Trugeda-Carrera S, Manuel-Palazuelos C, Lopez-Useros A, Gomez-Fleitas M (2016) Laparoscopic and robot-assisted laparoscopic digestive surgery: present and future directions. World J Gastroenterol 22:1975–2004. https://doi.org/10.3748/wjg.v22.i6.1975 CrossRefPubMedPubMedCentral

15.

Ghezzi TL, Corleta OC (2016) 30 Years of robotic surgery. World J Surg 40(10):1–8

16.

Higgins RM, Frelich MJ, Bosler ME, Gould JC (2017) Cost analysis of robotic versus laparoscopic general surgery procedures. Surg Endosc 31:185–192. https://doi.org/10.1007/s00464-016-4954-2 CrossRefPubMed

17.

Beasly RA (2012) Medical robots: current systems and research directions. J Robot 2012:1–14CrossRef

18.

Al-Ahmad A, Grossman JD, Wang PJ (2005) Early experience with a computerized robotically controlled catheter system. J Interv Card Electrophysiol 12:199–202. https://doi.org/10.1007/s10840-005-0325-y CrossRefPubMed

19.

Hansen Medical (2017). http://www.hansenmedical.com/us/en/why-robotics. Accessed 20 Dec 2017

20.

Rafii-Tari H, Payne CJ, Yang GZ (2014) Current and emerging robot-assisted endovascular catheterization technologies: a review. Ann Biomed Eng 42:697–715. https://doi.org/10.1007/s10439-013-0946-8 CrossRefPubMed

21.

Russo AD, Fassini G, Conti S, Casella M, Di Monaco A, Russo E, Riva S, Moltrasio M, Tundo F, De Martino G (2016) Analysis of catheter contact force during atrial fibrillation ablation using the robotic navigation system: results from a randomized study. J Interv Cardiac Electrophysiol 46:97–103CrossRef

22.

Hlivák P, Mlčochová H, Peichl P, ČIHÁK R, Wichterle D, Kautzner J (2011) Robotic navigation in catheter ablation for paroxysmal atrial fibrillation: midterm efficacy and predictors of postablation arrhythmia recurrences. J Cardiovasc Electrophysiol 22:534–540CrossRefPubMed

23.

Datino T, Arenal A, Pelliza M, Hernandez-Hernandez J, Atienza F, Gonzalez-Torrecilla E, Avila P, Bravo L, Fernandez-Aviles F (2014) Comparison of the safety and feasibility of arrhythmia ablation using the Amigo Robotic Remote Catheter System versus manual ablation. Am J Cardiol 113:827–831. https://doi.org/10.1016/j.amjcard.2013.11.030 CrossRefPubMed

24.

Stolzenburg JU, Franz T, Kallidonis P, Minh D, Dietel A, Hicks J, Nicolaus M, Al-Aown A, Liatsikos E (2011) Comparison of the FreeHand(R) robotic camera holder with human assistants during endoscopic extraperitoneal radical prostatectomy. BJU Int 107:970–974. https://doi.org/10.1111/j.1464-410X.2010.09656.x CrossRefPubMed

25.

Sbaih M, Arulampalam TH, Motson RW (2016) Rate of skill acquisition in the use of a robotic laparoscope holder (FreeHand®). Minim Invasive Ther Allied Technol 25:196–202CrossRefPubMed

26.

Tran H (2011) Robotic single-port hernia surgery. JSLS 15:309–314. https://doi.org/10.4293/108680811X13125733356198 CrossRefPubMedPubMedCentral

27.

Groth S, Rex DK, Rosch T, Hoepffner N (2011) High cecal intubation rates with a new computer-assisted colonoscope: a feasibility study. Am J Gastroenterol 106:1075–1080. https://doi.org/10.1038/ajg.2011.52 CrossRefPubMedPubMedCentral

28.

Kurniawan N, Keuchel M (2017) Flexible gastro-intestinal endoscopy—clinical challenges and technical achievements. Comput Struct Biotechnol J 15:168–179CrossRefPubMedPubMedCentral

29.

Sterile single-use endoscopy; invendo medical GmbH (2017). http://www.invendo-medical.com/. Accessed 20 Dec 2017

30.

Remacle M, Prasad V, Lawson G, Plisson L, Bachy V, Van der Vorst S (2015) Transoral robotic surgery (TORS) with the Medrobotics Flex™ System: first surgical application on humans. Eur Arch Otorhinolaryngol 272:1451–1455CrossRefPubMed

31.

Schuler PJ, Duvvuri U, Friedrich DT, Rotter N, Scheithauer MO, Hoffmann TK (2015) First use of a computer-assisted operator-controlled flexible endoscope for transoral surgery. Laryngoscope 125:645–648CrossRefPubMed

32.

Funk E, Goldenberg D, Goyal N (2017) Demonstration of transoral robotic supraglottic laryngectomy and total laryngectomy in cadaveric specimens using the Medrobotics Flex System. Head Neck 39(6):1218–1225CrossRef

33.

Johnson PJ, Serrano CMR, Castro M, Kuenzler R, Choset H, Tully S, Duvvuri U (2013) Demonstration of transoral surgery in cadaveric specimens with the medrobotics flex system. Laryngoscope 123:1168–1172CrossRefPubMed

34.

Mattheis S, Hasskamp P, Holtmann L, Schafer C, Geisthoff U, Dominas N, Lang S (2017) Flex robotic system in transoral robotic surgery: the first 40 patients. Head Neck 39:471–475. https://doi.org/10.1002/hed.24611 CrossRefPubMed

35.

Fanfani F, Monterossi G, Fagotti A, Rossitto C, Alletti SG, Costantini B, Gallotta V, Selvaggi L, Restaino S, Scambia G (2016) The new robotic TELELAP ALF-X in gynecological surgery: single-center experience. Surg Endosc 30:215–221CrossRefPubMed

36.

Fanfani F, Restaino S, Rossitto C, Alletti SG, Costantini B, Monterossi G, Cappuccio S, Perrone E, Scambia G (2016) Total laparoscopic (S-LPS) versus TELELAP ALF-X robotic-assisted hysterectomy: a case-control study. J Minim Invasive Gynecol 23:933–938CrossRefPubMed

37.

Rassweiler JJ, Autorino R, Klein J, Mottrie A, Goezen AS, Stolzenburg J, Rha KH, Schurr M, Kaouk J, Patel V (2017) Future of robotic surgery in urology. BJU Int 120(6):822–841CrossRefPubMed

38.

Stark M, Pomati S, D’Ambrosio A, Giraudi F, Gidaro S (2015) A new telesurgical platform–preliminary clinical results. Minim Invasive Ther Allied Technol 24:31–36CrossRefPubMed

39.

Spinelli A, David G, Gidaro S, Carvello M, Sacchi M, Montorsi M, Montroni I (2017) First experience in colorectal surgery with a new robotic platform with haptic feedback. Colorectal Dis. https://doi.org/10.1111/codi.13882

40.

Miller NS (2017) Florida Hospital 1st in nation to use new robotic surgery system. Orlando Sentinel. http://www.orlandosentinel.com/health/os-florida-hospital-TransEnterix-robotic-surgery-20171114-story.html. Accessed 20 Dec 2017

41.

Auris Surgical Robotics (2017) Auris indications for use statement and 510 k summary bronchscopy v4 052616 ra. http://www.accessdata.fda.gov/cdrh_docs/pdf15/k152319.pdf. Accessed 20 Dec 2017

42.

Romo E, Bogusky J (2014) Auris Surgical Robotics Inc. Endoscopic device with helical lumen design. US Patent 20,150,164,594

43.

Harris M (2016) First surgical robot from secretive startup Auris cleared for use. IEEE Spectr. https://spectrum.ieee.org/the-human-os/biomedical/devices/first-surgical-robot-from-secretive-startup-auris-cleared-for-use. Accessed 20 Dec 2017

44.

Eickhoff A, van Dam J, Jakobs R, Kudis V, Hartmann D, Damian U, Weickert U, Schilling D, Riemann JF (2007) Computer-assisted colonoscopy (the NeoGuide Endoscopy System): results of the first human clinical trial (“PACE study”). Am J Gastroenterol 102:261–266CrossRefPubMed

45.

Gudeloglu A, Brahmbhatt J, Parekattil S (2014) Robotic microsurgery in male infertility and urology—taking robotics to the next level. Transl Androl Urol 3:102PubMedPubMedCentral

46.

Prendergast JM, Rentschler ME (2016) Towards autonomous motion control in minimally invasive robotic surgery. Expert Rev Med Devices 13:741–748CrossRefPubMed

47.

Henry B, Novarro G, Santo G (2017) Peering Behind The Veil of Secrecy In Surgical Robotics & 2016 Market Outlook

48.

Hagn U, Konietschke R, Tobergte A, Nickl M, Jörg S, Kübler B, Passig G, Gröger M, Fröhlich F, Seibold U (2010) DLR MiroSurge: a versatile system for research in endoscopic telesurgery. Int J Comp Assist Radiol Surg 5:183–193CrossRef

49.

Konietschke R, Hagn U, Nickl M, Jorg S, Tobergte A, Passig G, Seibold U, Le-Tien L, Kubler B, Groger M, Frohlich F, Rink C, Albu-Schaffer A, Grebenstein M, Ortmaier T, Hirzinger G (2009) The DLR MiroSurge—A robotic system for surgery. Robotics and Automation, 2009 ICRA ‘09 IEEE International Conference on 1589–1590. https://doi.org/10.1109/ROBOT.2009.5152361

50.

Tobergte A, Helmer P, Hagn U, Rouiller P, Thielmann S, Grange S, Albu-Schaffer A, Conti F, Hirzinger G (2011) The sigma.7 haptic interface for MiroSurge: a bi-manual surgical console, pp 3023–3029

51.

Klibansky D, Rothstein RI (2012) Robotics in endoscopy. Curr Opin Gastroenterol 28:477–482. https://doi.org/10.1097/MOG.0b013e328356ac5e CrossRefPubMed

52.

Yeung BP, Gourlay T (2012) A technical review of flexible endoscopic multitasking platforms. Int J Surg 10:345–354. https://doi.org/10.1016/j.ijsu.2012.05.009 CrossRefPubMed

53.

ViaCath diagnostic catheters (2016). https://www.biotronik.com/sixcms/media.php/136/ViaCath_EN.pdf. Accessed 20 Dec 2017

54.

SPORT™ Surgical System (2017) Titan Medical Inc. http://www.titanmedicalinc.com/product/. Accessed 20 Dec 2017

55.

SurgiBot (2017) http://www.transenterix.com/SurgiBot

56.

Haskins O (2015) TransEnterix completes SurgiBot pre-clinical FDA work Bariatric News. http://www.bariatricnews.net/?q=node/1856. Accessed 20 Dec 2017

57.

Pryor AD, Tushar JR, DiBernardo LR (2010) Single-port cholecystectomy with the TransEnterix SPIDER: simple and safe. Surg Endosc 24:917–923. https://doi.org/10.1007/s00464-009-0695-9 CrossRefPubMed

58.

Haber G, Autorino R, Laydner H, Yang B, White MA, Hillyer S, Altunrende F, Khanna R, Spana G, Wahib I (2012) SPIDER surgical system for urologic procedures with laparoendoscopic single-site surgery: from initial laboratory experience to first clinical application. Eur Urol 61:415–422CrossRefPubMed

59.

Thibault M (2016) Finally, details on Medtronic’s robotics platform. Medical Device Business. http://www.mddionline.com/blog/devicetalk/finally-details-medtronics-robotics-platform-06-08-16. Accessed 20 Dec 2017

60.

CMR reveals versus robotic surgery system. (2016)

61.

Kume K (2016) Flexible robotic endoscopy: current and original devices. Comp Assisted Surg 21:150–159CrossRef

62.

Lomanto D, Wijerathne S, Ho LKY, Phee LSJ (2015) Flexible endoscopic robot. Minim Invasive Ther Allied Technol 24:37–44CrossRefPubMed

63.

Verb surgical delivers digital surgery prototype demonstration to collaboration partners (2017). http://www.prnewswire.com/news-releases/verb-surgical-delivers-digital-surgery-prototype-demonstration-to-collaboration-partners-300397192.html. Accessed 20 Dec 2017

64.

Simonite T (2016) The recipe for the perfect robot surgeon. https://www.technologyreview.com/s/602595/the-recipe-for-the-perfect-robot-surgeon/. MIT Technology Review 2017. Accessed 20 Dec 2017

65.

Here’s the Latest from Verb Surgical|MDDI Medical Device and Diagnostic Industry News Products and Suppliers (2017). http://www.mddionline.com/blog/devicetalk/heres-latest-verb-surgical-10-03-16. Accessed 20 Dec 2017

66.

Khateeb OM (2016) Democratizing Surgery Part 1: What Verb surgical is creating. Robotics Buisness Review. https://www.linkedin.com/pulse/democratizing-surgery-how-verb-surgical-invented-new-category. Accessed 20 Dec 2017

67.

Wortman TD (2011) Design, analysis, and testing of in vivo surgical robots. Department of Mechanical Engineering, University of Nebraska—Lincoln. http://digitalcommons.unl.edu/mechengdiss/28. Accessed 20 Dec 2017

68.

Rentschler ME, Oleynikov D (2007) Recent in vivo surgical robot and mechanism developments. Surg Endosc 21:1477–1481. https://doi.org/10.1007/s00464-007-9338-1 CrossRefPubMed

69.

Feussner H (2017) Surgery 4.0. In: Thuemmler C, Bai C (eds) Health 4.0: How Virtualization and Big Data are Revolutionizing healthcare. Springer, Cham, pp 91–107CrossRef

70.

Berci G, Forde K (2000) History of endoscopy. Surg Endosc 14:5–15CrossRefPubMed

71.

McMurray J, Strudwick G, Forchuk C, Morse A, Lachance J, Baskaran A, Allison L, Booth R (2017) The importance of trust in the adoption and use of intelligent assistive technology by older adults to support aging in place: scoping review protocol. JMIR Res Protoc 6:e218. https://doi.org/10.2196/resprot.8772 CrossRefPubMedPubMedCentral

72.

Yan A (2017) How a robot passed China’s medical licensing exam: Machine shows capacity to learn, reason and make judgments but is not quite ready to go into solo practice, developers say. South China Morning Post. http://www.scmp.com/news/china/society/article/2120724/how-robot-passed-chinas-medical-licensing-exam. Accessed 20 Dec 2017

73.

Moukarzel LA, Fader AN, Tanner EJ (2017) Feasibility of robotic-assisted laparoendoscopic single-site surgery in the gynecologic oncology setting. J Minim Invasive Gynecol 24:258–263CrossRefPubMed

74.

Tsukamoto S, Nishizawa Y, Ochiai H, Tsukada Y, Sasaki T, Shida D, Ito M, Kanemitsu Y (2017) Surgical outcomes of robot-assisted rectal cancer surgery using the da Vinci Surgical System: a multi-center pilot Phase II study. Jpn J Clin Oncol:1–6, https://doi.org/10.1093/jjco/hyx141

75.

Galvez D, Sorber R, Javed AA, He J (2017) Technical considerations for the fully robotic pancreaticoduodenectomy. J Vis Surg 3:81. https://doi.org/10.21037/jovs.2017.05.08 CrossRefPubMedPubMedCentral

76.

Randell R, Honey S, Hindmarsh J, Alvarado N, Greenhalgh J, Pearman A, Long A, Cope A, Gill A, Gardner P, Kotze A, Wilkinson D, Jayne D, Croft J, Dowding D (2017) https://doi.org/10.3310/hsdr05200

77.

Ozyurtkan MO, Kaba E, Toker A (2017) What happens while learning robotic lobectomy for lung cancer? J Vis Surg 3:27. https://doi.org/10.21037/jovs.2017.02.02 CrossRefPubMedPubMedCentral

78.

Criss CN, Gadepalli SK (2017) Sponsoring surgeons; an investigation on the influence of the da Vinci robot. Am J Surg, https://doi.org/10.1016/j.amjsurg.2017.08.017 PubMed

79.

Jeong IG, Khandwala YS, Kim JH, Han DH, Li S, Wang Y, Chang SL, Chung BI (2017) Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health Care costs, 2003 to 2015. JAMA 318:1561–1568. https://doi.org/10.1001/jama.2017.14586 CrossRefPubMed

80.

Vasudevan V, Reusche R, Wallace H, Kaza S (2016) Clinical outcomes and cost–benefit analysis comparing laparoscopic and robotic colorectal surgeries. Surg Endosc 30:5490–5493CrossRefPubMed

81.

Waite KE, Herman MA, Doyle PJ (2016) Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg 10:239–244CrossRefPubMed

Titel: Review of emerging surgical robotic technology
verfasst von: Brian S. Peters
Priscila R. Armijo
Crystal Krause
Songita A. Choudhury
Dmitry Oleynikov
Publikationsdatum: 13.02.2018
Verlag: Springer US
Erschienen in: Surgical Endoscopy / Ausgabe 4/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6079-2

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

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

Springer Medizin

Abstract

Background

Methods

Results

Conclusions

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

Weitere Artikel der Ausgabe 4/2018

Synoptic operative reporting: assessing the completeness, accuracy, reliability, and efficiency of synoptic reporting for Roux-en-Y gastric bypass

Comparison of two new techniques for the management of malignant central airway obstruction: argon plasma coagulation with mechanical tumor resection versus cryorecanalization

A Systematic review and meta-analysis of the efficacy and safety of video-assisted anal fistula treatment (VAAFT)

Laparoscopy for primary cytoreduction with multivisceral resections in advanced ovarian cancer: prospective validation. “The times they are a-changin”?

Inguinal hernia repair: is there a benefit to using the robot?

Operative and short-term oncologic outcomes of laparoscopic versus open liver resection for colorectal liver metastases located in the posterosuperior liver: a propensity score matching analysis

Update Chirurgie