Skip to main content
Erschienen in: Surgical Endoscopy 7/2019

17.10.2018

Comparative effectiveness of human scope assistant versus robotic scope holder in laparoscopic resection for colorectal cancer

verfasst von: Yasushi Ohmura, Hiromitsu Suzuki, Kazutoshi Kotani, Atsushi Teramoto

Erschienen in: Surgical Endoscopy | Ausgabe 7/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Several types of robotic scope holders have been developed to date, but there are only some experimental reports or the results of small clinical cases. The Soloassist® system is a unique robotic scope holder with which the surgeon can control the field of view by a joystick. We evaluated the efficacy of Soloassist in laparoscopic resection for colorectal cancer.

Materials and methods

We investigated operative time, blood loss, setup time, length of hospital stay, and the number of participating surgeons in 273 laparoscopic colorectal resections, including 130 cases with human assistant (HA group) and 143 cases with Soloassist (SA group). Additionally, we also used logistic regression of the perioperative factors for the propensity score calculation to balance the bias.

Results

The number of participating surgeons was apparently less in the SA group (HA group: 3.3 vs. SA group: 2.5, p < 0.01). The average operative time was shorter in the SA group, but there was no statistical difference (HA group: 287.0 min vs. SA group: 268.5 min, p = 0.07). No significant difference was found in setup time, conversion rate, perioperative complications, and length of hospital stay. There was no conversion case to human scope assistant and no system-specific adverse event. Similar results were observed between two groups after propensity score matching.

Conclusion

Laparoscopic colorectal resection with Soloassist is safe and feasible. The present study demonstrated that Soloassist system provided the possibilities of saving human resources in laparoscopic colorectal resection without prolonged operative time or system-specific morbidity. Soloassist is an effective robot-assisted surgical instrument for colorectal surgery.
Literatur
1.
Zurück zum Zitat Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150 Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150
2.
Zurück zum Zitat Bandoh T, Shiraishi N, Yamashita Y, Terachi T, Hashizume M, Akira S, Morikawa T, Kitagawa Y, Yanaga K, Endo S, Onishi K, Takiguchi S, Tamaki Y, Hasegawa T, Mimata H, Tabata M, Yozu R, Inomata M, Matsumoto S, Kitano S, Watanabe M (2017) Endoscopic surgery in Japan: The 12th national survey (2012–2013) by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 10:345–353CrossRefPubMed Bandoh T, Shiraishi N, Yamashita Y, Terachi T, Hashizume M, Akira S, Morikawa T, Kitagawa Y, Yanaga K, Endo S, Onishi K, Takiguchi S, Tamaki Y, Hasegawa T, Mimata H, Tabata M, Yozu R, Inomata M, Matsumoto S, Kitano S, Watanabe M (2017) Endoscopic surgery in Japan: The 12th national survey (2012–2013) by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 10:345–353CrossRefPubMed
3.
Zurück zum Zitat Watanabe J, Ota M, Fujii S, Suwa H, Ishibe A, Endo I (2016) Randomized clinical trial of single-incision versus multiport laparoscopic colectomy. Br J Surg 103:1276–1281CrossRefPubMed Watanabe J, Ota M, Fujii S, Suwa H, Ishibe A, Endo I (2016) Randomized clinical trial of single-incision versus multiport laparoscopic colectomy. Br J Surg 103:1276–1281CrossRefPubMed
4.
Zurück zum Zitat Brockhaus AC, Sauerland S, Saad S (2016) Single-incision versus standard multi-incision laparoscopic colectomy in patients with malignant or benign colonic disease: a systematic review, meta-analysis and assessment of the evidence. BMC Surg 16:71CrossRefPubMedPubMedCentral Brockhaus AC, Sauerland S, Saad S (2016) Single-incision versus standard multi-incision laparoscopic colectomy in patients with malignant or benign colonic disease: a systematic review, meta-analysis and assessment of the evidence. BMC Surg 16:71CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45:1689–1694CrossRefPubMed Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45:1689–1694CrossRefPubMed
6.
Zurück zum Zitat D’Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D (2004) Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 47:2162–2168CrossRefPubMed D’Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D (2004) Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 47:2162–2168CrossRefPubMed
7.
Zurück zum Zitat den Boer KT, Bruijn M, Jaspers JE, Stassen LP, Erp WF, Jansen A, Go PM, Dankelman J, Gouma DJ (2002) Time-action analysis of instrument positioners in laparoscopic cholecystectomy. Surg Endosc 16:142–147CrossRef den Boer KT, Bruijn M, Jaspers JE, Stassen LP, Erp WF, Jansen A, Go PM, Dankelman J, Gouma DJ (2002) Time-action analysis of instrument positioners in laparoscopic cholecystectomy. Surg Endosc 16:142–147CrossRef
8.
Zurück zum Zitat Merola S, Weber P, Wasielewski A, Ballantyne GH (2002) Comparison of laparoscopic colectomy with and without the aid of a robotic camera holder. Surg Laparosc Endosc Percutan Tech 12:46–51CrossRefPubMed Merola S, Weber P, Wasielewski A, Ballantyne GH (2002) Comparison of laparoscopic colectomy with and without the aid of a robotic camera holder. Surg Laparosc Endosc Percutan Tech 12:46–51CrossRefPubMed
9.
Zurück zum Zitat Zhou HX, Guo YH, Yu XF, Bao SY, Liu JL, Zhang Y, Ren YG (2006) Zeus robot-assisted laparoscopic cholecystectomy in comparison with conventional laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int 5:115–118PubMed Zhou HX, Guo YH, Yu XF, Bao SY, Liu JL, Zhang Y, Ren YG (2006) Zeus robot-assisted laparoscopic cholecystectomy in comparison with conventional laparoscopic cholecystectomy. Hepatobiliary Pancreat Dis Int 5:115–118PubMed
10.
Zurück zum Zitat Tyler JA, Fox JP, Desai MM, Perry WB, Glasgow SC (2013) Outcomes and costs associated with robotic colectomy in the minimally invasive era. Dis Colon Rectum 56:458–466CrossRef Tyler JA, Fox JP, Desai MM, Perry WB, Glasgow SC (2013) Outcomes and costs associated with robotic colectomy in the minimally invasive era. Dis Colon Rectum 56:458–466CrossRef
11.
Zurück zum Zitat Keller DS, Senagore AJ, Lawrence JK, Champagne BJ, Delaney CP (2014) Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection. Surg Endosc 28:212–221CrossRefPubMed Keller DS, Senagore AJ, Lawrence JK, Champagne BJ, Delaney CP (2014) Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection. Surg Endosc 28:212–221CrossRefPubMed
12.
Zurück zum Zitat Yeo HL, Isaacs AJ, Abelson JS, Milsom JW, Sedrakyan A (2016) Comparison of open, laparoscopic, and robotic colectomies using a large national database: outcomes and trends related to surgery center volume. Dis Colon Rectum 59:535–542CrossRef Yeo HL, Isaacs AJ, Abelson JS, Milsom JW, Sedrakyan A (2016) Comparison of open, laparoscopic, and robotic colectomies using a large national database: outcomes and trends related to surgery center volume. Dis Colon Rectum 59:535–542CrossRef
13.
Zurück zum Zitat Aiono S, Gilbert JM, Soin B, Finlay PA, Gordan A (2002) Controlled trial of the introduction of a robotic camera assistant (EndoAssist) for laparoscopic cholecystectomy. Surg Endosc 16:1267–1270CrossRefPubMed Aiono S, Gilbert JM, Soin B, Finlay PA, Gordan A (2002) Controlled trial of the introduction of a robotic camera assistant (EndoAssist) for laparoscopic cholecystectomy. Surg Endosc 16:1267–1270CrossRefPubMed
14.
Zurück zum Zitat Takahashi M, Takahashi M, Nishinari N, Matsuya H, Tosha T, Minagawa Y, Shimooki O, Abe T (2017) Clinical evaluation of complete solo surgery with the “ViKY®” robotic laparoscope manipulator. Surg Endosc 31:981–986CrossRefPubMed Takahashi M, Takahashi M, Nishinari N, Matsuya H, Tosha T, Minagawa Y, Shimooki O, Abe T (2017) Clinical evaluation of complete solo surgery with the “ViKY®” robotic laparoscope manipulator. Surg Endosc 31:981–986CrossRefPubMed
15.
Zurück zum Zitat Gillen S, Pletzer B, Heiligensetzer A, Wolf P, Kleeff J, Feussner H, Fürst A (2014) Solo-surgical laparoscopic cholecystectomy with a joystick-guided camera device: a case-control study. Surg Endosc 28:164–170CrossRefPubMed Gillen S, Pletzer B, Heiligensetzer A, Wolf P, Kleeff J, Feussner H, Fürst A (2014) Solo-surgical laparoscopic cholecystectomy with a joystick-guided camera device: a case-control study. Surg Endosc 28:164–170CrossRefPubMed
16.
Zurück zum Zitat Ohmura Y, Nakagawa M, Suzuki H, Kotani K, Teramoto A (2018) Feasibility and usefulness of a joystick-guided robotic scope holder (Soloassist) in laparoscopic surgery. Visc Med 34:37–44CrossRefPubMedPubMedCentral Ohmura Y, Nakagawa M, Suzuki H, Kotani K, Teramoto A (2018) Feasibility and usefulness of a joystick-guided robotic scope holder (Soloassist) in laparoscopic surgery. Visc Med 34:37–44CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Clinical Outcomes of Surgical Therapy Study Group, Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Ota D (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Clinical Outcomes of Surgical Therapy Study Group, Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Ota D (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
18.
Zurück zum Zitat Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52CrossRef Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Påhlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52CrossRef
19.
Zurück zum Zitat Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068CrossRef Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068CrossRef
20.
Zurück zum Zitat Arezzo A, Schurr MO, Braun A, Buess GF (2005) Experimental assessment of a new mechanical endoscopic solosurgery system: endofreeze. Surg Endosc 19:581–588CrossRefPubMed Arezzo A, Schurr MO, Braun A, Buess GF (2005) Experimental assessment of a new mechanical endoscopic solosurgery system: endofreeze. Surg Endosc 19:581–588CrossRefPubMed
21.
Zurück zum Zitat Lee YS, Jeon HG, Lee SR, Jeong WJ, Yang SC, Han WK (2010) The feasibility of solo-surgeon living donor nephrectomy: initial experience using video-assisted minilaparotomy surgery. Surg Endosc 24:2755–2759CrossRefPubMed Lee YS, Jeon HG, Lee SR, Jeong WJ, Yang SC, Han WK (2010) The feasibility of solo-surgeon living donor nephrectomy: initial experience using video-assisted minilaparotomy surgery. Surg Endosc 24:2755–2759CrossRefPubMed
22.
Zurück zum Zitat Omote K, Feussner H, Ungeheuer A, Arbter K, Wei GQ, Siewert JR, Hirzinger G (1999) Self-guided robotic camera control for laparoscopic surgery compared with human camera control. Am J Surg 177:321–324CrossRefPubMed Omote K, Feussner H, Ungeheuer A, Arbter K, Wei GQ, Siewert JR, Hirzinger G (1999) Self-guided robotic camera control for laparoscopic surgery compared with human camera control. Am J Surg 177:321–324CrossRefPubMed
24.
Zurück zum Zitat Stolzenburg JU, Franz T, Kallidonis P, Minh D, Dietel A, Hicks J, Nicolaus M, Al-Aown A, Liatsikos E (2011) Comparison of the FreeHand® robotic camera holder with human assistants during endoscopic extraperitoneal radical prostatectomy. BJU Int 107:970–974CrossRefPubMed Stolzenburg JU, Franz T, Kallidonis P, Minh D, Dietel A, Hicks J, Nicolaus M, Al-Aown A, Liatsikos E (2011) Comparison of the FreeHand® robotic camera holder with human assistants during endoscopic extraperitoneal radical prostatectomy. BJU Int 107:970–974CrossRefPubMed
25.
Zurück zum Zitat Bann S, Khan M, Hernandez J, Munz Y, Moorthy K, Datta V, Rockall T, Darzi A (2003) Robotics in surgery. J Am Coll Surg 196:784–795CrossRefPubMed Bann S, Khan M, Hernandez J, Munz Y, Moorthy K, Datta V, Rockall T, Darzi A (2003) Robotics in surgery. J Am Coll Surg 196:784–795CrossRefPubMed
26.
Zurück zum Zitat 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 24:1770–1777CrossRefPubMed 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 24:1770–1777CrossRefPubMed
27.
Zurück zum Zitat Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18:816–830CrossRefPubMed Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18:816–830CrossRefPubMed
28.
Zurück zum Zitat Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR Randomized Clinical Trial. JAMA 318:1569–1580CrossRefPubMedPubMedCentral Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR Randomized Clinical Trial. JAMA 318:1569–1580CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Mizuno Y, Narimatsu H, Kodama Y, Matsumura T, Kami M (2014) Mid-career changes in the occupation or specialty among general surgeons, from youth to middle age, have accelerated the shortage of general surgeons in Japan. Surg Today 44:601–606CrossRefPubMed Mizuno Y, Narimatsu H, Kodama Y, Matsumura T, Kami M (2014) Mid-career changes in the occupation or specialty among general surgeons, from youth to middle age, have accelerated the shortage of general surgeons in Japan. Surg Today 44:601–606CrossRefPubMed
31.
Zurück zum Zitat Chen YC, Shih CL, Wu CH, Chiu CH (2014) Exploring factors that have caused a decrease in surgical manpower in Taiwan. Surg Innov 21:520–527CrossRefPubMed Chen YC, Shih CL, Wu CH, Chiu CH (2014) Exploring factors that have caused a decrease in surgical manpower in Taiwan. Surg Innov 21:520–527CrossRefPubMed
32.
Zurück zum Zitat Deedar-Ali-Khawaja R, Khan SM (2010) Trends of surgical career selection among medical students and graduates: a global perspective. J Surg Educ 67:237–248CrossRefPubMed Deedar-Ali-Khawaja R, Khan SM (2010) Trends of surgical career selection among medical students and graduates: a global perspective. J Surg Educ 67:237–248CrossRefPubMed
33.
Zurück zum Zitat Marschall JG, Karimuddin AA (2003) Decline in popularity of general surgery as a career choice in North America: review of postgraduate residency training selection in Canada, 1996–2001. World J Surg 27:249–252CrossRefPubMed Marschall JG, Karimuddin AA (2003) Decline in popularity of general surgery as a career choice in North America: review of postgraduate residency training selection in Canada, 1996–2001. World J Surg 27:249–252CrossRefPubMed
34.
Zurück zum Zitat Dunlap KD, Wanzer L (1998) Is the robotic arm a cost-effective surgical tool? AORN J 68:265–272CrossRefPubMed Dunlap KD, Wanzer L (1998) Is the robotic arm a cost-effective surgical tool? AORN J 68:265–272CrossRefPubMed
Metadaten
Titel
Comparative effectiveness of human scope assistant versus robotic scope holder in laparoscopic resection for colorectal cancer
verfasst von
Yasushi Ohmura
Hiromitsu Suzuki
Kazutoshi Kotani
Atsushi Teramoto
Publikationsdatum
17.10.2018
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 7/2019
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6506-4

Weitere Artikel der Ausgabe 7/2019

Surgical Endoscopy 7/2019 Zur Ausgabe

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.

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
Berufsverband der Deutschen Chirurgie e.V.

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
Berufsverband der Deutschen Chirurgie e.V.

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
Berufsverband der Deutschen Chirurgie e.V.