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Journal of Robotic Surgery

Andrew K Battenberg, Nathan A Netravali, Jess H Lonner
Technology, including robotics, has been developed for use in unicompartmental knee arthroplasty (UKA) to improve accuracy and precision of bone preparation, implant positioning, and soft tissue balance. The NAVIO™ System (Smith and Nephew, Pittsburgh, PA, United States) is a handheld robotic system that assists surgeons in planning implant positioning based on an individual patient's anatomy and then preparing the bone surface to accurately achieve the plan. The surgical technique is presented herein. In addition, initial results are presented for 128 patients (mean age 64...
February 14, 2019: Journal of Robotic Surgery
Smriti Panda, Kapil Sikka, Alok Thakar, Suresh C Sharma, Padmavathi Krishnamurthy
To analyze the feasibility, surgical outcomes and possible risks and complications encountered during transoral robotic surgery (TORS) for approaching parapharyngeal space (PPS) tumours, a retrospective cohort study was conducted. Out of 108 TORS procedures performed, 5 PPS tumours were identified from May 2011- November 2017. This study included 2 retrostyloid (benign nerve sheath tumour) and 3 prestyloid tumours (pleomorphic adenoma), of which one patient had previously undergone a transcervical approach for deep lobe of parotid pleomorphic adenoma...
February 14, 2019: Journal of Robotic Surgery
Daisuke Motoyama, Yuto Matsushita, Hiromitsu Watanabe, Keita Tamura, Toshiki Ito, Takayuki Sugiyama, Atsushi Otsuka, Hideaki Miyake
The objective of this study was to evaluate the impact of the early unclamping (EU) technique on perioperative outcomes in patients who underwent robot-assisted partial nephrectomy (RAPN). This study included 96 patients with small renal masses who underwent RAPN performed by a single surgeon using the da Vinci Xi between April 2016 and September 2018. EU and conventional clamping (CC) procedures were defined as those removing the renal artery clamp before and after renorrhaphy, respectively. In this series, contrast-enhanced computed tomography was performed 3-5 days after RAPN to examine the incidence of renal artery pseudoaneurysm (RAP)...
February 2, 2019: Journal of Robotic Surgery
Iswanto Sucandy, Abdelrahman Attili, Janelle Spence, Timothy Bordeau, Sharona Ross, Alexander Rosemurgy
High body mass index (BMI) is associated with other multiple comorbidities such as non-alcoholic fatty liver disease, steatohepatitis, liver cirrhosis, and cardiopulmonary diseases, which can impact the perioperative outcomes following liver resection. We aimed to study the impact of BMI on perioperative outcomes after robotic liver resection. All the patients undergoing robotic liver resection between 2013 and 2017 were prospectively followed. The patients were divided into three groups (BMI < 25, BMI 25-35, BMI > 35 kg/m2 ) for illustrative purposes...
February 1, 2019: Journal of Robotic Surgery
Kevin Shee, Kevin Koo, Xiaotian Wu, Fady M Ghali, Ryan J Halter, Elias S Hyams
Robotic surgical skill development is central to training in urology as well as other surgical disciplines. Vesicourethral anastomosis (VUA) in robotic prostatectomy is a challenging task for novices due to delicate tissue and difficult suturing angles. Commercially available, realistic training models are limited. Here, we describe the development and validation of a 3D-printed model of the VUA for ex vivo training using the da Vinci Surgical System. Models of the bladder and urethra were created using 3D-printing technology based on estimations of average in vivo anatomy...
January 28, 2019: Journal of Robotic Surgery
Shayanne A Lajud, Jaime A Aponte-Ortiz, Miguel Garraton, Laureano Giraldez
Medullary thyroid cancer (MTC) represents less than 1% of all thyroid cancers. Complete surgical resection remains the mainstay of treatment for locoregional disease. Unfortunately, patients with recurrence may present with metastasis to challenging anatomic locations. We describe the first case of a recurrent MTC metastatic to the parapharyngeal space (PPS) that was managed using a combined transoral robotic surgery (TORS) and transcervical (TC) approach. We review the presentation, natural history, diagnosis and management of recurrent MTC, and describe a novel combined TORS-TC surgical approach for the treatment of PPS metastasis...
January 28, 2019: Journal of Robotic Surgery
M Renz, N Marjon, K Devereaux, S Raghavan, A K Folkins, A Karam
Sentinel lymph nodes sampling (SLN) in endometrial cancer is being evaluated as a means to gather prognostic information about lymphatic metastasis while avoiding the morbidity associated with complete lymphadenectomy. SLN ultrastaging has been advocated to identify low-volume metastases, but its value remains uncertain. This study aims to evaluate a pathological protocol for the immediate intraoperative SLN work-up using H&E staining alone. In this retrospective single-center study, patients received standardized cervical injection of indocyanine green, SLN mapping followed by pelvic lymphadenectomy with or without para-aortic lymphadenectomy...
January 28, 2019: Journal of Robotic Surgery
Francesca B Seal, Wenjing He, David Pinzon, Bin Zheng
Non-technical skill training improves outcomes in surgery and quantifying the effects of this training may aid in designing surgical teaching models. In our study, 12 novices performed a wire-chaser laparoscopic task in 9 training sessions, working both as individuals and dyads. Task duration (p < 0.001), number of ring-wire contacts (p < 0.001), total duration of contact (p < 0.001), and number of pick up attempts (p = 0.044) all showed significant improvement in both groups with no significant difference in the learning curves between individuals and dyads...
January 28, 2019: Journal of Robotic Surgery
Julia Xia, Terrah Jean Paul Olson, Seth A Rosen
Laparoscopic colectomy is the preferred approach for surgical management of non-complicated diverticulitis, with lower complication rates, shorter length of stay, and decreased narcotic use compared with open surgery. Complicated diverticulitis, characterized by abscess, fistula or stricture, is more difficult to manage with minimally invasive surgery, with reports of higher conversion rates, prolonged operative time, longer length of stay, and increased complication rates. The robotic platform may provide an alternative safe and feasible option for managing complicated diverticulitis with minimally invasive surgery...
January 23, 2019: Journal of Robotic Surgery
Salvatore Smelzo, Guglielmo Mantica, Nazareno Suardi, Giovanni Passaretti, Davide De Marchi, Giovannalberto Pini, Davide Oreggia, Franco Gaboardi
The reports on the performance of robotic surgery in patients with dwarfism are anecdotal; anesthesiological issues and a challenging anatomy are the main factors that lead most of surgeons to prefer a more traditional approach. We present a case of bilateral robotic partial nephrectomy in a patient affected by achondroplastic dwarfism and aim to evaluate risks and issues in this type of surgery.
January 23, 2019: Journal of Robotic Surgery
Axel Sahovaler, David E Eibling, Ida Bruni, Uma Duvvuri, S Danielle MacNeil, Anthony C Nichols, John Yoo, Kevin Fung, Kathryn Roth
Post-operative hemorrhage is the most concerning complication after minimally invasive transoral surgery, as can result in airway compromise. Simulation-based medical education provides trainees with structured learning in an intensive and immersive environment allowing deliberate practice of skills and behaviors in the management of real-life situations. We implemented a novel post-oropharyngeal surgery bleeding model in a nationwide otolaryngology emergencies bootcamp, to teach and evaluate technical and non-technical skills required to competently manage this clinical scenario...
January 23, 2019: Journal of Robotic Surgery
Gaby N Moawad, Paul Tyan, Jiheum Paek, Erryn E Tappy, Daniel Park, Souzanna Choussein, Serene S Srouji, Antonio Gargiulo
Minimizing the number of port incisions during minimally invasive surgery is associated with improved outcomes and patient satisfaction. We designed this work to study the perioperative outcomes of robotic single-site myomectomy (RSSM) in comparison to robotic multiport myomectomy (RMM) in a certain subset of patients. The design of the study is a multicenter retrospective analysis (Canadian Task Force classification III). The setting was three university hospitals. Eighty patients with symptomatic uterine fibroids undergoing robot-assisted single-site myomectomy were selected for the study...
January 21, 2019: Journal of Robotic Surgery
Ashwin Sunil Tamhankar, Saurabh Ramesh Patil, Surya Prakash Ojha, Puneet Ahluwalia, Gagan Gautam
Retroperitoneal lymph node dissection (RPLND) is a therapeutic standard of care for post-chemotherapy residual masses in testicular cancer. While a robotic approach to this procedure has the potential of decreasing the morbidity associated with this major endeavour, it is often criticised for its inability to provide a bilateral complete template resection without redocking and repositioning the patient. Herein, we present the technique and initial outcomes of a supine approach to Robotic RPLND (R-RPLND) using the da Vinci Xi® system, which obviates the need for repositioning or redocking for a bilateral full template resection...
January 17, 2019: Journal of Robotic Surgery
Amanda E Kahn, Ashley M Shumate, Colleen T Ball, David D Thiel
To prospectively evaluate outcomes of robotic-assisted partial nephrectomy (RAPN) following elimination of surgical drains. 100 consecutive drainless RAPN performed by a single surgeon were analyzed following a previously published quantitative assessment of drain creatinine/serum creatinine ratios. This cohort was compared to 100 preceding RAPN with drains. Variables analyzed included pre-operative patient/tumor characteristics and post-operative outcomes including post-operative estimated glomerular filtration rate (eGFR), length of hospital stay (LOS), and complications...
January 9, 2019: Journal of Robotic Surgery
Courtney A Green, Patricia S O'Sullivan, Hueylan Chern
Most robotic curriculum requires simulation on a console prior to operative exposure. This practice does not permit experiencing the physical collisions with the robotic tools, which occurs during surgery. We designed and evaluated an innovative curriculum to address cognitive components and trouble-shoot robotic collisions when the surgeon lacks haptic feedback. We adapted our previous curriculum, designed to teach and document proficiency of robotic docking and instrument exchange, to include robotic collisions...
January 9, 2019: Journal of Robotic Surgery
Farnoosh Nik-Ahd, Colby P Souders, Hanson Zhao, Justin Houman, Lynn McClelland, Bilal Chughtai, Jennifer T Anger
There is a lack of information regarding malpractice claims and indemnity payments associated with robotic cases in surgery. Malpractice claims and indemnity payouts will elucidate and mitigate harms of future adoption of new technology into surgery. We analyzed claims filed against Intuitive Surgical, Inc. from 2000 to 2017. A law librarian identified product liability claims from 2000 to 2017 with the defendant "Intuitive Surgical, Inc." using the Bloomberg Law database. We reviewed all available legal documents pertaining to identified claims, and extracted data points including filing date, surgery date, surgery type, robot type, instrument type, complications, and case outcomes...
January 8, 2019: Journal of Robotic Surgery
Kyle Miller, Dale Bergman, Glenn Stante, Chandu Vemuri
Robotic-assisted surgical approaches for vascular surgery are feasible regarding minimally invasive exposure, dissection, ligation and skeletonization for varicose vein ligation, anterior spine exposure, femoral-popliteal bypass, femoral vein harvest and aortic aneurysm repair. The authors performed a cadaveric exploration to demonstrate proof of concept and feasibility for a robotic-assisted approached. Surgeon autonomy over endoscopic vision, robotic instrumentation and retraction were noted as key benefits over existing open vascular approaches...
January 4, 2019: Journal of Robotic Surgery
A J W Beulens, W M Brinkman, H G Van der Poel, A N Vis, J P van Basten, R P Meijer, C J Wijburg, A J M Hendrikx, J J G van Merriënboer, C Wagner
OBJECTIVE: To develop an assessment instrument for the evaluation of surgical videos to elucidate the association between surgical skills and postoperative outcomes after a robot-assisted radical prostatectomy (RARP). DESIGN: A Delphi study consisting of two consecutive online surveys and a consensus group meeting. SETTING: Urology departments of general, teaching and university hospitals in the Netherlands. PARTICIPANTS: All Dutch urologists with a specialization in RARP...
January 4, 2019: Journal of Robotic Surgery
Sarah Nisivaco, Michael Henry, R Parker Ward, Husam H Balkhy
Although they comprise a small number of primary tumors of the heart, papillary fibroelastomas (PFEs) are the second most common type of benign cardiac tumor. PFEs of the right heart are uncommon, and those arising from the right-ventricular (RV) wall are extremely rare, with only a handful of reported cases in the literature. Removal of these tumors has been described, primarily through a median sternotomy approach, with only one report of using a right-sided mini-thoracotomy technique. The advantages of endoscopic robotic-assisted cardiac surgery have been demonstrated and described extensively...
January 4, 2019: Journal of Robotic Surgery
Luca Morelli, Gregorio Di Franco, Andrea Moglia, Alfred Cuschieri
No abstract text is available yet for this article.
January 3, 2019: Journal of Robotic Surgery
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