Trends in laparoscopic and robotic surgery among gynecologic oncologists: A survey update (original) (raw)
Feasibility and safety of robotic surgery for gynecologic cancers
Asian Pacific journal of cancer prevention : APJCP, 2014
To determine surgical outcomes, perioperative complications, and patient outcomes in gynecologic cancer patients undergoing robotic surgery. Surgical outcomes, including docking time, total operative time, console time, estimated blood loss (EBL), conversion rate and perioperative complications were retrospectively reviewed in 30 gynecologic cancer patients undergoing robotic surgery. Patient outcomes included recovery time and patient satisfaction, as scored by a visual analogue scale (VAS) from 0-10. The operations included 24 hysterectomies with pelvic lymphadenectomy (PLD) and/or para-aortic lymphadenectomy, four radical hysterectomies with PLD, and two radical trachelectomies with PLD. Mean docking time was 12.8 ± 9.7 min, total operative time was 345.5 ± 85.0 min, and console time was 281.9 ± 78.6 min. These times were decreased in the second half of the cases. There was no conversion rate. Three intraoperative complications, including one external iliac artery injury, one bla...
Outcomes of Robot-assisted Laparoscopic Gynecological Surgery
Journal of the College of Physicians and Surgeons Pakistan
Numerous studies comparing standard laparoscopic gynecological surgery (S-LGS) and robot-assisted lyparoscopic gynecological surgery (RA-LGS) have shown improved surgical accuracy, faster intracorporeal knot tying, reduced skill-based errors and shorter time required for learning. 5-8 However, there is a lack of data regarding RA surgeries from developing nations, where training is necessary to improve the frequency of use and outcomes of such technologies. Therefore, the primary aim of the present study was to compare the outcomes, particularly short-term ones, and the complications between these procedures in a tertiary care facility in Saudi Arabia.
Purpose: To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis. Methods: The MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library databases were searched. Studies clearly documenting a comparison between robotic surgery and laparoscopy or between robotic surgery and laparotomy for endometrial cancer were selected. The outcome measures included operating time (OT), number of complications, length of hospital stay (LOHS), estimated blood loss (EBL), number of transfusions, total lymph nodes harvested (TLNH), and number of conversions. Pooled odds ratios and weighted mean differences with 95% confidence intervals were calculated using either a fixed-effects or random-effects model. Results: Twenty-two studies were included in the meta-analysis. These studies involved a total of 4420 patients, 3403 of whom underwent both robotic surgery and laparoscopy and 1017 of whom underwent both robotic surgery and laparotomy. The EBL (p = 0.01) and number of conversions (p = 0.0008) were significantly lower and the number of complications (p,0.0001) was significantly higher in robotic surgery than in laparoscopy. The OT, LOHS, number of transfusions, and TLNH showed no significant differences between robotic surgery and laparoscopy. The number of complications (p,0.00001), LOHS (p,0.00001), EBL (p,0.00001), and number of transfusions (p = 0.03) were significantly lower and the OT (p,0.00001) was significantly longer in robotic surgery than in laparotomy. The TLNH showed no significant difference between robotic surgery and laparotomy. Conclusions: Robotic surgery is generally safer and more reliable than laparoscopy and laparotomy for patients with endometrial cancer. Robotic surgery is associated with significantly lower EBL than both laparoscopy and laparotomy; fewer conversions but more complications than laparoscopy; and shorter LOHS, fewer complications, and fewer transfusions but a longer OT than laparoscopy. Further studies are required.
The International Journal of Medical Robotics and Computer Assisted Surgery, 2009
BackgroundEvaluation of the impact of a new robotic surgery programme on perioperative outcomes for endometrial cancerMethodsA prospective database of all patients undergoing staging for endometrial cancer during July 2007–July 2008 was collected and analysed. Demographic data and perioperative outcomes were compared between cases performed via laparotomy, laparoscopy and robotics.ResultsSixty‐five patients underwent staging during the time of data collection (LAP‐26, LSC‐7, ROB‐32). No difference in surgical volume in the year before vs. after robotics was identified. Median operative time for robotics and laparotomy was significantly less than for laparoscopy (p = 0.023). There was no significant difference in lymph node yields between the three groups (p = 0.92). Robotics was associated with significantly less blood loss (p < 0.0001). Complication rates were significantly lower in the robotic group compared to the laparotomy group (p = 0.05). Median hospital stay was 1 day for...