Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous s...Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous systems(da Vinci S&Si)have arguably slowed down its wholesale adoption.The latest robotic platform,the da Vinci Xi,addresses these limitations.This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems.Materials and methods:All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases.The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed.Results:A total of 240 patients were identified(124 Si,116 Xi).Median operation-time and length-of-stay were 260 minutes and 6 days respectively.Conversion and 30-day mortality rates were 0.The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group(230 vs 300 min,p=0.000)but length-of-stay,lymph node yield and circumferential resection margin favoured the Xi group(7 vs 5 days,p=0.010;17 vs 21,p=0.000;92.7%vs 99.1%,p=0.020).Conclusion:Single-docking fully-robotic rectal cancer surgery is safe,feasible and can lead to good shortterm outcomes,making it a good alternative to laparoscopic rectal cancer surgery.The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion.展开更多
Laparoendoscopic single-site surgery(LESS)is technically challenging;it can reduces instrument triangulation and robust retraction and is associated with a steep learning curve.The instruments of the daVinci surgic...Laparoendoscopic single-site surgery(LESS)is technically challenging;it can reduces instrument triangulation and robust retraction and is associated with a steep learning curve.The instruments of the daVinci surgical system(Intuitive Surgical)are designed with seven degrees of motion mimicing the dexterity of the human hand and wrist.This inherent feature of the robotic arm provides superior ergonomics when performing LESS,especially for complex reconstructive surgery.This review analyzes the evidence supporting current and future application of robotic technology in the field of urologic LESS.展开更多
检索了美国食品药品监督管理局(Food and Drug Administration,FDA)制造商和用户设施设备体验(Manufa-cturer and User Facility Device Experience,MAUDE)数据库中2000—2021年的达芬奇机器人手术系统不良事件数据,利用Python对所有不...检索了美国食品药品监督管理局(Food and Drug Administration,FDA)制造商和用户设施设备体验(Manufa-cturer and User Facility Device Experience,MAUDE)数据库中2000—2021年的达芬奇机器人手术系统不良事件数据,利用Python对所有不良事件进行了智能化处理与分析,重点阐述了达芬奇机器人手术系统的不良事件变化趋势、应用科室分布和各类不良事件占比、主要设备故障类型、2013—2019年的手术量及分布科室,为达芬奇机器人手术系统安全性评价提供了临床证据。展开更多
Introduction: Single Incision Laparoscopic Surgery (SILSTM) has been developed as a less invasive laparoscopic surgery. On the other hand, robotically assisted surgical technology has offered new options for minimally...Introduction: Single Incision Laparoscopic Surgery (SILSTM) has been developed as a less invasive laparoscopic surgery. On the other hand, robotically assisted surgical technology has offered new options for minimally invasive surgery. In this study, we report a new surgical technology to perform SILS using the da Vinci S surgical system (Intuitive Surgical Inc., Sunnyvale, CA). Materials and Surgical Technique: A porcine liver with gallbladder was placed on an endoscopic surgery trainer, and a 25 mm incision was made for one robotic camera and two instruments at the umbilicus position. Both instruments were crossed while preventing them from colliding with each other, and Robot-assisted single-incision cholecyctectomy was perfumed. Discussion: This technique is expected to contribute to the development of a number of procedures in the future.展开更多
文摘Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous systems(da Vinci S&Si)have arguably slowed down its wholesale adoption.The latest robotic platform,the da Vinci Xi,addresses these limitations.This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems.Materials and methods:All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases.The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed.Results:A total of 240 patients were identified(124 Si,116 Xi).Median operation-time and length-of-stay were 260 minutes and 6 days respectively.Conversion and 30-day mortality rates were 0.The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group(230 vs 300 min,p=0.000)but length-of-stay,lymph node yield and circumferential resection margin favoured the Xi group(7 vs 5 days,p=0.010;17 vs 21,p=0.000;92.7%vs 99.1%,p=0.020).Conclusion:Single-docking fully-robotic rectal cancer surgery is safe,feasible and can lead to good shortterm outcomes,making it a good alternative to laparoscopic rectal cancer surgery.The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion.
文摘Laparoendoscopic single-site surgery(LESS)is technically challenging;it can reduces instrument triangulation and robust retraction and is associated with a steep learning curve.The instruments of the daVinci surgical system(Intuitive Surgical)are designed with seven degrees of motion mimicing the dexterity of the human hand and wrist.This inherent feature of the robotic arm provides superior ergonomics when performing LESS,especially for complex reconstructive surgery.This review analyzes the evidence supporting current and future application of robotic technology in the field of urologic LESS.
文摘检索了美国食品药品监督管理局(Food and Drug Administration,FDA)制造商和用户设施设备体验(Manufa-cturer and User Facility Device Experience,MAUDE)数据库中2000—2021年的达芬奇机器人手术系统不良事件数据,利用Python对所有不良事件进行了智能化处理与分析,重点阐述了达芬奇机器人手术系统的不良事件变化趋势、应用科室分布和各类不良事件占比、主要设备故障类型、2013—2019年的手术量及分布科室,为达芬奇机器人手术系统安全性评价提供了临床证据。
文摘Introduction: Single Incision Laparoscopic Surgery (SILSTM) has been developed as a less invasive laparoscopic surgery. On the other hand, robotically assisted surgical technology has offered new options for minimally invasive surgery. In this study, we report a new surgical technology to perform SILS using the da Vinci S surgical system (Intuitive Surgical Inc., Sunnyvale, CA). Materials and Surgical Technique: A porcine liver with gallbladder was placed on an endoscopic surgery trainer, and a 25 mm incision was made for one robotic camera and two instruments at the umbilicus position. Both instruments were crossed while preventing them from colliding with each other, and Robot-assisted single-incision cholecyctectomy was perfumed. Discussion: This technique is expected to contribute to the development of a number of procedures in the future.
