The benefit of the da Vinci robotic system in abdominal oncosurgery – our preliminary results


Authors: D. Langer;  J. Pudil;  J. Rudiš;  M. Ryska
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN – Vojenská fakultní nemocnice Praha přednosta: Prof. MUDr. M. Ryska, CSc.
Published in: Rozhl. Chir., 2013, roč. 92, č. 2, s. 85-90.
Category: Original articles

Overview

Introduction:
The robotization of minimally invasive treatment in surgery has been evident since the beginning of the third Millennium. The authors present their current evaluation of the benefits of the da Vinci robotic system in the treatment of abdominal malignancy.

Material and methods:
The authors summarize published studies in the Medline and Pubmed databases that compare robotic, laparoscopic and open approaches in the treatment of abdominal malignancy. Epidemiological data, intraoperative blood loss, complications and oncological outcomes are monitored in a group of 30 patients with carcinoma of rectum.

Results:
The results measured in the evaluated parameters (open conversion, perioperative and non – surgery complications, intraoperative blood loss, histological findings, lethality) are similar in the published studies, i.e. without significant differences in both groups subject to the robotic and laparoscopic treatment. The operative time in the group of robotic surgery has been is slightly longer (a non-significant difference) in most of published studies. 30 patients underwent the robotic assisted treatment of the carcinoma of the rectum (14 men and 16 women, average age of 60 years (33–80). Neoadjuvant treatment was indicated in 50% of the patients. Average blood loss was 260 ml, transfusion was administered in one case. Conversion to laparotomic treatment was performed twice, four patients had post-operative complications, no patient has died. We have not found any relapse of oncological disease in the observed set to this date.

Conclusion:
The Da Vinci robotic system is a safe manipulator in the treatment of abdominal malignancy (including HPB surgery). Randomized clinical trials (RCT) have confirmed (short-term clinical and oncological) results comparable to the laparoscopic or open approach treatment. The benefits of robotic surgery for patients in abdominal surgery (long-term results, sufficient number of patients and high-grade EBM) are yet to be evaluated, however. It is necessary to implement more randomized clinical trials going forward. Our preliminary results are similar to the results reached in other, published studies.

Key words:
da Vinci robotic system – abdominal oncosurgery – randomized trials


Sources

1. Himpens J, Leman G, Cadiere GB Telesurgical laparoscopic cholecystectomy. Surg Endosc 1998:12:1091.

2. Marescaux J, Smith MK, et al. Telerobotic laparoscopic cholecystectomy: Initial clinical experience with 25 patients. Ann Surg 2001:234:1–7.

3. Ryska M, Froněk J, Rudiš J, Jurenka B, Langer D, Pudil J. Manuální a robotická laparoskopická resekce jater. Dvě kazuistiky. Rozhl Chir 2006;85:511–516.

4. Štádler P, Vitásek P, Matouš P. Úvodní zkušenosti s robotickým systémem da Vinci v cévní chirurgii. Rozhl Chir 2006;85: 228–232.

5. Vlček P, Čapov I, Jedlička V, et al. Robotické výkony v kolorektální chirurgii. Rozhl Chir 2008;87:135–137.

6. Balantyne GH. Robotic surgery, telerobotic surgery, telepresence and telementoring. Surg Endosc 2002;16:1389–1402.

7. Corcione F, Esposito C, et al. Advantages and limits of robot – assisted laparoscopic surgery. Surg Endosc 2005;19:117–119.

8. Caruso S, et al. Open vs robot – assisted laparoscopic gastric resection with D2 lymph node dissection for adenocarcinoma: a case – control study. Int J Med Robot 2011;7:452–458.

9. Weber PA, et al. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign dinase. Dis Colon Rectum 2002: 12:1689–1696.

10. Rawlings AL, Woodland JH, Crawford DL. Telerobotic Surgery for right and sigmoid colectomies: 30 consecutive cases. Surg Endosc 2006;20:1713–1718.

11. Baik SH, Ko YT, Kang CM, et al. Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc 2008;22:1601–1608.

12. Baek JH, Pastor C, Pigazzi A. Robotic and laparoscopic total mesorectal exciton for rectal cancer: a case-matched study. Surg Endosc 2011;25:521–525.

13. Leong QM, et al. Robot – assisted intersphincteric resection for low rectal cancer: technique and short – term outcome for 29 consecutive patients. Surg Endosc 2011;25:2987–2992.

14. Patriti A, Ceccarelli G, et al. Laparoscopic and robot – assisted one – stage resection of colorectal cancer with synchronous liver metastases: a pilot study. J Hepatobiliary Pancreat Surg 2009; 16:450–457.

15. Berber E, Akyildiz HY, et al. Robotic versus laparoscopic resection of liver tumors. HPB 2010;12:583–586.

16. Giulianotti PC, Coratti A, et al. Robotic liver surgery: results for 70 resections. Surgery 2011;149:29–39.

17. Choi GH, Choi SH, et al. Robotic liver resection: technique and results of 30 consecutive procedures. Surg Endosc 2012;26: 2247–2258.

18. Giulianotti PC, Tzvetanov I, et al. Robot – assisted right lobe donor hepatectomy. Transpl Int 2012;25:5–9.

19. Giulianotti PC, Sbrana F, et al. Robot – assisted laparoscopic pancreatic surgery: single – surgeon experience. Surg Endosc 2010;24:1646–1657.

20. Buchs NC, et al. Robotic versus open pancreaticoduodenectomy: a comparative study at a single institution. World J Surg 2011;35:2739–2746.

21. Giulianotti PC, et al. Robotic extended pancreatectomy with vascular resection for locally advanced pancreatic tumors. Pancreas 2011;40:1264–1270.

22. Maeso S, Reza M, Mayol JA, et al. Efficacy of the da Vinci surgical system in abdominal surgery compared with that of review and meta-analysis. Annals of Surgery 2010;(2)252:254–262.

23. Langer D, Pudil J, Ryska M. Robotická laparoskopická cholecystektomie. Rozhl Chir 2006;85:450–454.

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Surgery Orthopaedics Trauma surgery
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