Editorial Comment on: Rates and Predictors of Conversion to Open Surgery During Minimally Invasive Radical Cystectomy by Ko et al.

2018 ◽  
Vol 32 (6) ◽  
pp. 495-495
Author(s):  
Ram A. Pathak ◽  
Ashok K. Hemal
Keyword(s):  
Editorial Comment ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Open Surgery ◽  
Conversion To Open Surgery

Rates and Predictors of Conversion to Open Surgery During Minimally Invasive Radical Cystectomy

2018 ◽  
Vol 32 (6) ◽  
pp. 488-494 ◽  
Author(s):  
Oliver S. Ko ◽  
Adam B. Weiner ◽  
Norm D. Smith ◽  
Joshua J. Meeks
Keyword(s):  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Open Surgery ◽  
Conversion To Open Surgery

Conversion to open surgery during minimally invasive esophagectomy portends worse short-term outcomes: an analysis of the National Cancer Database

2019 ◽  
Vol 34 (8) ◽  
pp. 3470-3478
Author(s):  
Alison L. Halpern ◽  
Chloe Friedman ◽  
Robert J. Torphy ◽  
Mohammed H. Al-Musawi ◽  
John D. Mitchell ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Surgery ◽  
Minimally Invasive Esophagectomy ◽  
National Cancer Database ◽  
Short Term ◽  
Conversion To Open Surgery ◽  
Invasive Esophagectomy

Incidence of minimally invasive colorectal cancer (CRC) surgery in patients treated at NCCN institutions

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6575-6575
Author(s):  
M. Weiser ◽  
D. Romanus ◽  
A. terVeer ◽  
A. Rajput ◽  
J. Skibber ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Early Stage ◽  
Oncologic Outcome ◽  
Stage I ◽  
Invasive Approach ◽  
Conversion To Open Surgery ◽  
The North ◽  
Minimally Invasive Surgical

6575 Background: In May 2004 the Clinical Outcomes of Surgical Therapy Study Group published the results of the North American randomized trial demonstrating that oncologic outcome is similar for laparoscopic assisted and open surgery for CRC. This and other studies have shown quicker recovery with laparoscopic CRC surgery including earlier resolution of postoperative ileus, less discomfort, and earlier discharge from the hospital. The extent to which surgeons have adopted the minimally invasive surgical (MIS) approach in CRC is unknown. Methods: Using the NCCN Colon/Rectal Cancer Outcomes Project Database, 715 patients were identified who underwent CRC resection in 2005–6. The distribution of lesions included right colon (39%), left colon (31%), and rectum (30%). The incidence of MIS for CRC and clinicopathologic features associated with this approach were analyzed by logistic regression; results are reported as odd ratio (OR) with 95% confidence intervals (CI), and significance defined at p<0.05 level. Results: A total of 167 (23%) patients underwent MIS colorectal surgery (laparoscopy in 98% and robotic in 2%). Conversion to open surgery was noted in 33 cases (20%). Surgery was performed in outside institutions in 21% of cases prior to patients presenting to NCCN institutions for further treatment. The MIS approach was more common in colon than rectal cancer (30% vs.12%, OR 2.96, CI 1.94–4.51, p<0.0001). Within the colon cancer cohort, right sided lesions were more likely to be approached with MIS techniques rather than left sided lesions (32% vs. 25%; OR 1.42, CI 1.96–2.21, p<0.0001). Stage I tumors were also more likely to be managed with the less invasive approach: Stage I-41%; II-20%; III-21%; IV-19% (Stage I vs. IV, OR=3.00, CI 1.74–5.16 p<0.0001). No differences in surgical approach were noted based on age, gender, race, Charlson comorbidity score, insurance type, or location of surgery (NCCN vs outside facility). Conclusion: The majority of CRC surgery for patients presenting to NCCN institutions is performed by open techniques. Right sided and early stage CRCs were more likely treated with MIS, possibly related to the less demanding nature of the procedure. The adoption of MIS is expected to rise as surgeons become trained in MIS techniques for CRC. No significant financial relationships to disclose.

scholarly journals Evaluation of difficulties in laparoscopic cholecystectomy

2017 ◽  
Vol 70 (9-10) ◽  
pp. 271-276
Author(s):  
Katarina Sarcev ◽  
Dimitrije Damjanov ◽  
Dijana Kosijer ◽  
Dragomir Damjanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Conversion To Open Surgery ◽  
Preoperative Prediction ◽  
Conversion To Open Cholecystectomy ◽  
Group B

Introduction. For decades, laparoscopic cholecystectomy has been the gold standard in surgical treatment of patients with cholelithiasis all over the world. The main advantage of this approach is that it is a minimally invasive procedure for patients. Although this method is a routine in our country, there are certain cases where the presumed outcome of minimally invasive procedure is not achieved, and the surgery is converted to open surgery, or a subsequent laparoscopic surgery is performed, in order to deal with the complications. The aim of this study was to establish if it was possible to create a model for preoperative prediction of difficult laparoscopic cholecystectomies. Material and Methods. Two groups of patients were analyzed. Group A included patients with cholelithiasis who were studied in order to determine parameters associated with difficult laparoscopic cholecystectomies. Out of 16 analyzed parameters, 8 showed significant correlation with difficult laparoscopic cholecystectomies. Based on these parameters, a prediction model was established, consisting of five groups: I - easy (score 1), II - laparoscopic cholecystectomy with mild difficulties (score 2), III - laparoscopic cholecystectomy with major difficulties (score 3), IV - difficult (score 4), V - conversion to open surgery is expected (score 5). This model was preoperatively applied in patients with cholelithiasis included in group B. Results. The overall predictability of the model was 82%. The greatest prediction accuracy was achieved in groups II and III (98.3% and 100%, respectively). Conversion to open cholecystectomy was predicted in 76% of patients. Conclusion. Based on certain preoperative parameters it is possible to establish a model to predict a difficult laparoscopic cholecystectomy.

A Comprehensive Guide to Perioperative Management and Operative Technique for Robotic Cystectomy with Intracorporeal Urinary Diversion

2017 ◽  
Vol 84 (2) ◽  
pp. 71-78
Author(s):  
Wei Shen Tan ◽  
Benjamin W. Lamb ◽  
Ashwin Sridhar ◽  
Timothy P. Briggs ◽  
John D. Kelly
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Open Surgery ◽  
High Volume ◽  
Normal Function ◽  
Small Sample ◽  
Invasive Approach ◽  
Conversion To Open Surgery ◽  
Oncological Outcomes ◽  
Intracorporeal Urinary Diversion

Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion. Conversion to open surgery invariably masks the benefits of a truly minimally invasive approach. Moreover, such studies tend to report a small sample size, likely reflecting early surgical experience that may contribute to the lack of observed benefit. Nonetheless, it is established that short-term oncological outcomes following RARC are comparable to those after ORC. It is likely that the benefits of RARC are only observed in cases wherein intracorporeal urinary diversion (iRARC) is performed by a surgical team with high volume experience, which will minimise morbidity and maximise early return to normal function. In this review, we will discuss a holistic approach to iRARC, including patient selection, perioperative optimisation, the surgical technique for iRARC with urinary diversion reconstruction, the use of enhanced recovery protocol, oncological outcomes and perioperative complications.

scholarly journals Laparoscopic cystectomy with lymphadenectomy and ileoconduitis creation: А case report

2021 ◽  
Vol 61 (3) ◽  
pp. 31-34
Author(s):  
T. A. Kurmanov ◽  
A. K. Digay ◽  
Sh. V. Mugalbekov ◽  
Zh. D. Zhumagazin ◽  
A. K. Mukazhanov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Open Surgery ◽  
Locally Advanced ◽  
Surgical Interventions ◽  
Quick Recovery ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Cystectomy ◽  
The Creation

Relevance: Radical cystectomy remains the «gold standard» of muscle-invasive and locally advanced bladder cancer treatment. The article describes the capacity and technique of laparoscopic cystoprostatectomy with lymphadenectomy and the creation of ileoconduitis in bladder cancer since the authors could not find publications on conducting laparoscopic cystoprostatectomy with the creation of an ileoconduitis in oncological and urological clinics in Kazakhstan by domestic specialists. The purpose was to describe an attempt to reproduce the method of open radical cystectomy laparoscopically as accurately as possible. Results: In the described case, the patient diagnosed with bladder cancer T2N0M0 IIst underwent surgery in the form of laparoscopic cystectomy with lymphadenectomy and the creation of ileoconduitis. This method of surgical intervention is minimally invasive, less traumatic, and ensures quick recovery in the postoperative period. Conclusion: Laparoscopic execution of radical cystectomy allows preserving the advantages of minimally invasive interventions without losing the reliability of the well-proven open surgery. Currently, the implementation of such minimally invasive surgical interventions is possible in many clinics in Kazakhstan, equipped with endoscopic video equipment, if there are specialists experienced in open surgery

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

Complication Rate after Radical Cystectomy Depends on the Surgical Technique and Patient’s Clinical Status

2021 ◽  
pp. 1-8
Author(s):  
Przemysław Adamczyk ◽  
Paweł Pobłocki ◽  
Mateusz Kadlubowski ◽  
Adam Ostrowski ◽  
Witold Mikołajczak ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Tnm Stage ◽  
Complication Rates ◽  
Open Approach ◽  
Invasive Approach ◽  
Asa Score

<b><i>Purpose:</i></b> This study aimed to explore the complication rates of radical cystectomy in patients with muscle-invasive bladder cancer and identify potential risk factors. <b><i>Methods:</i></b> A total of 553 patients were included: 131 were operated on via an open approach (ORC), 242 patients via a laparoscopic method (LRC), and 180 by a robot-assisted procedure (RARC). Patient age, gender, American Society of Anesthesiologists (ASA) score, urinary diversion type, preoperative albumin level, body mass index (BMI), pathological (TNM) stage, and surgical times were collected. The severity of complications was classified according to the Clavien-Dindo scale (Grades 1–5). <b><i>Results:</i></b> The surgical technique was significantly related to the number of complications (<i>p</i> &#x3c; 0.00005). Grade 1 complications were observed most frequently following LRC (52.5%) and RARC (51.1%), whereas mostly Grade 2 complications were detected after ORC (78.6%). Those with less severe complications had significantly higher albumin levels than those with more severe complications (<i>p</i> &#x3c; 0.05). Patients with an elevated BMI had fewer complications if a minimally invasive approach was used rather than ORC. The patient’s general condition (ASA score) did not impact the number of complications, and urinary diversion type did not affect the severity of the complications. Mean surgical time differed according to the urinary diversion type in patients with a similar TNM stage (<i>p</i> &#x3c; 0.005); however, no difference was found in those with more locally advanced disease. Longer operation time and lower protein concentration were associated with higher probability of complication rate, that is, Clavien-Dindo score 3–5. <b><i>Conclusions:</i></b> The risk of complications after RC is not related to the type of urinary diversion, and can be reduced by using a minimally invasive surgical technique, especially in patients with high BMI.

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