Extraperitoneal colostomy in robotic surgery for rectal cancer using a tip‐up fenestrated grasper

2020 ◽  
Author(s):  
Shintaro Akamoto ◽  
Shin Imura ◽  
Yuta Fujiwara ◽  
Kyosuke Habu ◽  
Yusuke Konishi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Extraperitoneal Colostomy

scholarly journals Difference in surgical outcomes of rectal cancer by study design: meta-analyses of randomized clinical trials, case-matched studies, and cohort studies

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
N Hoshino ◽  
T Sakamoto ◽  
K Hida ◽  
Y Takahashi ◽  
H Okada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Robotic Surgery ◽  
Cohort Studies ◽  
Anastomotic Leakage ◽  
Study Design ◽  
Randomized Clinical Trials ◽  
Postoperative Mortality ◽  
Resection Margins ◽  
Meta Analyses

Abstract Background RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design. Methods A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model. Results Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively). Conclusion Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs.

scholarly journals Experiences of a “COVID protected” robotic surgical centre for colorectal and urological cancer in the COVID-19 pandemic

2021 ◽  
Author(s):  
Jeremy R. Huddy ◽  
Matthew Crockett ◽  
A Shiyam Nizar ◽  
Ralph Smith ◽  
Manar Malki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Length Of Stay ◽  
Elective Surgery ◽  
Standard Operating Procedure ◽  
Major Surgery ◽  
Renal Surgery ◽  
Increased Risk ◽  
Acute Hospitals ◽  
Da Vinci Si

AbstractThe recent COVID-19 pandemic led to the cancellation of elective surgery across the United Kingdom. Re-establishing elective surgery in a manner that ensures patient and staff safety has been a priority. We report our experience and patient outcomes from setting up a “COVID protected” robotic unit for colorectal and renal surgery that housed both the da Vinci Si (Intuitive, Sunnyvale, CA, USA) and the Versius (CMR Surgical, Cambridge, UK) robotic systems. “COVID protected” robotic surgery was undertaken in a day-surgical unit attached to the main hospital. A standard operating procedure was developed in collaboration with the trust COVID-19 leadership team and adapted to national recommendations. 60 patients underwent elective robotic surgery in the initial 10-weeks of the study. This included 10 colorectal procedures and 50 urology procedures. Median length of stay was 4 days for rectal cancer procedures, 2 days less than prior to the COVID period, and 1 day for renal procedures. There were no instances of in-patient coronavirus transmission. Six rectal cancer patients waited more than 62 days for their surgery because of the initial COVID peak but none had an increase T-stage between pre-operative staging and post-operative histology. Robotic surgery can be undertaken in “COVID protected” units within acute hospitals in a safe way that mitigates the increased risk of undergoing major surgery in the current pandemic. Some benefits were seen such as reduced length of stay for colorectal patients that may be associated with having a dedicated unit for elective robotic surgical services.

scholarly journals Modified technique of extraperitoneal colostomy without incision of the posterior rectus sheath

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tao Zhang ◽  
Daye Yang ◽  
Gongping Sun ◽  
Dewei Zhang
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Parastomal Hernia ◽  
Retrospective Studies ◽  
Rectus Sheath ◽  
Lower Rectal Cancer ◽  
Modified Technique ◽  
Posterior Rectus Sheath ◽  
Rectal Sheath ◽  
Extraperitoneal Colostomy

AbstractExtraperitoneal colostomy is a widely used technique during abdominoperineal resection (APR) operation for lower rectal cancer. This technique has been reported to be effective to prevent the postoperative parastomal hernia in some retrospective studies, however, there is still a certain incidence of parastomal hernia. A modification of the extraperitoneal colostomy technique is described in this paper that keeps posterior rectal sheath intact instead of having a conventional incision, to further reduce the risk of parastomal hernia. Until now, this modified technique has been performed in 15 patients, no occurrence of parastomal hernia was observed.

scholarly journals A review on robotic surgery in rectal cancer

2016 ◽  
Vol 1 ◽  
pp. 5-5 ◽  
Author(s):  
Zairul Azwan Mohd Azman ◽  
Seon-Hahn Kim
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery

scholarly journals Robotic Surgery for Rectal Cancer: Hype or Hope? (Indian Experience)

2020 ◽  
Vol 11 (4) ◽  
pp. 604-612 ◽  
Author(s):  
S. P. Somashekhar ◽  
K. R. Ashwin ◽  
C. Rohit Kumar
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Indian Experience

Robotic surgery may confer advantages in morbidly obese patients with low rectal cancer: Video vignette

2020 ◽  
Author(s):  
Mahmood Al Dhaheri ◽  
Mahwish Khawar ◽  
Mohammad Yousif ◽  
Adham Darweesh ◽  
Mohamed Abu Nada ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Low Rectal Cancer ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Video Vignette

Robotic Surgery for Colon and Rectal Cancer: Current Status, Recent Advances, and Future Directions

2017 ◽  
Vol 13 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Ajit Pai ◽  
George Melich ◽  
Slawomir J. Marecik ◽  
John J. Park ◽  
Leela M. Prasad
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Current Status ◽  
Future Directions ◽  
Recent Advances ◽  
Colon And Rectal Cancer
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