AB046. 100. Robotic assisted colorectal surgery at University Hospital Limerick

2018 ◽  
Vol 2 ◽  
pp. AB046-AB046
Author(s):  
Daniel Westby ◽  
Rishabh Sehgal ◽  
Kah Hoong Chang ◽  
David Waldron ◽  
Eoghan Condon ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
University Hospital ◽  
Robotic Assisted

Prospective Surveillance Effectively Reduced Rates of Surgical Site Infection Associated With Elective Colorectal Surgery at a University Hospital in Japan

2006 ◽  
Vol 27 (5) ◽  
pp. 526-528 ◽  
Author(s):  
Tsuyoshi Konishi ◽  
Toshiaki Watanabe ◽  
Keita Morikane ◽  
Kazuhiko Fukatsu ◽  
Joji Kitayama ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
University Hospital ◽  
Site Infection ◽  
Prospective Surveillance ◽  
Elective Colorectal Surgery ◽  
Nationwide Surveillance ◽  
Surveillance Database

At a university hospital in Japan, the introduction of prospective surveillance and subsequent interventions was effective in reducing the rate of surgical site infection associated with elective colorectal surgery from 27.5% to 17.8% of surgeries. Japan should both recognize the importance of broader surveillance for surgical site infection and establish its own nationwide surveillance database.

scholarly journals Supervised Immediate Postoperative Mobilization After Elective Colorectal Surgery: A Feasibility Study

2021 ◽  
Author(s):  
Rose-Marie W. Thörn ◽  
Jan Stepniewski ◽  
Hans Hjelmqvist ◽  
Anette Forsberg ◽  
Rebecca Ahlstrand ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Feasibility Study ◽  
Early Mobilization ◽  
University Hospital ◽  
Serious Adverse Events ◽  
Elective Colorectal Surgery ◽  
Post Surgery ◽  
Surgical Icu ◽  
Patient Refusal ◽  
Four Levels

Abstract Background Early mobilization is a significant part of the ERAS® Society guidelines, in which patients are recommended to spend 2 h out of bed on the day of surgery. However, it is not yet known how early patients can safely be mobilized after completion of colorectal surgery. The aim of this study was to evaluate the feasibility, and safety of providing almost immediate structured supervised mobilization starting 30 min post-surgery at the postoperative anesthesia care unit (PACU), and to describe reactions to this approach. Methods This feasibility study includes 42 patients aged ≥18 years who received elective colorectal surgery at Örebro University Hospital. They underwent a structured mobilization performed by a specialized physiotherapist using a modified Surgical ICU Optimal Mobilization Score (SOMS). SOMS determines the level of mobilization at four levels from no activity to ambulating. Mobilization was considered successful at SOMS ≥ 2, corresponding to sitting on the edge of the bed as a proxy of sitting in a chair due to lack of space. Results In all, 71% (n = 30) of the patients reached their highest level of mobilization between the second and third hour of arrival in the PACU. Before discharge to the ward, 43% (n = 18) could stand at the edge of the bed and 38% (n = 16) could ambulate. Symptoms that delayed advancement of mobilization were pain, somnolence, hypotension, nausea, and patient refusal. No serious adverse events occurred. Conclusions Supervised mobilization is feasible and can safely be initiated in the immediate postoperative care after colorectal surgery. Trial registration Clinical trials.gov identifier: NTC03357497.

Initial experience with a dual-console robotic-assisted platform for training in colorectal surgery

2017 ◽  
Vol 21 (9) ◽  
pp. 721-727 ◽  
Author(s):  
J. C. Bolger ◽  
M. P. Broe ◽  
M. A. Zarog ◽  
A. Looney ◽  
K. McKevitt ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Initial Experience ◽  
Robotic Assisted

Assessment of postoperative gastrointestinal motility in colorectal surgery: a study with the Motilis 3D-transit system

2020 ◽  
Vol 7 (1) ◽  
pp. 53-60
Author(s):  
Jesper Nors ◽  
Mette Winther Klinge ◽  
Thorbjørn Sommer ◽  
Søren Laurberg ◽  
Klaus Krogh ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Transit Time ◽  
Primary Anastomosis ◽  
Postoperative Recovery ◽  
University Hospital ◽  
Double Blind ◽  
Transit System ◽  
Study Region ◽  
Gi Transit ◽  
Gi Motility

PurposePostoperative recovery following colorectal surgery remains impaired by severe complications including postoperative ileus (POI). Human studies of POI have been limited by a lack of safe and easy-to-use objective methods. Motilis 3D-transit is a completely ambulatory, minimally invasive system whereby electromagnetic capsules are followed by external sensors during their passage of the gastrointestinal (GI) tract. The aim of this study was to evaluate the applicability of the 3D-transit system in a surgical setting.MethodWe included 12 patients as a substudy of the randomised double blind controlled Stimulation of the Autonomic Nervous System In Colorectal Surgery by perioperative nutrition (SANICS)-II trial undergoing elective segmental colonic resection with primary anastomosis at Aarhus University Hospital and Randers Regional Hospital, Denmark. To study region-specific motility, three electromagnetic capsules were administered. One was taken 3 hours before surgery, the next was taken 1 hour before surgery, while the third was placed distal to the anastomosis during surgery. Total and regional GI transit times as well as time until first propulsive colonic contraction were determined.ResultsAll patients tolerated the setup well with no adverse events related to the 3D-transit system. Large variations were found in total GI transit time (26.7–127.6 hours), gastric emptying (0.07–>106.9 hours), small intestinal (1.2–58.4 hours) and colorectal transit time (14.3–>118.1 hours). Time from end of surgery to first propulsive movement in the colon varied from 3.9 to 85 hours. No correlation was found between parameters of GI motility and tolerance of an oral diet or recovery of bowel function.ConclusionThe 3D-transit system allows safe assessment of GI motility in patients operated with segmental colonic resections and primary anastomosis for colorectal cancer. Postsurgical motility varies significantly between patients.

scholarly journals The effect of transversus abdominis plane block on the chronic pain after colorectal surgery: a retrospective cohort study

2020 ◽  
Author(s):  
Zi-Ye Pan ◽  
Zhong-Hua Hu ◽  
Fan Zhang ◽  
Wen-Xiu Xie ◽  
Yong-Zhong Tang ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Repeated Measures ◽  
Transversus Abdominis ◽  
University Hospital ◽  
Tap Block ◽  
Chi Square ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain ◽  
Significant Difference ◽  
Chi Square Test

Abstract Background: Chronic postsurgical pain (CPSP) is common and would reduce the quality of life of patients. Transversus abdominal plane (TAP) block has been widely used in lower abdominal surgery and many researches demonstrated that it could improve acute postsurgical pain. We aim to determine whether TAP block could improve chronic postoperative pain at 3 months and 6 months after colorectal surgery.Methods: A total of 307 patients received selective colorectal surgery under general anesthesia between January, 2015 and January, 2019 in a single university hospital were included: 128 patients received TAP block combined with patient-controlled intravenous analgesia (PCIA) for postsurgical analgesia (group TP) and 179 only administrated with PCIA (group P). Main outcome was the NRS score of pain at 24 hours, 48 hours, 3 months and 6 months after colorectal surgery. The data was analyzed by two-way repeated measures anova and the chi-square test.Results: The NRS score at rest and during movement was decreased significantly at 24 hours after surgery (rest NRS 1.07±1.34 vs 1.65±1.67, movement NRS 3.00±1.45 vs 3.65±1.89; all P=0.003) in group TP than those of group P. There was no significant difference of NRS score at 48 hours after surgery (P>0.05). At 3 months after surgery, the NRS score during movement was also lower in group TP than that in group P (0.59±1.23 vs 0.92±1.65, P=0.045). There was no significant difference of NRS score at 6 months after surgery (P>0.05). The prevalence of CPSP was 19.5% (25/128) in group TP and 20.7% (37/179) in group P at 3 months after surgery. 13.2% (17/128) of patients suffered from CPSP in group TP and 13.9% (25/179) in group P at 6 months after surgery. Both at 3 months and 6 months after surgery, there was no statistical difference of the prevalence of CPSP between the two groups (all P >0.05) .Conclusions: TAP block reduced NRS during movement at 3 months after surgery but did not reduce the incidence of CPSP at 3 months and 6 months after selective colorectal surgery.

scholarly journals Enhanced Recoveryafter Colorectal Surgery. Results from Aprospective Observational Two-Centre Study

2009 ◽  
Vol 98 (3) ◽  
pp. 155-159 ◽  
Author(s):  
A. C. Miohn ◽  
S. V. Bernardshaw ◽  
S.-M. Ristesund ◽  
P. E. Hovde Hansen ◽  
O. Rœkke
Keyword(s):  
Colorectal Surgery ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Leisure Activities ◽  
University Hospital ◽  
Daily Activities ◽  
Median Hospital Stay ◽  
Surgical Department ◽  
Preparation Period ◽  
Median Hospital

Background and Aims: Enhanced recovery after surgery (ERAS) has reduced the median hospital stay from 8–10 days with traditional peri-operative routines to four days. The aim of the present study was to introduce the principles of ERAS in our hospital and measure the effect on hospital stay, complications and quality of life after discharge from hospital. Material and Methods: 94 consecutive patients, 40 males, 54 females, median age 66 years, were included in a prospective non-randomised observational study at Haukeland University Hospital and Haugesund Hospital from October 2000 until February 2003. After a three-month preparation period, the principles of ERAS were implemented. The results were evaluated with questionnaires and by follow-ups 8–10 and 30 days after surgery. The results were compared to the results of colorectal surgery before introduction of accelerated recovery. Results: 45 (48%) and 73 (78%) patients were discharged within three and five days after surgery with ERAS, compared to zero and seven (5%) patients with traditional recovery. The complication rate with ERAS was 31%, and the readmission rate was 15%. After one week, 57% had resumed their daily activities at home. After 30 days, 65% of the patients had resumed their normal and leisure activities. Conclusion: After a proper preparation period, ERAS principles may be implemented in surgical department, and is followed by a reduced median hospital stay and rapid return to normal daily activities for most patients after colorectal surgery.

Trends in Open, Laparoscopic, and Robotic Approaches to Colorectal Operations

2021 ◽  
pp. 000313482110347
Author(s):  
Luv N. Hajirawala ◽  
Claudia Leonardi ◽  
Guy R. Orangio ◽  
Kurt G. Davis ◽  
Jeffrey S. Barton
Keyword(s):  
Colorectal Surgery ◽  
Open Approach ◽  
Robotic Approach ◽  
Surgical Quality ◽  
Improvement Project ◽  
Robotic Assisted ◽  
American College Of Surgeons ◽  
American Society ◽  
Minimally Invasive Colorectal Surgery ◽  
To Receive

The use of robotic approach has gained momentum in colorectal surgery. We analyzed the trends in the adoption of robotic-assisted platform (RAP) for colorectal surgery over a 6-year period (2013-2018) using the American College of Surgeons National Surgical Quality Improvement Project. We assessed yearly prevalence of robotic, laparoscopic, and open approaches, and evaluated trends in the adoption of RAP across age, gender, BMI, and American Society of Anesthesiology (ASA) subgroups. Overall, the frequency of open, laparoscopic, and robotic approach was 36%, 46.8%, and 7.8%, respectively. While the use of laparoscopic cases remained stable over the study period, the prevalence of RAP increased from 2.8% to 11.4%. This was accompanied by a concomitant decline in the use of open approach, from 40.8% to 33%. The use of RAP also increased across all age, gender, BMI, and ASA subgroups. Robotic-assisted platform is increasingly utilized for higher risk, older, and obese patients, allowing more patients to receive minimally invasive colorectal surgery.

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