Abstract
Background and aims
The laparoscopic approach is common for several surgical procedures. Although the laparoscopic approach in colorectal surgery is described as being beneficial, its use is not yet widespread. This restriction may be due to technical difficulties. The use of telerobotic assistance may simplify complex laparoscopic procedures. We compared the traditional laparoscopic and the telerobotic-assisted approaches to colorectal surgery.
Patients and methods
Between August 2002 and January 2004, 61 laparoscopic colorectal operations were performed. In this study we focused on sigmoid resection for benign disease. Twenty-three patients underwent sigmoid resection for diverticulitis using traditional laparoscopy, and 4 using telerobotic-assisted laparoscopy. The DaVinci system was used for telerobotic assistance. Four patients underwent resection rectopexies, 2 with traditional and 2 with telerobotic-assisted laparoscopy.
Results
The DaVinci device worked well during all operations. No robot-related complications occurred. The conversion rate was 3 out of 23 with traditional laparoscopy and 1 out of 4 in the telerobotic-assisted group. The incidence of postoperative complications was 5 out of 23 after traditional laparoscopic and 1 out of 4 following telerobotic-assisted laparoscopic resection. Operation time was significantly longer using the telerobotic-assisted approach (236.7±5.8 vs. 172.4±38 min, p<0.05).
Conclusion
Colorectal surgery using the DaVinci system is safe and feasible. Compared to traditional laparoscopy, we did not see any relevant practical advantages of the supportive features of the telerobotic assistance that simplified the operation significantly. However, it would be useful to evaluate the telerobotic-assisted approach for other kinds of laparoscopic procedures.
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References
Lauter DM, Serna S (2003) Surgeon experience with laparoscopic-assisted colorectal surgery in Washington State. Am J Surg 186:13–16
Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45:1689–1694
Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring. Review of early clinical results. Surg Endosc 16:1389–1402
Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25:1467–1477
Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestra T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138:777–784
Melvin WS, Needleman BJ, Krause KR, Schneider C, Wolf RK, Michler RE, Ellison EC (2002) Computer-enhanced robotic telesurgery. Surg Endosc 16:1790–1792
Talamini MA, Chapman S, Horgan S, Melvin WS (2003) A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc 17:1521–1524
Bruch H-P, Herold A, Schiedeck T, Schwandner O (1999) Laparoscopic surgery for rectal prolapse and outlet obstruction. Dis Colon Rectum 42:1189–1194
Korolija D, Sauerland S, Wood-Dauphinee S, Abbou CC, Eypasch E, Caballero MG, Lumsden MA, Millat B, Monson JR, Nilsson G, Pointner R, Schwenk W, Shamiyeh A, Szold A, Taragarona E, Ure B, Neugebauer E (2004) Evaluation of quality of life after laparoscopic surgery: evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 18:879–897
Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo V (2002) Laparoscopic versus open colorectal surgery. A randomized trial on short-term outcome. Ann Surg 236:759–767
Lacy AM, Garcia-Valdecasas JC, Pique JM, Delgado S, Campo E, Bordas JM, Taura P, Grande L, Pacheco JL (1995) Short-term outcome analysis of a randomized study comparing laparoscopy vs open colectomy for colon cancer. Surg Endosc 9:1101–1105
Milson JW, Böhm B, Hammerhofer KA, Fazio VW, Steiger E, Elson P (1998) A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. Am Coll Surg 187:46–57
Lauter DM, Froines EJ (2001) Initial experience with 150 cases of laparoscopic assisted colectomy. Am J Surg 181:398–403
Schwenk W, Böhm B, Müller JM (1998) Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. Surg Endosc 12:1131–1136
Delaney CP, Kiran RP, Senagore AJ, Brady K, Fazio VW (2003) Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery. Ann Surg 238:67–72
Ruurda JP, Broeders IA, Simmermacher RP, Rinkes IH, Van Vroonhoven TJ (2002) Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc Percutan Tech 12:41–45
Horgan S, Berger RA, Elli EF, Espat NJ (2003) Robotic-assisted minimally invasive transhiatal esophagectomy. Am Surg 69:624–626
Vibert E, Denet C, Gayet B (2003) Major digestive surgery using a remote-controlled robot: the next revolution. Arch Surg 38:1002–1006
Broeders IA, Ruurda JP (2002) Robotics in laparoscopic surgery: current status and future perspectives. Scand J Gastroenterol Suppl 236:76–80
Ballantyne GH (2002) The pitfalls of laparoscopic surgery: challenges for robotics and telerobotic surgery. Surg Laparosc Endosc Percutan Tech 12:1–5
Falk V, Mintz D, Grünenfelder J, Fann JI, Burdon TA (2001) Influence of three-dimensional vision on surgical telemanipulator performance. Surg Endosc 15:1282–1288
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Woeste, G., Bechstein, W.O. & Wullstein, C. Does telerobotic assistance improve laparoscopic colorectal surgery?. Int J Colorectal Dis 20, 253–257 (2005). https://doi.org/10.1007/s00384-004-0671-8
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DOI: https://doi.org/10.1007/s00384-004-0671-8