88 research outputs found
Figures do matter: A literature review of 4587 robotic pancreatic resections and their implications on training
No full textBackground The use of robotic assistance in minimally invasive pancreatic resection is quickly growing. Methods We present a systematic review of the literature regarding all types of robotic pancreatic resection (RPR). Our aim is to show for which procedures there is enough experience to permit safe training and provide an estimation of how many centers could serve as teaching institutions. Results Sixty-four studies reporting on 4587 RPRs were analyzed. A total of 2598 pancreatoduodenectomies (PD) were reported by 28 centers from Europe (6/28; 21.4%), the Americas (11/28; 39.3%), and Asia (11/28; 39.3%). Six studies reported >100 robot PD (1694/2598; 65.2%). A total of 1618 distal pancreatectomies (DP) were reported by 29 centers from Europe (10/29; 34.5%), the Americas (10/29; 34.5%), and Asia (9/29; 31%). Five studies reported >100 robotic DP (748/1618; 46.2%). A total of 154 central pancreatectomies were reported by six centers from Europe (1/6; 16.7%), the Americas (2/6; 33.3%), and Asia (3/6; 50%). Only 49 total pancreatectomies were reported. Finally, 168 enucleations were reported in seven studies (with a mean of 15.4 cases per study). A single center reported on 60 enucleations (35.7%). Results of each type of robotic procedure are also presented. Conclusions Experience with RPR is still quite limited. Despite high case volume not being sufficient to warrant optimal training opportunities, it is certainly a key component of every successful training program and is a major criterion for fellowship accreditation. From this review, it appears that only PD and DP can currently be taught at few institutions worldwide
First experience of laparoscopic adjustable banded sleeve gastrectomy (LabSG) for an extremely obese patient
No full textA research agenda for the European Association for Endoscopic Surgeons (EAES)
No full textAbstract
INTRODUCTION:
The European Association of Endoscopic Surgeons (EAES) conducted this study aiming to identify the top research questions which are relevant to surgeons in Minimal Access Surgery (MAS). This is in order to promote and link research questions to the current clinical practice in MAS in Europe.
METHODS:
Using a systematic methodology, (modified Delphi), the EAES members and leadership teams were surveyed to obtain consensus on the top research priorities in MAS. The responses were categorized and redistributed to the membership to rate the level of importance of each research question. The data were reported as the weighted average score with a scale from 1 (lowest agreement) to 5 (highest agreement).
RESULTS:
In total, 324 of 2580 (12.5%) of the EAES members and the leaders responded to the survey and contributed to the final consensus. The ranked responses over the 80th percentile identified 39 research priorities with rating ranged from 4.22 to 3.67. The top five highest ranking research priorities in the EAES were centered on improving training in MAS, laparoscopic surgery for benign upper gastrointestinal conditions, integration of novel technology in OR, translational and basic science research in bariatric surgery and investigating the role of MAS in rectal cancer.
CONCLUSION:
An EAES research agenda was developed using a systematic methodology and can be used to focus MAS research. This study was commissioned by the European Association for Endoscopic Surgery (EAES)
Laparoscopic cytoreductive surgery for metastatic colon cancer – how to improve treatment strategy
No full textBackground: Colon cancer (CC) one of the most common oncological disease in World. Up to 30% patients in Russia have metastatic CC at first visiting to oncologist. The treatment results still controversial. Nowadays, minimally invasive laparoscopic precision technique allowed extending the indication for cytoreductive surgery even in patients with severe comorbidities. Materials and methods: 89 patients with colon cancer (T1-4a) and curable synchronous distant metastases include in study. All patients underwent cytoreductive surgery with primary tumor resection. In study group (44) we performed laparoscopic surgery, in main group (45) – open surgery procedure. The groups were similar by sex, age, tumor localization and histological structure, comorbidities. Results: R0 resection performed 27% patients. The average number of lymph node removal was similar 13 and 12 respectively. Average operation time was significantly longer in study group 210 vs 120 min. In study group blood loss was lower: 300 mL vs 1200 mL. Postoperative patient recovery shorter after laparoscopic surgery (p < 0.05): time to activation 2.2 vs 3.9 days; time to first peristalsis – 1.8 vs 4.5 days; first bowel movement – 3.4 vs 4.8 days; first food taken – 2.9 vs 3.9 days. Shorter time of analgesics intake – 2.3 vs 4.4 days, p < 0.05. Hospital stay shorter: 9.3 vs 13.4 days, p = 0.05. Time to start chemotherapy reduced since 27.5 to 14.7 days, p < 0.05. Postoperative complications lower in study group: 6.8 vs 17.8%, p = 0.05. Kaplan–Meier 2-year overall survival were similar: 69.5% vs 61.6%, p = 0.96. Conclusion: Laparoscopic cytoreductive surgery for metastatic CC is safe, minimized surgical trauma and speed up patient recovery. Resumo: Fundamento: Câncer de cólon (CC) é uma das doenças oncológicas mais comuns no mundo. Até 30% dos pacientes na Rússia têm CC metastático na primeira visita ao oncologista. Os resultados do tratamento ainda são controversos. Atualmente, a técnica de precisão laparoscópica minimamente invasiva permitiu estender a indicação para a cirurgia citorredutora mesmo em pacientes com comorbidades graves. Materiais e métodos: 89 pacientes com câncer de cólon (T1-4a) e metástases distantes síncronas curáveis foram incluídos no estudo. Todos os pacientes foram submetidos à cirurgia citorredutora com ressecção do tumor primário. No grupo de estudo (44) realizamos cirurgia laparoscópica, no grupo principal (45), a cirurgia aberta. Os grupos eram semelhantes em relação à sexo, idade, localização e estrutura histológica do tumor, e comorbidades. Resultados: A ressecção R0 foi realizada em 27% dos pacientes. O número médio de remoção de linfonodos foi similar, 13 e 12, respectivamente. O tempo médio de cirurgia foi significativamente mais longo no grupo de estudo, 210 versus 120 min. A perda de sangue foi menor no grupo de estudo: 300 mL versus 1200 mL. A recuperação pós-operatória foi mais curta após a cirurgia laparoscópica (p < 0,05): tempo de ativação - 2,2 vs. 3,9 dias; tempo até o primeiro peristaltismo - 1,8 vs. 4,5 dias; primeiro movimento intestinal - 3.4 vs. 4.8 dias; primeiro alimento consumido - 2.9 vs. 3.9 dias. Menor tempo de ingestão de analgésicos - 2,3 versus 4,4 dias, p < 0,05; menor tempo de hospitalização: 9,3 vs. 13,4 dias, p = 0,05. O tempo para iniciar a quimioterapia foi reduzido de 27,5 para 14,7 dias, p < 0,05. Complicações pós-operatórias menores no grupo de estudo: 6,8 vs. 17,8%, p = 0,05. A sobrevivência global de Kaplan–Meier aos 2 anos foi semelhante: 69,5% vs. 61,6%, p = 0,96. Conclusão: A cirurgia citorredutora laparoscópica para CC metastático é segura, minimiza o trauma cirúrgico e acelera a recuperação do paciente. Keywords: Laparoscopic surgery for colorectal cancer, Cytoreductive surgery, Metastatic colorectal cancer, Palavras-chave: Cirurgia laparoscópica para câncer colorretal, Cirurgia citorredutora, Câncer colorretal metastátic
Laparoscopic cytoreductive surgery for metastatic colon cancer – how to improve treatment strategy
No full textAbstract
Background Colon cancer (CC) one of the most common oncological disease in World. Up to 30% patients in Russia have metastatic CC at first visiting to oncologist. The treatment results still controversial. Nowadays, minimally invasive laparoscopic precision technique allowed extending the indication for cytoreductive surgery even in patients with severe comorbidities.
Materials and methods 89 patients with colon cancer (T1-4a) and curable synchronous distant metastases include in study. All patients underwent cytoreductive surgery with primary tumor resection. In study group (44) we performed laparoscopic surgery, in main group (45) – open surgery procedure. The groups were similar by sex, age, tumor localization and histological structure, comorbidities.
Results R0 resection performed 27% patients. The average number of lymph node removal was similar 13 and 12 respectively. Average operation time was significantly longer in study group 210 vs 120 min. In study group blood loss was lower: 300 mL vs 1200 mL. Postoperative patient recovery shorter after laparoscopic surgery (p < 0.05): time to activation 2.2 vs 3.9 days; time to first peristalsis – 1.8 vs 4.5 days; first bowel movement – 3.4 vs 4.8 days; first food taken – 2.9 vs 3.9 days. Shorter time of analgesics intake – 2.3 vs 4.4 days, p < 0.05. Hospital stay shorter: 9.3 vs 13.4 days, p = 0.05. Time to start chemotherapy reduced since 27.5 to 14.7 days, p < 0.05. Postoperative complications lower in study group: 6.8 vs 17.8%, p = 0.05. Kaplan–Meier 2-year overall survival were similar: 69.5% vs 61.6%, p = 0.96.
Conclusion Laparoscopic cytoreductive surgery for metastatic CC is safe, minimized surgical trauma and speed up patient recovery.</jats:p
- …
