Introduction: Proper bladder drainage is crucial. Children with bladder dysfunction may require alternative methods like clean intermittent catheterisation (CIC). However, CIC can be challenging for individuals with impairments.
View Article and Find Full Text PDFAim: Complete mesocolic excision (CME) is an oncologically driven technique for treating right colon cancer. While laparoscopic CME is technically demanding and has been associated with more complications, the robotic approach might reduce morbidity. The aim of this study was to assess the safety of stepwise implementation of robotic CME.
View Article and Find Full Text PDFBackground: Complete mesocolon excision (CME) and central vascular ligation for right colonic cancers have been developed to improve oncological outcomes. However, it has been linked with a higher risk of morbidity and technical difficulties in operating near major vessels. This study investigated the impact of preoperative surgical planning utilizing CT reconstruction on surgical outcomes in right colectomy with CME.
View Article and Find Full Text PDFPurpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery.
View Article and Find Full Text PDFBackground: While total mesorectal excision is the gold standard for rectal cancer, the optimal surgical approach to achieve adequate oncological outcomes remains controversial. This network meta-analysis aims to compare the histopathological outcomes of robotic (R-RR), transanal (Ta-RR), laparoscopic (L-RR), and open (O-RR) resections for rectal cancer.
Materials And Methods: MEDLINE, Embase, and the Cochrane Library were screened from inception to June 2024.
Background: Total mesorectal excision remains the gold standard for the management of rectal cancer however local excision of early rectal cancer is gaining popularity due to lower morbidity and higher acceptance by the elderly and frail patients.
Aim: To investigate the results of local excision of rectal cancer by transanal endoscopic microsurgery (TEMS) approach carried out at three large cancer centers in the United Kingdom.
Methods: TEMS database was retrospectively reviewed to assess demographics, operative findings and post operative clinical and oncological outcomes.
Background: Structured training programs for robotic colorectal surgery are limited, and there are concerns about surgical outcomes and operating times.
Objective: To compare perioperative and oncological outcomes of robotic total mesorectal excision for rectal cancer performed by expert consultants and surgical trainees in a modular surgical training program.
Design: Retrospective cohort study.
Introduction: The best approach for total mesorectal excision (TME) remains controversial. Two recently described approaches are robotic TME (RTME) and transanal TME (TaTME). This systematic review and meta-analysis aimed to compare the outcomes between robotic surgery and TaTME in patients undergoing rectal cancer resection.
View Article and Find Full Text PDFAnastomotic leakage (AL) is one of the most feared complications in colorectal surgery, with an incidence of 12-39% and associated risk of mortality of 2-24%. The causes of AL and the ways to prevent it are currently under investigation. This study aims to verify if a quadruple assessment of colorectal anastomosis could reduce AL incidence.
View Article and Find Full Text PDFThis study aims to discuss the principles and pillars of robotic colorectal surgery training and share the training pathway at Portsmouth Hospitals University NHS Trust. A narrative review is presented to discuss all the relevant and critical steps in robotic surgical training. Robotic training requires a stepwise approach, including theoretical knowledge, case observation, simulation, dry lab, wet lab, tutored programs, proctoring (in person or telementoring), procedure-specific training, and follow-up.
View Article and Find Full Text PDFStandardised proficiency-based progression is the cornerstone of safe robotic skills acquisition, however, is currently lacking within surgical training curricula. Expert consensuses have defined a modular pathway to accredit surgeons. This study aimed to address the lack of a formal, pre-clinical core robotic skills, proficiency-based accreditation curriculum in the UK.
View Article and Find Full Text PDFJ Pers Med
July 2024
(1) Background: In recent years, there has been a change in practice for diverting stomas in rectal cancer surgery, shifting from routine diverting stomas to a more selective approach. Studies suggest that the benefits of temporary ileostomies do not live up to their risks, such as high-output stomas, stoma dysfunction, and reoperation. (2) Methods: All rectal cancer patients treated with a robotic resection in a single tertiary colorectal centre in the UK from 2013 to 2021 were analysed.
View Article and Find Full Text PDFObjective: To compare long-term outcomes between laparoscopic and robotic total mesorectal excisions (TMEs) for rectal cancer in a tertiary center.
Background: Laparoscopic rectal cancer surgery has comparable long-term outcomes to the open approach, with several advantages in short-term outcomes. However, it has significant technical limitations, which the robotic approach aims to overcome.
The robotic approach is rapidly gaining momentum in colorectal surgery. Its benefits in pelvic surgery have been extensively discussed and are well established amongst those who perform minimally invasive surgery. However, the same cannot be said for the robotic approach for colonic resection, where its role is still debated.
View Article and Find Full Text PDFBackground: Transanal minimally invasive surgery (TAMIS) is an advanced technique for excision of early rectal cancers. Robotic TAMIS (r-TAMIS) has been introduced as technical improvement and potential alternative to total mesorectal excision (TME) in early rectal cancers and in frail patients. This study reports the perioperative and short-term oncological outcomes of r-TAMIS for local excision of early-stage rectal cancers.
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