Introduction: It is believed that the outcomes of robotic surgery depends not only on the experience of the console surgeon but also the patient-side assistant. However, objective data supporting it is lacking. The aim of this study was to objectively determine change in operative outcomes with increasing experience of patient-side assistant.
Materials And Methods: We performed a retrospective analysis of 222 urologic robotic procedures performed by two teams of surgeon-assistant and split the data into two chronological halves according to date of surgery. We considered that the assistant was inexperienced in the 1(st) half and had become experienced by the 2(nd) half, and we compared mean operative time and blood loss between these two halves of his experience.
Results: We observed that with increasing experience of the assistant, the mean operative time reduced from 138.06 to 124.32 min (P = 0.001) and mean blood loss decreased from 191.93 to 187.61 ml (P = 0.57). On subset analysis, a consistent trend of reduction in the mean operative time was noted for both the assistants separately and for all surgical procedures included in the analysis. Maximum reduction was noted for pyeloplasty which was the most commonly performed surgery. The mean blood loss had a varied relation to the experience of the assistant and did not reach statistical significance in either direction.
Conclusions: With increasing experience of the patient-side surgeon, the mean operative time for all robotic procedures showed a consistent trend of reduction across all types of surgery with greater reduction for commonly performed procedures.
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http://dx.doi.org/10.4103/0970-1591.185095 | DOI Listing |
J Neurosurg
January 2025
1Department of Neurosurgery, ASST Cremona, Italy.
Objective: Brainstem cavernous malformations (BSCMs) were once considered inoperable. Microsurgical resection now represents a valuable option for treating patients with hemorrhagic or symptomatic lesions. The aim of this study was to provide a practical guide for surgical planning by analyzing postoperative neurological and functional outcomes.
View Article and Find Full Text PDFJ Robot Surg
January 2025
BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
Robot-assisted surgery represents a significant innovation in reconstructive microsurgery, providing enhanced precision and reduced surgeon fatigue. This study examines the integration of robotic assistance in a series of 85 consecutive robot-assisted microsurgical (RAMS) operations. It aims to evaluate changes in the integration of RAMS during the implementation phase in a single institution.
View Article and Find Full Text PDFHernia
January 2025
Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, 1025 Morehead Medical Drive Suite 300, Charlotte, NC, 28204, USA.
Purpose: To present updated outcomes after previously describing a novel technique for the robotic repair of parastomal hernias.
Methods: Patients who underwent parastomal hernia repair with a robotic Sugarbaker technique at a tertiary hernia center were identified from an institutional database. The approach involves mesh placement in the intraperitoneal or preperitoneal position after closure of the fascial defect.
Ann Surg Oncol
January 2025
Department of Surgery, University of California San Diego School of Medicine, San Diego, CA, USA.
Background: Textbook outcome (TO) has been utilized to assess the quality of surgical care. This study aimed to define TO rates for minimally invasive gastric gastrointestinal stromal tumor (GIST) resections in a bi-institutional cohort.
Methods: Patients with gastric GIST (≤ 5 cm) who underwent laparoscopic or robotic resection (January 2014 to January 2024) were retrospectively identified from two GIST centers.
Urolithiasis
January 2025
Urology Department, Benha University, Benha, Qalubia, Egypt.
Studies in literature discussed the drawbacks of the ureteral access sheath use in flexible ureteroscopy and in the same time mentioned the benefits of ureteral access sheath in decreasing the incidence of urosepsis and better stone free rate. In the current study we aim to compare between percutaneous nephrostomy tube (PCN) insertion before flexible ureteroscopy and conventional ureteral access sheath (UAS) flexible ureteroscopy in terms of safety, efficacy and perioperative outcomes. In all, 100 Patients aged 20 to 67 years with upper ureteric stones and mild hydronephrosis or renal pelvic stones less than 20 mm with mild hydronephrosis were randomized into 2 groups; patients undergoing PCN insertion before flexible ureteroscopy, and patients undergoing the conventional UAS flexible ureteroscopy.
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