Dataset Information

Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy.

ABSTRACT: Cooperation with multiple departments is essential for the treatment of patients with rectal cancer and other pelvic cancers. In our department, we experienced two cases of rectal cancer that underwent robotic low anterior resection (LAR) and simultaneous resection of other pelvic organs (case 1 with prostatectomy and case 2 with hysterectomy) using the da Vinci Xi system. Here, we show the precise procedures of these two robotic surgeries. Under general anesthesia and lithotomy position, five da Vinci ports were symmetrically placed along the umbilical horizontal line with a 7 cm interval, and a 5 mm AirSeal Access Port was added in the right or left upper quadrant. Patients were placed with 22-degree Trendelenburg and 8-degree tilt to the right. The operators used the center port on the umbilicus as a camera port and chose the docking arms with either two-left-one-right or one-left-two-right setting depending on their preference. This port setting was quite useful for the operators from multiple departments to change the docking arms, even if their preference may be different. Moreover, assistants could use the remaining two ports to provide a well-expanded and safer surgical field. "With a familiar view" and "with a wide view" are our two concepts to safely perform extended pelvic surgeries. We have employed this symmetrical horizontal port site position as a general setting for usual rectal surgeries.

SUBMITTER: Itatani Y

PROVIDER: S-EPMC6744546 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy.

Itatani Yoshiro Y Kawada Kenji K Hida Koya K Inamoto Susumu S Mizuno Rei R Goto Saori S Okuchi Yoshihisa Y Okada Tomoaki T Sakai Yoshiharu Y

International cancer conference journal 20190603 4

Cooperation with multiple departments is essential for the treatment of patients with rectal cancer and other pelvic cancers. In our department, we experienced two cases of rectal cancer that underwent robotic low anterior resection (LAR) and simultaneous resection of other pelvic organs (case 1 with prostatectomy and case 2 with hysterectomy) using the da Vinci Xi system. Here, we show the precise procedures of these two robotic surgeries. Under general anesthesia and lithotomy position, five d ...[more]

PMID: 31559111

Similar Datasets

Project description:ObjectiveThis study aimed to compare the short-term and long-term outcomes between robotic-assisted simultaneous resection and open surgery in patients with rectal cancer and liver metastases.BackgroundOpen simultaneous resection of colorectal cancer and synchronous liver metastases is widely performed and the potential cure for eligible patients. However, the feasibility of robotic simultaneous resection of primary and secondary liver lesions has not been established as a treatment option for metastatic rectal cancer.Patients and methodsA single-center randomized controlled trial was conducted at a hospital in China. Enrolling patients were aged from 18 to 75 years and diagnosed with surgically resectable metastatic rectal cancer (distal extension to ≤15 cm from the anal margin). Patients selected for simultaneous resection were randomly assigned to have robotic or open surgery at a 1:1 ratio. The primary endpoint was the incidence rate of complications within 30 days after surgery. Secondary endpoints were bladder, sexual function, 3-year disease-free survival and overall survival.ResultsA total of 171 patients were enrolled in this trial with 86 in the robotic group and 85 in the open group. As a result, patients in the robotic group demonstrated fewer complications within 30 days after surgery than those in the open group (31.4% vs. 57.6%, P=0.014) and no mortality seen in either group. Patients in the robotic group had less blood loss (mean [SD], 125.5 [38.3] vs. 211.6 [68.7] mL; P<0·001), faster bowel function recovery (mean [SD], 63.7 [27.4] vs. 93.8 [33.5] hours) P<0·001) and shorter hospital stay (mean [SD], 8.0 [2.2] vs. 10.7 [5.4] days; P<0·001) compared with those in the open group. The robotic group had faster recovery of bladder and sexual function at 3 months after surgery than that of the open group. The 3-year disease-free survival rate (39.5% vs. 35.3%, P=0.739) and the 3-year overall survival rate (76.7% vs. 72.9%, P=0.712) were not statistically significant between the two groups.ConclusionsIn our randomized clinical trial, robotic simultaneous resection treatment of patients with rectal cancer and liver metastases resulted in fewer surgical complications, and faster recovery to those of open surgery. Oncological outcomes showed no significant difference between two groups.

Project description:BackgroundLow anterior resection syndrome is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The low anterior resection syndrome score was designed as a simple tool for clinical evaluation of low anterior resection syndrome. Although the low anterior resection syndrome score has good clinical utility, it may not capture all important aspects that patients may experience.ObjectiveThe aim of this collaboration was to develop an international consensus definition of low anterior resection syndrome that encompasses all aspects of the condition and is informed by all stakeholders.DesignThis international patient-provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting.ParticipantsThree expert groups participated: patients, surgeons, and other health professionals from 5 regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in 3 languages (English, Spanish, and Danish).Main outcome measureThe primary outcome measured was the priorities for the definition of low anterior resection syndrome.ResultsThree hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96%, and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to 8 symptoms and 8 consequences that capture essential aspects of the syndrome.LimitationsSampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this.ConclusionsThis is the first definition of low anterior resection syndrome developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of low anterior resection syndrome. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in low anterior resection syndrome over time and with intervention.

Dataset Information

Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy.

Publications

Simultaneous robotic surgery with low anterior resection and prostatectomy/hysterectomy.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets