Dataset Information

ROBOTIC GASTRECTOMY: TECHNIQUE STANDARDIZATION.

ABSTRACT:

Background

Trocars position for the Si model (position is similar for the Xi, although trocars stay more in line). Robotic gastrectomy is gaining popularity worldwide. It allows reduced blood loss and lesser pain. However, it widespread use is limited by the extensive learning curve and costs.

Aim

To describe our standard technique with reduced use of robotic instruments.

Methods

We detail the steps involved in the procedure, including trocar placement, necessary robotic instruments, and meticulous surgical description.

Results

After standardizing the procedure, 28 patients were operated with this budget technique. For each procedure material used was: 1 (Xi model) or 2 disposable trocars (Si) and 4 robotic instruments. Stapling and clipping were performed by the assistant through an auxiliary port, limiting the use of robotic instruments and reducing the cost.

Conclusion

This standardization helps implementing a robotic program for gastrectomy in the daily practice or in one`s institution.

SUBMITTER: Dias AR

PROVIDER: S-EPMC7812686 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

ROBOTIC GASTRECTOMY: TECHNIQUE STANDARDIZATION.

Dias Andre Roncon AR Ramos Marcus Fernando Kodama Pertille MFKP Szor Daniel Jose DJ Abdalla Ricardo R Barchi Leandro L Yagi Osmar Kenji OK Ribeiro-Junior Ulysses U Zilberstein Bruno B Cecconello Ivan I

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery 20210115 3

<h4>Background</h4>Trocars position for the Si model (position is similar for the Xi, although trocars stay more in line). Robotic gastrectomy is gaining popularity worldwide. It allows reduced blood loss and lesser pain. However, it widespread use is limited by the extensive learning curve and costs.<h4>Aim</h4>To describe our standard technique with reduced use of robotic instruments.<h4>Methods</h4>We detail the steps involved in the procedure, including trocar placement, necessary robotic in ...[more]

PMID: 33470372

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Project description:ImportanceRobotic gastrectomy (RG) for gastric cancer may be associated with decreased incidence of intra-abdominal infectious complications, including pancreatic fistula, leakage, and abscess. Prospective randomized clinical trials comparing laparoscopic gastrectomy (LG) and RG are thus required.ObjectiveTo compare the short-term surgical outcomes of RG with those of LG for patients with gastric cancer.Design, setting, and participantsIn this phase 3, prospective superiority randomized clinical trial of RG vs LG regarding reduction of complications, 241 patients with resectable gastric cancer (clinical stages I-III) were enrolled between April 1, 2018, and October 31, 2020.InterventionsLG vs RG.Main outcomes and measuresThe primary end point was the incidence of postoperative intra-abdominal infectious complications. Secondary end points were incidence of any complications, surgical results, postoperative courses, and oncologic outcomes. The modified intention-to-treat population excluded patients who had been randomized and met the postrandomization exclusion criteria. There was also a per-protocol population for analysis of postoperative complications.ResultsThis study enrolled 241 patients, with 236 patients in the modified intention-to-treat population (150 men [63.6%]; mean [SD] age, 70.8 [10.7] years). There was no significant difference in the incidence of intra-abdominal infectious complications (per-protocol population: 10 of 117 [8.5%] in the LG group vs 7 of 113 [6.2%] in the RG group). Of 241 patients, 122 were randomly assigned to the LG group, and 119 patients were randomly assigned to the RG group. Two of the 122 patients (1.6%) in the LG group converted from LG to open surgery, and 4 of 119 patients (3.4%) in the RG group converted from RG to open or laparoscopic surgery, with no significant difference. Finally, 117 patients in the LG group completed the procedure, and 113 in the RG group completed the procedure; these populations were defined as the per-protocol population. The overall incidence of postoperative complications of grade II or higher was significantly higher in the LG group (23 [19.7%]) than in the RG group (10 [8.8%]) (P = .02). Even in analysis limited to grade IIIa or higher, the complication rate was still significantly higher in the LG group (19 [16.2%]) than in the RG group (6 [5.3%]) (P = .01).Conclusions and relevanceThis study found no reduction of intra-abdominal infectious complications with RG compared with LG for gastric cancer.Trial registrationumin.ac.jp/ctr Identifier: UMIN000031536.

Dataset Information

ROBOTIC GASTRECTOMY: TECHNIQUE STANDARDIZATION.

Background

Aim

Methods

Results

Conclusion

Publications

ROBOTIC GASTRECTOMY: TECHNIQUE STANDARDIZATION.

Similar Datasets

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