The Use of Robotic and Laparoscopic Surgical Stapling Devices During Minimally Invasive Colon and Rectal Surgery: A Comparison
| Autor: | Samuel Luka, Samir Agarwal, Madiha Aziz, Vincent Obias, Jeremy L. Holzmacher, Richard Amdur |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Colectomies Demographics Surgical stapling Operative Time Anastomotic Leak Malignancy Inflammatory bowel disease Diverticulitis Colonic 03 medical and health sciences Surgical Staplers 0302 clinical medicine Robotic Surgical Procedures Colon Sigmoid Surgical Stapling Humans Medicine Rectal resection Colectomy Retrospective Studies business.industry Rectum Middle Aged Inflammatory Bowel Diseases medicine.disease Colorectal surgery Surgery surgical procedures operative 030220 oncology & carcinogenesis Costs and Cost Analysis Female Laparoscopy 030211 gastroenterology & hepatology Colorectal Neoplasms business Body mass index |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:151-155 |
| ISSN: | 1557-9034 1092-6429 |
| DOI: | 10.1089/lap.2016.0409 |
| Popis: | To date there exists no published study examining the safety and efficacy of the EndoWrist 45 (Intuitive Surgical, Inc.) robotic stapler. We compared outcomes between the robotic and comparable laparoscopic stapler in robotic-assisted colorectal procedures.We conducted a retrospective review of 93 patients who underwent robotic-assisted colorectal surgery at our institution from 2012 to 2014. Surgeries included left, sigmoid, subtotal and total colectomies, and low anterior rectal resections. Indications were malignancy and diverticular and inflammatory bowel disease. Preoperative demographics, intraoperative data, and postoperative outcomes were examined. Student's t-test and Fischer's exact used were appropriate.Forty-five millimeters laparoscopic staplers were used in 58 cases, while the 45 mm robotic stapler was used in 35 cases. There was no difference in age (P = .651), gender (P = .832), or body mass index (P = .204) between groups. There was no difference in estimated blood loss (P = .524), operative time (P = .769), length of stay (P = .895), or complication rate (P = .778). The robotic stapler group had one anastomotic leak, while the laparoscopic stapler group had six (P = .705). There were more laparoscopic stapler fires (2.69) per patient than robotic stapler fires (1.86) (P = .001). The cost per patient for the laparoscopic group was $631.45 versus $473.28 for the robotic group (P = .001).This is the first study to evaluate the robotic stapler. Advantages of the robotic stapler include large range of motion and 90° of articulation, which may provide a benefit when using the stapler in difficult areas like the pelvis. The robotic stapler has a comparable level of safety as a 45 mm laparoscopic stapler and is more cost effective. |
| Databáze: | OpenAIRE |
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