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Published in: Langenbeck's Archives of Surgery 3/2006

01-06-2006 | Original Article

Prospective study comparing standard and robotically assisted laparoscopic cholecystectomy

Authors: Peter Kornprat, Georg Werkgartner, Herwig Cerwenka, Heinz Bacher, Azab El-Shabrawi, Peter Rehak, Hans Jörg Mischinger

Published in: Langenbeck's Archives of Surgery | Issue 3/2006

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Abstract

Background and aims

Laparoscopic surgery has become the treatment of choice for cholecystectomy. Many studies showed that while this approach benefits the patient, the surgeon faces such distinct disadvantages as a poor ergonomic situation and limited degrees of freedom with limited motion as a consequence. Robots have the potential to overcome these problems. To evaluate the efficiency and feasibility of robotically assisted surgery (RAC), we designed a prospective study to compare it with standard laparoscopic cholecystectomy (SLC).

Materials and methods

Between 2001 and 2003, 26 patients underwent SLC and 20 patients underwent RAC using the ZEUS system. The feasibility, safety, and possible advantages were evaluated. To assess the efficacy, the total time in the operating room was divided into preoperative, operative, and postoperative time frames.

Results

For RAC in comparison with SLC, the preoperative phase including equipment setup was significantly longer. In the intraoperative phase, the cut-closure time and camera and trocar insertion times were significantly longer. It is interesting to note that the net dissection time for the cystic artery, duct, and the gall bladder was not different from SLC.

Conclusions

The study demonstrates the feasibility of robotically assisted cholecystectomy without system-specific morbidity. There is time loss in several phases of robotic surgery due to equipment setup and deinstallation and therefore, presents no benefit in using the robot in laparoscopic cholecystectomy.
Literature
1.
go back to reference Williams LF, Chapman WC, Bonau RA et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465PubMedCrossRef Williams LF, Chapman WC, Bonau RA et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465PubMedCrossRef
2.
go back to reference Allendorf JD, Bessler M, Whelan RL et al (1997) Postoperative immune function varies inversely with the degree of surgical trauma in a murine model. Surg Endosc 11:427–430PubMedCrossRef Allendorf JD, Bessler M, Whelan RL et al (1997) Postoperative immune function varies inversely with the degree of surgical trauma in a murine model. Surg Endosc 11:427–430PubMedCrossRef
3.
go back to reference Heikkinen TJ, Haukipuro K, Bringman S et al (2000) Comparison of laparoscopic and open Nissen fundoplication 2 years after operation: a prospective randomized trial. Surg Endosc 14:1019–1023PubMedCrossRef Heikkinen TJ, Haukipuro K, Bringman S et al (2000) Comparison of laparoscopic and open Nissen fundoplication 2 years after operation: a prospective randomized trial. Surg Endosc 14:1019–1023PubMedCrossRef
4.
go back to reference Himpens J, Leman G, Cadier GB (1998) Telesurgical laparoscopic cholecystectomy (letter). Surg Endosc 12:1091PubMedCrossRef Himpens J, Leman G, Cadier GB (1998) Telesurgical laparoscopic cholecystectomy (letter). Surg Endosc 12:1091PubMedCrossRef
5.
go back to reference Cecconi S, Coratti A, Angelini M et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465CrossRef Cecconi S, Coratti A, Angelini M et al (1993) Comparison of laparoscopic cholecystectomy with open cholecystectomy in a single center. Am J Surg 165:459–465CrossRef
6.
go back to reference Chapman WHH, Albrecht RJ, Kim VB et al (2001) Computer enhanced robotically assisted telemanipulative cholecystectomy (abstract). Surg Endosc 15:S114 Chapman WHH, Albrecht RJ, Kim VB et al (2001) Computer enhanced robotically assisted telemanipulative cholecystectomy (abstract). Surg Endosc 15:S114
8.
10.
go back to reference Ruurda JP, Visser PL, Broeders IAMJ (2003) Analysis of procedure time in robot-assisted surgery: comparative study in laparoscopic cholecystectomy. Comput Aided Surg 8:24–29PubMedCrossRef Ruurda JP, Visser PL, Broeders IAMJ (2003) Analysis of procedure time in robot-assisted surgery: comparative study in laparoscopic cholecystectomy. Comput Aided Surg 8:24–29PubMedCrossRef
11.
go back to reference Nio D, Bemelman WA, den Boer KT et al (2002) Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in performance of standardized tasks. Surg Endosc 16:412–415PubMedCrossRef Nio D, Bemelman WA, den Boer KT et al (2002) Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in performance of standardized tasks. Surg Endosc 16:412–415PubMedCrossRef
12.
go back to reference Prasad SM, Maniar HS, Soper NJ et al (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183:702–707PubMedCrossRef Prasad SM, Maniar HS, Soper NJ et al (2002) The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 183:702–707PubMedCrossRef
13.
go back to reference Sung GT, Gill IS, Hsu TH (1999) Robotic assisted laparoscopic pyeloplasty: a pilot study. Urology 53:1099–1103PubMedCrossRef Sung GT, Gill IS, Hsu TH (1999) Robotic assisted laparoscopic pyeloplasty: a pilot study. Urology 53:1099–1103PubMedCrossRef
14.
go back to reference Garcia-Ruiz A, Gagner M, Miller JF et al (1998) Manual versus robotically assisted laparoscopic surgery in the performance of basic manipulation and suturing task. Arch Surg 133:957–961PubMedCrossRef Garcia-Ruiz A, Gagner M, Miller JF et al (1998) Manual versus robotically assisted laparoscopic surgery in the performance of basic manipulation and suturing task. Arch Surg 133:957–961PubMedCrossRef
15.
go back to reference Chitwood WR, Nifong LW, Chapman WHH et al (2001) Robotic surgical training in an academic institution. Ann Surg 234:475–486PubMedCrossRef Chitwood WR, Nifong LW, Chapman WHH et al (2001) Robotic surgical training in an academic institution. Ann Surg 234:475–486PubMedCrossRef
16.
go back to reference Kim VB, Chapman WHM, Albrecht RJ et al (2002) Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using Da Vinci. Surg Laparosc Endosc Percutan Tech 12:33–40PubMedCrossRef Kim VB, Chapman WHM, Albrecht RJ et al (2002) Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using Da Vinci. Surg Laparosc Endosc Percutan Tech 12:33–40PubMedCrossRef
17.
go back to reference White P, Carbajal-Ramos A, Gracia C et al (2003) A prospective randomized study of the ZEUS robotic surgical system for laparoscopic cholecystectomy. In: Proceedings of the SAGES 2003 meeting, Los Angeles, CA, March 12–15. Surg Endosc 17:S061–S089 White P, Carbajal-Ramos A, Gracia C et al (2003) A prospective randomized study of the ZEUS robotic surgical system for laparoscopic cholecystectomy. In: Proceedings of the SAGES 2003 meeting, Los Angeles, CA, March 12–15. Surg Endosc 17:S061–S089
18.
go back to reference Marescaux J, Smith MK, Fölscher D et al (2001) Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 234:1–7PubMedCrossRef Marescaux J, Smith MK, Fölscher D et al (2001) Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 234:1–7PubMedCrossRef
19.
go back to reference Mischinger HJ, Rigler MY, Werkgartner G (2001) Erste klinische Erfahrungen mit dem Einsatz der Robotertechnik in der Viszeralchirurgie. Acta Chir Austriaca 33(Suppl 175):57 Mischinger HJ, Rigler MY, Werkgartner G (2001) Erste klinische Erfahrungen mit dem Einsatz der Robotertechnik in der Viszeralchirurgie. Acta Chir Austriaca 33(Suppl 175):57
20.
go back to reference Marescaux J, Rubino F (2005) Robotic surgery: potentials, barriers, and limitations. Eur Surg 37/5:279–283CrossRef Marescaux J, Rubino F (2005) Robotic surgery: potentials, barriers, and limitations. Eur Surg 37/5:279–283CrossRef
21.
go back to reference Meir AH, Rawn CL, Krummel TM (2001) Virtual reality: surgical application—challenge for the new millenium. J Am Coll Surg 192:372–384CrossRef Meir AH, Rawn CL, Krummel TM (2001) Virtual reality: surgical application—challenge for the new millenium. J Am Coll Surg 192:372–384CrossRef
22.
go back to reference Perrisat J (1993) Laparoscopic cholecystectomy: the European experience. Am J Surg 165:444–449CrossRef Perrisat J (1993) Laparoscopic cholecystectomy: the European experience. Am J Surg 165:444–449CrossRef
23.
go back to reference Gadacz TR (2000) Update on laparoscopic cholecystectomy, including a clinical pathway. Surg Clin North Am 80:1127–1149PubMedCrossRef Gadacz TR (2000) Update on laparoscopic cholecystectomy, including a clinical pathway. Surg Clin North Am 80:1127–1149PubMedCrossRef
Metadata
Title
Prospective study comparing standard and robotically assisted laparoscopic cholecystectomy
Authors
Peter Kornprat
Georg Werkgartner
Herwig Cerwenka
Heinz Bacher
Azab El-Shabrawi
Peter Rehak
Hans Jörg Mischinger
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 3/2006
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-006-0046-4

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