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Published in:

01-06-2011 | Review Article

Robotic surgery: review of the latest advances, risks, and outcomes

Authors: Mary Downes Gastrich, Joseph Barone, Gloria Bachmann, Mark Anderson, Adrian Balica

Published in: Journal of Robotic Surgery | Issue 2/2011

Abstract

Using differing levels of evidence, we developed criteria to critically review 21 scientifically peer-reviewed articles on robot-assisted surgeries in various medical fields. The advantages and limitations of robotic systems are discussed and compared with traditional surgical methods. Since training in the use of robotic skills is essential, various training models are discussed to teach the complex skills necessary for robotic surgery. There is a paucity of control studies on a sufficient number of subjects in robot-assisted surgeries in all fields. Studies that meet more stringent clinical trials criteria show that robot-assisted surgery appears comparable to traditional surgery in terms of feasibility and outcomes but that costs associated with robot-assisted surgery are higher because of longer operating times and expense of equipment. While a limited number of studies on the da Vinci robotic system have proven the benefit of this approach in regard to patient outcomes, including significantly reduced blood loss, lower percentage of postoperative complications, and shorter hospital stays, there are mechanical and institutional risks that must be more fully addressed. In addition, trials are needed to identify simulators for learners that can enhance the da Vinci performance in order to shorten the learning curve.

Cystectomy

Surgical removal of all or part of the urinary bladder

Pyeloplasty

Kidney surgery to reconstruct a damaged ureter and the renal pelvis

Myomectomy (sometimes also fibroidectomy)

Surgical removal of uterine leiomyomas, also known as fibroids

Fundoplication

Nissen fundoplication is a surgical procedure used to treat gastroesophageal reflux disease (GORD) and hiatus hernia

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Ayav A, Bresler L, Brunaud L, Boissel P (2004) Early results of one-year robotic surgery using the da Vinci system to perform advanced laparoscopic procedures. J Gastrointest Surg 8:720–726PubMedCrossRef

Berryhill R, Jhaveri J, Yadav R, Leung R, Rao S, El-Hakim A, Tewari A (2008) Robotic prostatectomy: a review of outcomes compared with laparoscopic and open approaches. Urology 72:15–23PubMedCrossRef

Boggess JF, Gehrig PA, Cantrell L et al (2008) A case-control study of robot-assisted type III radical hysterectomy with pelvic lymph node dissection compared with open radical hysterectomy. Am J Obstet Gynecol 199:357.e1–357.e7CrossRef

Braumann C, Jacobi CA, Menenakos C, Borchert U, Rueckert JC, Mueller JM (2005) Computer-assisted laparoscopic colon resection with the da Vinci^® system: our first experiences. Dis Colon Rectum 48:1820–1827PubMedCrossRef

Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery. Surg Endosc 19:117–119PubMedCrossRef

D’Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D (2004) Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 47(12):2162–2168PubMedCrossRef

Doumerc N, Yuen C, Savdie R, Rahman MB, Rasiah KK, Pe Benito R, Delprado W, Matthews J, Haynes A, Stricker PD (2010) Should experienced open prostatic surgeons convert to robotic surgery? The real learning curve for one surgeon over 3 years. BJU Int 106:378–384PubMedCrossRef

10.

Draaisma WA, Ruurda JP, Scheffer RCH, Simmermacher RKJ, Gooszen HG, Rijnhart-de Jon HG, Buskens E, Broeders IAMJ (2006) Randomized clinical trial of standard laparoscopic versus robot-assisted laparoscopic Nissen fundoplication for gastroesophageal reflux disease. Br J Surg 93:1351–1359PubMedCrossRef

11.

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12.

Folliguet T, Vanhuyse F, Constantino X, Realli M, Laborde F (2006) Mitral valve repair robotic versus sternotomy. Eur J Cardiothorac Surg 29:362–366PubMedCrossRef

13.

Franco I, Dyer LL, Zelkovic P (2007) Laparoscopic pyeloplasty in the pediatric patient: hand sewn anastomosis versus robotic assisted anastomosis—is there a difference? J Urol 178:1483–1486PubMedCrossRef

14.

Geller EJ, Siddiqui NY, Wu JM, Visco AG (2008) Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol 112(6):1201–1206PubMedCrossRef

15.

Hartmann J, Jacobi CA, Menenakos C, Ismail M, Braumann C (2008) Surgical treatment of gastroesophageal reflux disease and upside-down stomach using the da Vinci^® robotic system. A prospective study. J Gastrointest Surg 12:504–509PubMedCrossRef

16.

Hemal AK, Kolla SB, Wadhwa P (2008) First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system. J Robot Surg 2:35–40CrossRef

17.

Hernandez JD, Bann SD, Munz Y, Moorthy K, Datta V, Martin S, Dosis A, Bello F, Darzi A, Rockall T (2004) Qualitative and quantitative analysis of the learning curve of a simulated surgical task on the da Vinci system. Surg Endosc 18:372–378PubMedCrossRef

18.

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19.

Hubens G, Coveliers H, Balliu L, Ruppert M, Vaneerdeweg W (2003) A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system. Surg Endosc 17:1595–1599PubMedCrossRef

20.

Jung YW, Lee DW, Kim SW, Nam EJ, Kim JH, Kim JW, Kim YT (2010) Robot-assisted staging using three robotic arms for endometrial cancer: comparison to laparoscopy and laparotomy at a single institution. J Surg Oncol 101(2):116–121PubMed

21.

Katsavelis D, Siu KC, Brown-Clerk B, Lee IH, Lee YK, Oleynikov O, Stergio N (2009) Validated robotic laparoscopic surgical training in a virtual-reality environment. Surg Endosc 23:66–73PubMedCrossRef

22.

Krambeck AE, DiMarco DS, Rangel LJ, Bergstralh EJ, Myers RP, Blute ME, Gettman MT (2009) Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int 103:448–453PubMedCrossRef

23.

Lee RS, Retik AB, Borer JG, Peters CA (2006) Pediatric robot assisted laparoscopic dismembered pyeloplasty: comparison with a cohort of open surgery. J Urol 175:683–687PubMedCrossRef

24.

Lowe MP, Chamberlain DH, Kamelle SA, Johnson PR, Tillmanns TD (2009) A multi-institutional experience with robotic-assisted radical hysterectomy for early stage cervical cancer. Gynecol Oncol 113(2009):191–194PubMedCrossRef

25.

Marecik SJ, Prasad LM, Park JJ, Pearl RK, Evenhouse J, Shah A, Khan K, Abcarian H (2008) A lifelike patient simulator for teaching robotic colorectal surgery: how to acquire skills for robotic rectal dissection. Surg Endosc 22:1876–1881PubMedCrossRef

26.

McDougall EM (2007) Validation of surgical simulators. J Endourol 21(3):244–247PubMedCrossRef

27.

Maggioni A, Minig L, Zanagnolo V, Peiretti M, Sanguineti F, Bocciolone L, Colombo N, Landoni F, Roviglione G, Vélez JI (2009) Robotic approach for cervical cancer: comparison with laparotomy: a case control study. Gynecol Oncol 115:60–64.

28.

Mehrabi A, Yetimoglu CL, Nickkholgh A, Kashfi A, Kienle P, Konstantinides L, Ahmadi MR, Fonouni H, Schemmer P, Friess H, Gebhard MM, Buchler MW, Schmidt J, Gutt CN (2006) Development and evaluation of a training module for the clinical introduction of the da Vinci robotic system in visceral and vascular surgery. Surg Endosc 20:1376–1382PubMedCrossRef

29.

Morino M, Pellegrino L, Giaccone C, Garrone C, Rebecchi F (2006) Randomized clinical trial of robot-assisted versus laparoscopic Nissen fundoplication. Br J Surg 93:553–558PubMedCrossRef

30.

Muacevic A, Drexler C, Kufeld M, Romanelli P, Duerr HJ, Wowra B (2009) Fiducial-free real-time image-guided robotic radiosurgery for tumors of the sacrum/pelvis. Radiother Oncol 93(1):37–44PubMedCrossRef

31.

Nezhat C, Morozov V (2010) Robot-assisted laparoscopic presacral neurectomy: feasibility, techniques, and operative outcomes. J Minim Invasive Gynecol 17:508–512PubMedCrossRef

32.

Obermair O, Gebski V, Frumovitz M, Soliman PT, Schmeler KM, Levenback C, Ramirez PT (2008) A phase III randomized clinical trial comparing laparoscopic or robotic radical hysterectomy with abdominal radical hysterectomy in patients with early stage cervical cancer. J Minim Invasive Gynecol 15:584–588PubMedCrossRef

33.

Payne TN, Dauterive FR, Pitter MC, Giep HN, Giep BN, Grogg TW, Shanbour KA, Goff DW, Hubert HB (2010) Robotically assisted hysterectomy in patients with large uteri. Obstet Gynecol 115(3):535–542PubMedCrossRef

34.

Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, Cobelli OD (2009) Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int 104:991–995PubMedCrossRef

35.

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36.

Seamon LG, Bryant SA, Rheaume PS, Kimball KJ, Huh WK, Fowler JM, Phillips GS, Cohn DE (2009) Comprehensive surgical staging for endometrial cancer in obese patients. Obstet Gynecol 114:16–21PubMed

37.

Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, Chandrasekhar P, Wilding GE, Guru KA (2010) Face validation of a novel robotic surgical simulator. Urology 76:357–360

38.

Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH (2009) Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc 23:1204–1211PubMedCrossRef

39.

Stadler P, Dvoracek L, Vitasek P, Matous P (2010) Robotic vascular surgery, 150 cases. Int J Med Robot Comput Assist Surg 6(4):394–398

40.

Sung GT, Gill IS (2001) Robotic laparoscopic surgery: a comparison of the da Vinci and Zeus systems. Urology 58:893–898PubMedCrossRef

Title: Robotic surgery: review of the latest advances, risks, and outcomes
Authors: Mary Downes Gastrich
Joseph Barone
Gloria Bachmann
Mark Anderson
Adrian Balica
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Journal of Robotic Surgery / Issue 2/2011
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-011-0246-y

At a glance: The STEP trials

Springer Medicine

Robotic surgery: review of the latest advances, risks, and outcomes

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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Other articles of this Issue 2/2011

Immediate robot-assisted ureteral reimplantation during robotic prostatectomy in locally advanced prostate cancer

A prospective study of 100 roboticallyassisted laparoscopic adrenalectomies

Robotic-assisted laparoscopic donor nephrectomies: early experience and review of the literature

Differences in hand movements and task completion times between laparoscopic, robotically assisted, and open surgery: an in vitro study

The Giep needle pass: a simple technique for the passage of needles for vaginal cuff closure in robotically assisted laparoscopic hysterectomy

Operative blood loss and use of blood products after full robotic and conventional low anterior resection with total mesorectal excision for treatment of rectal cancer