Robotic 8-mm trocar fascial wounds: To close or not to close?

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2024-03-02 DOI:10.1002/rcs.2624

Marco Milone, Pietro Anoldo, Michele Manigrasso, Grazia Cantore, Silvia Campanile, Gianluca Rompianesi, Roberto Ivan Troisi, Anna D’Amore, Giovanni Domenico De Palma

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Abstract

Background

The aim of this study was to investigate 8-mm robotic trocar site hernia (TSH) rate over the short and long term, providing aids to manage the related fascial wounds.

Methods

A retrospective analysis of 320 patients undergoing robotic surgery was conducted. The primary outcome was 8-mm TSH rate with a minimum follow-up of 12 months. The secondary outcome was the rate of haematomas and infections related to 8-mm wounds and their association with patient comorbidities and trocar position.

Results

One case of TSH was observed (0.31%). There were 15 cases of wound infection (4.68%) and 22 cases of wound haematoma (6.87%). Trocar related complications were significantly associated with patient comorbidities, not with trocar position.

Conclusions

Our results do not justify the 8-mm fascial wound closure. Data concerning the association between trocar-related complications and patient comorbidities strengthen the need to implement the control of metabolic state and correct administration of perioperative therapy in high-risk patients.

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机器人 8 毫米套管筋膜伤口：缝合还是不缝合？

背景本研究旨在调查 8 毫米机器人套管部位疝（TSH）的短期和长期发病率，为处理相关筋膜伤口提供帮助。方法对 320 名接受机器人手术的患者进行了回顾性分析。主要结果是随访至少 12 个月的 8 毫米 TSH 率。次要结果是与 8 毫米伤口相关的血肿率和感染率，以及它们与患者合并症和套管位置的关系。结果观察到 1 例 TSH（0.31%）。伤口感染 15 例（4.68%），伤口血肿 22 例（6.87%）。套管相关并发症与患者的合并症有很大关系，而与套管位置无关。结论我们的结果不能证明 8 毫米筋膜伤口闭合是正确的。有关套管相关并发症与患者合并症之间关系的数据加强了对高危患者实施代谢状态控制和正确进行围手术期治疗的必要性。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.