Since the United States Food and Drug Administration approval of the da Vinci Surgical System for gynecologic surgery in 2005, it has been rapidly adopted at various centers where it is available. Previous studies reported that the da Vinci robotic platform is a feasible treatment option for hysterectomy. The EndoWrist function of robotic instruments allows for better and more precise performance than that of straight-stick laparoscopic instruments. Different surgical platforms are used by different institutions or surgeons in robotic hysterectomies. This is a review and summary of the various surgical platforms and instruments used in robotic hysterectomy using the da Vinci Xi system.
{"title":"Surgical platforms and instruments in robotic hysterectomy using the da Vinci Xi system","authors":"K. So","doi":"10.36637/grs.2023.00178","DOIUrl":"https://doi.org/10.36637/grs.2023.00178","url":null,"abstract":"Since the United States Food and Drug Administration approval of the da Vinci Surgical System for gynecologic surgery in 2005, it has been rapidly adopted at various centers where it is available. Previous studies reported that the da Vinci robotic platform is a feasible treatment option for hysterectomy. The EndoWrist function of robotic instruments allows for better and more precise performance than that of straight-stick laparoscopic instruments. Different surgical platforms are used by different institutions or surgeons in robotic hysterectomies. This is a review and summary of the various surgical platforms and instruments used in robotic hysterectomy using the da Vinci Xi system.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122411248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sang-Hee Lee, Min-Joung Kim, J. Song, Youn-Jee Chung, Mee-Ran Kim
{"title":"Single port robot assisted total laparoscopic hysterectomy with bilateral uterine artery double ligation at the isthmic level of uterus","authors":"Sang-Hee Lee, Min-Joung Kim, J. Song, Youn-Jee Chung, Mee-Ran Kim","doi":"10.36637/grs.2023.00143","DOIUrl":"https://doi.org/10.36637/grs.2023.00143","url":null,"abstract":"","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130796377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To analyse real time data over a decade of robotic surgery for benign Gynecological conditions using the da Vinci Si system.Methods: This is a retrospective analysis of prospectively collected data of da Vinci Si robotic surgery between August 2012 and July 2021 at single medical centre by a single surgeon.Results: Of the total 452 cases, the procedures were broadly categorised into myomectomy (RM-204), hysterectomy (RH-150), endometriosis excision (RE-80). The mean age of 46.12±6.77 and the mean BMI 28.89±5.02 kg/m2 in RH group was higher in RH group when compared to RM and RE groups. The mean docking time over 10 years was 10.59 minutes and mean console time was 96.35±47.77 minutes and both were significantly lower in the last 5 years when compared to first 5 years. 49.9% patients did not require intravenous analgesics beyond 24 hours and only 7.2% needed beyond 48 hours. 44.7% had less than 24 hours of hospital stay and 1.1% stayed beyond 48 hours. The mean hemoglobin drop was 1.109±0.7531 g%, significantly higher in RM group. The mean specimen weight in RM group was 323.8 g (200–1,372 g) and 84 cases had multiple leiomyomas. The commonest indication of robotic surgery was fibroid uterus.Conclusion: Robotic surgery for benign gynecologic surgery feasible and safe. It has equivalent outcomes when compared to laparoscopic surgery and superior when compared with laparotomy. Using robots to reduce open and repeat surgery for injury corrections could translate to reductions in the over-all economic burden of treatment.
{"title":"Single centre experience in India for benign gynecological robotic surgery with da Vinci Si system: A real world data analysis of one decade","authors":"S. Rooma, B. Rupa, Nikitha K Reddy","doi":"10.36637/grs.2023.00164","DOIUrl":"https://doi.org/10.36637/grs.2023.00164","url":null,"abstract":"Objective: To analyse real time data over a decade of robotic surgery for benign Gynecological conditions using the da Vinci Si system.Methods: This is a retrospective analysis of prospectively collected data of da Vinci Si robotic surgery between August 2012 and July 2021 at single medical centre by a single surgeon.Results: Of the total 452 cases, the procedures were broadly categorised into myomectomy (RM-204), hysterectomy (RH-150), endometriosis excision (RE-80). The mean age of 46.12±6.77 and the mean BMI 28.89±5.02 kg/m2 in RH group was higher in RH group when compared to RM and RE groups. The mean docking time over 10 years was 10.59 minutes and mean console time was 96.35±47.77 minutes and both were significantly lower in the last 5 years when compared to first 5 years. 49.9% patients did not require intravenous analgesics beyond 24 hours and only 7.2% needed beyond 48 hours. 44.7% had less than 24 hours of hospital stay and 1.1% stayed beyond 48 hours. The mean hemoglobin drop was 1.109±0.7531 g%, significantly higher in RM group. The mean specimen weight in RM group was 323.8 g (200–1,372 g) and 84 cases had multiple leiomyomas. The commonest indication of robotic surgery was fibroid uterus.Conclusion: Robotic surgery for benign gynecologic surgery feasible and safe. It has equivalent outcomes when compared to laparoscopic surgery and superior when compared with laparotomy. Using robots to reduce open and repeat surgery for injury corrections could translate to reductions in the over-all economic burden of treatment.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123372408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Wong, Joseph Ng, H. Chung, Chi-Heum Cho, Mee-Ran Kim, Tae-Joong Kim, Rebecca Singson, J. Paek, R. Sinha, Jennifer B. José, Ka-Yu Tse, Joseph J. Noh, H. Lai, Keun Ho Lee
The second Asian Summit on Robotic Surgery (ASRS) was convened in Singapore, 12 November 2022. This meeting was well attended by speakers and participants from around the region. The Gynecology tract of the ASRS 2022 was supported by the Asian Society for Gynecology Robotic Surgery. Co-chaired by Dr. Jeslyn Wong of Singapore, and Dr. Hyewon Chung of South Korea, the Gynecology program saw experts share their experiences, tips and surgical pearls with enthusiastic participants from the region. This article summarizes the key topics that were discussed during the meeting.
{"title":"Asian Summit on Robotic Surgery 2022 gynecology tract meeting report","authors":"J. Wong, Joseph Ng, H. Chung, Chi-Heum Cho, Mee-Ran Kim, Tae-Joong Kim, Rebecca Singson, J. Paek, R. Sinha, Jennifer B. José, Ka-Yu Tse, Joseph J. Noh, H. Lai, Keun Ho Lee","doi":"10.36637/grs.2023.00150","DOIUrl":"https://doi.org/10.36637/grs.2023.00150","url":null,"abstract":"The second Asian Summit on Robotic Surgery (ASRS) was convened in Singapore, 12 November 2022. This meeting was well attended by speakers and participants from around the region. The Gynecology tract of the ASRS 2022 was supported by the Asian Society for Gynecology Robotic Surgery. Co-chaired by Dr. Jeslyn Wong of Singapore, and Dr. Hyewon Chung of South Korea, the Gynecology program saw experts share their experiences, tips and surgical pearls with enthusiastic participants from the region. This article summarizes the key topics that were discussed during the meeting.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127608539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. As robotic surgery is becoming more common, surgical tools regarding robotic surgery is also developing at a fast rate. Initially, robotic surgery was performed using multi-port; however, with gaining popularity with single-port surgery, single-port robot was developed. Therefore, the field of single-port robot surgery is expanding and the number of cases are increasing. In single site robotic surgery, the size of incision limits the number of equipment that may simultaneously enter the operation field to one camera and two robot arms. Therefore, in cases where an additional laparoscopic instrument is needed, another incision has to be made. This video contains single site robotic surgery using a multi-articulating instrument performed on two patients. The first case is a single-site robotic surgery using a multi-robot system and the second case is a single-port robotic surgery using single-port robot system. In both patients, total hysterectomy and both salpingo-oophorectomy were performed. Additional sentinel lymph node dissection was done in the single-site surgical case (first case) and pelvic lymph node dissection in singleport surgical case (second case). Artisential was used for both cases. The Artisential allowed multiple degrees of movement and therefore more complex techniques were able to be performed compared to rigid or straight instruments. In surgeries that would previously have required an additional incision, we were able to successfully complete the single-site or single-port robotic endometrial cancer staging using the Artisential.
{"title":"Single-site robotic, endometrial cancer staging surgery using additional laparoscopic multi-articulating instrument, Artisential","authors":"Seongeun Bak, Seo， Ji Min, Keun Ho Lee","doi":"10.36637/grs.2022.00115","DOIUrl":"https://doi.org/10.36637/grs.2022.00115","url":null,"abstract":"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/ licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. As robotic surgery is becoming more common, surgical tools regarding robotic surgery is also developing at a fast rate. Initially, robotic surgery was performed using multi-port; however, with gaining popularity with single-port surgery, single-port robot was developed. Therefore, the field of single-port robot surgery is expanding and the number of cases are increasing. In single site robotic surgery, the size of incision limits the number of equipment that may simultaneously enter the operation field to one camera and two robot arms. Therefore, in cases where an additional laparoscopic instrument is needed, another incision has to be made. This video contains single site robotic surgery using a multi-articulating instrument performed on two patients. The first case is a single-site robotic surgery using a multi-robot system and the second case is a single-port robotic surgery using single-port robot system. In both patients, total hysterectomy and both salpingo-oophorectomy were performed. Additional sentinel lymph node dissection was done in the single-site surgical case (first case) and pelvic lymph node dissection in singleport surgical case (second case). Artisential was used for both cases. The Artisential allowed multiple degrees of movement and therefore more complex techniques were able to be performed compared to rigid or straight instruments. In surgeries that would previously have required an additional incision, we were able to successfully complete the single-site or single-port robotic endometrial cancer staging using the Artisential.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125153673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robotic surgery has advantages in myomectomies, which are a technically complex surgery. Multi-site robotic myomectomy (MRM) is widely used and is a safe, minimally invasive surgery. Single-site robotic myomectomy (SSRM) is further expected to provide potential advantages such as better cosmesis and easier fibroid removal. Compared with MRM, SSRM has technical limitations, including a restricted range of motion, especially for large-sized myomas; less powerful suturing in thick myometrium; and non-articulating instruments. To overcome these limitations, additional ports are used, larger skin incisions are made, and the procedure is combined with laparoscopy. However, these adjustments may neutralize the advantages of a single-port surgery. Here we describe our novel gradual turning out method, which enables us to do SSRM without adjustments. Additionally, we introduce know-how on how to accomplish an SSRM.
{"title":"Overcoming the limitations of single-site robotic myomectomy via the gradual turning out method without an accessory port, and a know-how","authors":"E. Lee, Jin-A Oh","doi":"10.36637/grs.2022.00101","DOIUrl":"https://doi.org/10.36637/grs.2022.00101","url":null,"abstract":"Robotic surgery has advantages in myomectomies, which are a technically complex surgery. Multi-site robotic myomectomy (MRM) is widely used and is a safe, minimally invasive surgery. Single-site robotic myomectomy (SSRM) is further expected to provide potential advantages such as better cosmesis and easier fibroid removal. Compared with MRM, SSRM has technical limitations, including a restricted range of motion, especially for large-sized myomas; less powerful suturing in thick myometrium; and non-articulating instruments. To overcome these limitations, additional ports are used, larger skin incisions are made, and the procedure is combined with laparoscopy. However, these adjustments may neutralize the advantages of a single-port surgery. Here we describe our novel gradual turning out method, which enables us to do SSRM without adjustments. Additionally, we introduce know-how on how to accomplish an SSRM.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128670457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asian Society for Gynecologic Robotic Surgery Congress 2022, a start of new chapter","authors":"Hye-Kyeong Chung","doi":"10.36637/grs.2022.00122","DOIUrl":"https://doi.org/10.36637/grs.2022.00122","url":null,"abstract":"","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126352567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robotic surgery (RS) is a breakthrough in gynecologic oncology in the past decade and it is now part of the routine in many centers. Although there is a concern about the oncological outcomes after RS in cervical cancer, it is proven to be safe and effective in endometrial cancer. However, RS has some drawbacks such as the loss of tactile feedback. Complications can therefore occur, and are usually multi-factorial. These can be related to the nature of the operations, the physical fitness of the patients, the control and choice of the devices, and more importantly, the experience and knowledge of the surgical team. To minimise the risk of complications, we need to understand the limitations of RS and have a proper set-up of the operations. It is important to anticipate these potential complications before and during the operations. And a careful setup of the operations, including the instrument set-up, patients’ positioning, port placement, and communication with the anesthetists and surgical team, are crucial in ensuring the safety and success of robotic surgery. In this article, different complications and their preventive measures at set-up were discussed.
{"title":"Tips for set-up to prevent complications in robotic gynecologic cancer surgery","authors":"K. Tse","doi":"10.36637/grs.2022.00129","DOIUrl":"https://doi.org/10.36637/grs.2022.00129","url":null,"abstract":"Robotic surgery (RS) is a breakthrough in gynecologic oncology in the past decade and it is now part of the routine in many centers. Although there is a concern about the oncological outcomes after RS in cervical cancer, it is proven to be safe and effective in endometrial cancer. However, RS has some drawbacks such as the loss of tactile feedback. Complications can therefore occur, and are usually multi-factorial. These can be related to the nature of the operations, the physical fitness of the patients, the control and choice of the devices, and more importantly, the experience and knowledge of the surgical team. To minimise the risk of complications, we need to understand the limitations of RS and have a proper set-up of the operations. It is important to anticipate these potential complications before and during the operations. And a careful setup of the operations, including the instrument set-up, patients’ positioning, port placement, and communication with the anesthetists and surgical team, are crucial in ensuring the safety and success of robotic surgery. In this article, different complications and their preventive measures at set-up were discussed.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132766651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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