{"title":"Thanks for endeavor of professor Chi-Heum Cho, the first editor-in-chief of Gynecologic Robotic Surgery","authors":"Keun Ho Lee","doi":"10.36637/grs.2022.00108","DOIUrl":"https://doi.org/10.36637/grs.2022.00108","url":null,"abstract":"","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"27 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":"128496342","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}
Chang-Bok Song, Seungmee Lee, H. Chung, T. Jang, S. Kwon, C. Cho
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. The mainstay of treatment generally considered for early stage cervical cancer below International Federation of Gynecology and Obstetrics (FIGO) stage IIa1 is surgery. The standard treatment for patients from FIGO stage Ia2 to IIa1 cervical cancer who do not wish to preserve fertility is radical hysterectomy with pelvic lymph node dissection [1,2]. During radical hysterectomy, the risk of ureter injury is increased [3,4]. IRIS U-kit (Stryker, Kalamazoo, MI, USA) is a lighted ureteral stent comprising a 6 F translucent ureteral sheath for the bilateral ureters, with optical fibers inserted into the ureteral sheath, and a device for light source. It is placed in the bilateral ureters using cystoscopic approach. It enables the visualization of the bilateral ureter lining during surgery. L10 AIM light source (Stryker) was used in this case. It can generate heat exceeding 41°C at the tip of the optic fiber. However, the optic fiber is placed in the ureteral sheath, which keeps it from coming into direct contact with the tissue. We report a case report of robot assisted single-site radical hysterectomy by inserting lighted ureteral stent for cervical cancer treatment. A 41-year-old woman who was diagnosed with cervical cancer FIGO stage Ib1 underwent robot assisted single-site modified radical hysterectomy (type II) with insertion of lighted ureteral stent. da Vinci Xi Surgical system (Intuitive Surgical, Sunnyvale, CA, USA) platform was used for the surgery. After routine surgical draping, using the cystoscopic approach, ureteral sheath was inserted 20 cm into each ureteral opening. Optic fibers of the IRIS U-kit (Stryker) was inserted into the ureteral sheath. Subsequently, the cystoscope was removed. After installing the lighted ureteral stent, robot docking of the da Vinci Xi surgical system (Intuitive Surgical) was performed followed by radical hysterectomy. Both ureters were fully visualized during the surgery. Total operation time was 105 minutes and time taken for lighted ureteral stent insertion was 7 minutes. There was no immediate or delayed side effect. Lighted ureteral stent insertion in robot assisted singlesite radical hysterectomy for cervical cancer treatment is a safe and feasible option and helps to overcome the limitaCase report of lighted ureteral stent insertion with robotic single-site radical hysterectomy in early cervical cancer treatment
{"title":"Case report of lighted ureteral stent insertion with robotic single-site radical hysterectomy in early cervical cancer treatment","authors":"Chang-Bok Song, Seungmee Lee, H. Chung, T. Jang, S. Kwon, C. Cho","doi":"10.36637/grs.2022.00094","DOIUrl":"https://doi.org/10.36637/grs.2022.00094","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. The mainstay of treatment generally considered for early stage cervical cancer below International Federation of Gynecology and Obstetrics (FIGO) stage IIa1 is surgery. The standard treatment for patients from FIGO stage Ia2 to IIa1 cervical cancer who do not wish to preserve fertility is radical hysterectomy with pelvic lymph node dissection [1,2]. During radical hysterectomy, the risk of ureter injury is increased [3,4]. IRIS U-kit (Stryker, Kalamazoo, MI, USA) is a lighted ureteral stent comprising a 6 F translucent ureteral sheath for the bilateral ureters, with optical fibers inserted into the ureteral sheath, and a device for light source. It is placed in the bilateral ureters using cystoscopic approach. It enables the visualization of the bilateral ureter lining during surgery. L10 AIM light source (Stryker) was used in this case. It can generate heat exceeding 41°C at the tip of the optic fiber. However, the optic fiber is placed in the ureteral sheath, which keeps it from coming into direct contact with the tissue. We report a case report of robot assisted single-site radical hysterectomy by inserting lighted ureteral stent for cervical cancer treatment. A 41-year-old woman who was diagnosed with cervical cancer FIGO stage Ib1 underwent robot assisted single-site modified radical hysterectomy (type II) with insertion of lighted ureteral stent. da Vinci Xi Surgical system (Intuitive Surgical, Sunnyvale, CA, USA) platform was used for the surgery. After routine surgical draping, using the cystoscopic approach, ureteral sheath was inserted 20 cm into each ureteral opening. Optic fibers of the IRIS U-kit (Stryker) was inserted into the ureteral sheath. Subsequently, the cystoscope was removed. After installing the lighted ureteral stent, robot docking of the da Vinci Xi surgical system (Intuitive Surgical) was performed followed by radical hysterectomy. Both ureters were fully visualized during the surgery. Total operation time was 105 minutes and time taken for lighted ureteral stent insertion was 7 minutes. There was no immediate or delayed side effect. Lighted ureteral stent insertion in robot assisted singlesite radical hysterectomy for cervical cancer treatment is a safe and feasible option and helps to overcome the limitaCase report of lighted ureteral stent insertion with robotic single-site radical hysterectomy in early cervical cancer treatment","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125228853","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}
The inaugural scientific meeting of the Asian Society for Gynecologic Robotic Surgery (ASGRS) on gynecological field was held at Advanced Surgery Training Centre of National University Hospital in Singapore, 18 and 19 August 2015. The ASGRS was established for raising the bar on women’s surgical healthcare in Asia with robotic surgery through research, innovation, and leadership. In addition, this scientific meeting was aimed at enhancing and sharing up-to-date knowledge about robotic surgery for patients with gynecologic disease. A total of 40 participants from eight countries (Hong Kong, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, and USA) participated in the congress (Figs. 1-4), which comprised 13 lectures and one live surgery divided into five sessions (Table 1).
{"title":"Overview of the inaugural congress of Asian Society for Gynecologic Robotic Surgery (ASGRS) 2015","authors":"J. Paek, J. Ng","doi":"10.36637/grs.2022.00087","DOIUrl":"https://doi.org/10.36637/grs.2022.00087","url":null,"abstract":"The inaugural scientific meeting of the Asian Society for Gynecologic Robotic Surgery (ASGRS) on gynecological field was held at Advanced Surgery Training Centre of National University Hospital in Singapore, 18 and 19 August 2015. The ASGRS was established for raising the bar on women’s surgical healthcare in Asia with robotic surgery through research, innovation, and leadership. In addition, this scientific meeting was aimed at enhancing and sharing up-to-date knowledge about robotic surgery for patients with gynecologic disease. A total of 40 participants from eight countries (Hong Kong, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, and USA) participated in the congress (Figs. 1-4), which comprised 13 lectures and one live surgery divided into five sessions (Table 1).","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"188 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114628643","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. The aim of this video article is to describe the robotic single-site paratubal cystectomy technique for a huge paraovarian borderline malignancy with no spillage of cystic contents in a morbidly obese woman. Video presentation of the procedure. A 23-year-old virgin woman with a body mass index of 42.87 kg/m was referred for a 27×21-cm left adnexal tumor, suggesting borderline ovarian malignancy. Her serum cancer antigen (CA)-125 level was 64.2 U/mL and risk of ovarian malignancy algorithm was 3.3% (low risk). There was no evidence of metastatic tumor or lymph node enlargement on magnetic resonance imaging or positron emission tomography/computed tomography. Decreased ovarian reserve was suspected, considering the low serum level of anti-mullerian hormone (1.24 ng/mL), and we decided to perform cystectomy for preserving ovarian function. Under general anesthesia, a 2.7-cm vertical intraumbilical incision was made, and a glove single-port device was inserted. No seeding tumors or adhesions were observed in the abdominal cavity. Peritoneal washing was negative for malignant cells. We performed robotic single-site right paraovarian cystectomy. After completing the cystectomy, we sutured the defect with 2-0 polydioxanone suture using a continuous running technique with a wristed needle driver. A specimen was removed from the pelvic cavity without spilling the contents in the operative field. The total operative time was 105 minutes and the console time was 50 minutes. The estimated blood loss was 30 mL, and the hospital stay was 3.5 days without any complications. Histopathologic evaluation revealed a serous borderline tumor in the background of a cystadenofibroma of the fallopian tube without external surface involvement or stromal microinvasion. The patient was tumor-free until the follow-up at 2 years post-operation, and her CA-125 level was normal (22.8 U/mL). We successfully performed a Single-Site robot-assisted laparoscopic cystectomy for a huge adnexal mass presumed to be a clinically borderline ovarian malignancy in a morbidly obese woman without any complications. Single-site robot-assisted laparoscopic cystectomy for a huge, presumed borderline ovarian malignancy in a morbidly obese woman
{"title":"Single-site robot-assisted laparoscopic cystectomy for a huge, presumed borderline ovarian malignancy in a morbidly obese woman","authors":"Sungwook Choi, J. Yoo, Sa-Ra Lee","doi":"10.36637/grs.2021.00073","DOIUrl":"https://doi.org/10.36637/grs.2021.00073","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. The aim of this video article is to describe the robotic single-site paratubal cystectomy technique for a huge paraovarian borderline malignancy with no spillage of cystic contents in a morbidly obese woman. Video presentation of the procedure. A 23-year-old virgin woman with a body mass index of 42.87 kg/m was referred for a 27×21-cm left adnexal tumor, suggesting borderline ovarian malignancy. Her serum cancer antigen (CA)-125 level was 64.2 U/mL and risk of ovarian malignancy algorithm was 3.3% (low risk). There was no evidence of metastatic tumor or lymph node enlargement on magnetic resonance imaging or positron emission tomography/computed tomography. Decreased ovarian reserve was suspected, considering the low serum level of anti-mullerian hormone (1.24 ng/mL), and we decided to perform cystectomy for preserving ovarian function. Under general anesthesia, a 2.7-cm vertical intraumbilical incision was made, and a glove single-port device was inserted. No seeding tumors or adhesions were observed in the abdominal cavity. Peritoneal washing was negative for malignant cells. We performed robotic single-site right paraovarian cystectomy. After completing the cystectomy, we sutured the defect with 2-0 polydioxanone suture using a continuous running technique with a wristed needle driver. A specimen was removed from the pelvic cavity without spilling the contents in the operative field. The total operative time was 105 minutes and the console time was 50 minutes. The estimated blood loss was 30 mL, and the hospital stay was 3.5 days without any complications. Histopathologic evaluation revealed a serous borderline tumor in the background of a cystadenofibroma of the fallopian tube without external surface involvement or stromal microinvasion. The patient was tumor-free until the follow-up at 2 years post-operation, and her CA-125 level was normal (22.8 U/mL). We successfully performed a Single-Site robot-assisted laparoscopic cystectomy for a huge adnexal mass presumed to be a clinically borderline ovarian malignancy in a morbidly obese woman without any complications. Single-site robot-assisted laparoscopic cystectomy for a huge, presumed borderline ovarian malignancy in a morbidly obese woman","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128050567","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}
Jong-wook Seo, I. Lee, Hye soo Yoon, Kyung Lim Lee, J. Chung
Objective: To compare the perioperative outcomes of robotic single-site myomectomy (RSSM) and laparoendoscopic single-site myomectomy (LSSM).Methods: From January 2017 to December 2019, electronic medical records of the consecutively held 17 RSSM and 20 LSSM were reviewed. Parameters including patient’s characteristics, the total operation time, size and number of myomas taken out, operative findings, intra and postoperative complications were compared.Results: Patients who undertook RSSM were younger (27.0±7.1 vs. 32.9±7.9) and only one out of 17 (2.9%) had previous pregnancy compared to 10 out of 20 in LSSM (50.0%). Complex cases with tumors of larger size and accompanied adhesion were done using RSSM. The median operative time was longer in the RSSM (176.1±59.0 vs. 77.5±47.1). All cases were successfully performed via a single port. No cases of postoperative complication including wound dehiscence or intestinal obstruction occurred in either group.Conclusion: Perioperative outcomes of myomectomy undertaken by robotic single-site surgery and laparoendoscopic single-site surgery were comparable, though myomectomy for the larger myoma were performed with robotic single-site surgery. The role of robotic single-site myomectomy on fertility needs further investigation.
{"title":"Single-port myomectomy: robotic versus laparoscopic","authors":"Jong-wook Seo, I. Lee, Hye soo Yoon, Kyung Lim Lee, J. Chung","doi":"10.36637/grs.2021.00066","DOIUrl":"https://doi.org/10.36637/grs.2021.00066","url":null,"abstract":"Objective: To compare the perioperative outcomes of robotic single-site myomectomy (RSSM) and laparoendoscopic single-site myomectomy (LSSM).Methods: From January 2017 to December 2019, electronic medical records of the consecutively held 17 RSSM and 20 LSSM were reviewed. Parameters including patient’s characteristics, the total operation time, size and number of myomas taken out, operative findings, intra and postoperative complications were compared.Results: Patients who undertook RSSM were younger (27.0±7.1 vs. 32.9±7.9) and only one out of 17 (2.9%) had previous pregnancy compared to 10 out of 20 in LSSM (50.0%). Complex cases with tumors of larger size and accompanied adhesion were done using RSSM. The median operative time was longer in the RSSM (176.1±59.0 vs. 77.5±47.1). All cases were successfully performed via a single port. No cases of postoperative complication including wound dehiscence or intestinal obstruction occurred in either group.Conclusion: Perioperative outcomes of myomectomy undertaken by robotic single-site surgery and laparoendoscopic single-site surgery were comparable, though myomectomy for the larger myoma were performed with robotic single-site surgery. The role of robotic single-site myomectomy on fertility needs further investigation.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114981251","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}
S. R. Lee, Sungwook Choi, Al-Otaibi Mozon, Ju-Hee Kim, Jung Ryeol Lee, S. Seong, Mee-Ran Kim
Objective: This study aimed to investigate the of robotic-assisted laparoscopic myomectomy (RALM) techniques among Korean gynecologic robotic surgeons with heavy robotic gynecologic caseloads.Methods: We conducted this online survey consisting of 11 questions regarding various aspects of RALM, such as the type of da Vinci system, number of skin incisions, trocar ports, robotic instruments, and suture materials, with a focus on multiport RALM. Twenty-one board-certified robotic gynecologic surgeons from 16 university-based tertiary medical centers responded.Results: The da Vinci Xi was the most commonly installed system at the respondents’ affiliated hospitals. In terms of instruments, monopolar curved scissors, fenestrated bipolar forceps, and mega suture needle driver were the most used. The most commonly used suture materials for serosal and myometrial layer closure were barbed suture materials, and the endometrial layer was most commonly closed with multifilament delayed absorbable suture material. Continuous running and baseball suture techniques were most frequently used for serosal layer closure.Conclusion: This is the first study investigating RALM surgical methods among Korean gynecologic robotic surgeon with heavy caseloads, and the findings can be of a great benefit to beginners as well as experts in the field of robotic surgery.
{"title":"A survey on robotic-assisted laparoscopic myomectomy technique among high-volume gynecologic robotic surgeons in Korea","authors":"S. R. Lee, Sungwook Choi, Al-Otaibi Mozon, Ju-Hee Kim, Jung Ryeol Lee, S. Seong, Mee-Ran Kim","doi":"10.36637/grs.2022.00080","DOIUrl":"https://doi.org/10.36637/grs.2022.00080","url":null,"abstract":"Objective: This study aimed to investigate the of robotic-assisted laparoscopic myomectomy (RALM) techniques among Korean gynecologic robotic surgeons with heavy robotic gynecologic caseloads.Methods: We conducted this online survey consisting of 11 questions regarding various aspects of RALM, such as the type of da Vinci system, number of skin incisions, trocar ports, robotic instruments, and suture materials, with a focus on multiport RALM. Twenty-one board-certified robotic gynecologic surgeons from 16 university-based tertiary medical centers responded.Results: The da Vinci Xi was the most commonly installed system at the respondents’ affiliated hospitals. In terms of instruments, monopolar curved scissors, fenestrated bipolar forceps, and mega suture needle driver were the most used. The most commonly used suture materials for serosal and myometrial layer closure were barbed suture materials, and the endometrial layer was most commonly closed with multifilament delayed absorbable suture material. Continuous running and baseball suture techniques were most frequently used for serosal layer closure.Conclusion: This is the first study investigating RALM surgical methods among Korean gynecologic robotic surgeon with heavy caseloads, and the findings can be of a great benefit to beginners as well as experts in the field of robotic surgery.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114203226","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. In the gynecological field, minimally invasive surgery is becoming increasingly popular due to its short hospitalization period, rapid recovery, and cosmetic benefits [1,2]. With the U.S. Food and Drug Administration approval of the da Vinci® Surgical System (Intuitive Surgical Inc., Synnyvale, CA, USA), robotic surgery (RS) has become widespread to overcome the shortcomings of laparoscopic surgery, such as collisions and clashing of instruments and limited range of motion [3]. Introduction of RS has numerous benefits, including less postoperative pain, the reduced blood loss during surgery, and shorter hospital stay. In 2013, a single-site platform of da Vinci Si Surgical System was introduced for performance of gynecologic procedures through a single umbilical incision similar to laparoendoscopic single-site surgery. Robotic single-site surgery (RSSS) maintains the advantages of the RS that were already mentioned above, but in addition, the patient's cosmetic satisfaction for a single site scar on the umbilicus remains high and the complications related to accessory port sites can be avoided [4]. Although the feasibility and safety of RSS surgery using the da Vinci Si or Xi Surgical System have been investigated in hysterectomy or myomectomy, there are still limitations due to semi-rigid and non-articulating instruments with lack of triangulation in those systems [5-7]. In order to perform more robotic single-site surgeries successfully, we must develop good surgical skills and better suturing techniques with the current set of limited instruments [7-9]. Therefore, the da Vinci SP Surgical System was recently introduced in 2018 to overcome the limitations of RSSS using the da Vinci Si or Xi Surgical System. The new da Vinci SP System enabled sufficient articulation with fully wristed, double-jointed instruments, and included a flexible three-dimensional camera. The surgeons were able to perform meticulous sutures comfortably with all three instruments of the da Vinci SP Surgical System even through a single umbilical incision [10]. Preliminary data were reported that robotic singleport surgery (RSPS) using the da Vinci SP Surgical System might be an alternative surgical technique for various benign gynecologic diseases. Especially, robotic single-port myomectomy (RSPM) using the da Vinci SP Surgical System is a feasible surgical modality for women with symptomatic myoma and is expected to increase indications of single port myomectomy with following advantages (in submission). Single-port instruments have sufficient mechanical power to hold and suture thicker tissues than previous Single-site instruments. The utilization of three instruments se
{"title":"Robotic single-port surgery","authors":"H. Moon","doi":"10.36637/grs.2021.00052","DOIUrl":"https://doi.org/10.36637/grs.2021.00052","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. In the gynecological field, minimally invasive surgery is becoming increasingly popular due to its short hospitalization period, rapid recovery, and cosmetic benefits [1,2]. With the U.S. Food and Drug Administration approval of the da Vinci® Surgical System (Intuitive Surgical Inc., Synnyvale, CA, USA), robotic surgery (RS) has become widespread to overcome the shortcomings of laparoscopic surgery, such as collisions and clashing of instruments and limited range of motion [3]. Introduction of RS has numerous benefits, including less postoperative pain, the reduced blood loss during surgery, and shorter hospital stay. In 2013, a single-site platform of da Vinci Si Surgical System was introduced for performance of gynecologic procedures through a single umbilical incision similar to laparoendoscopic single-site surgery. Robotic single-site surgery (RSSS) maintains the advantages of the RS that were already mentioned above, but in addition, the patient's cosmetic satisfaction for a single site scar on the umbilicus remains high and the complications related to accessory port sites can be avoided [4]. Although the feasibility and safety of RSS surgery using the da Vinci Si or Xi Surgical System have been investigated in hysterectomy or myomectomy, there are still limitations due to semi-rigid and non-articulating instruments with lack of triangulation in those systems [5-7]. In order to perform more robotic single-site surgeries successfully, we must develop good surgical skills and better suturing techniques with the current set of limited instruments [7-9]. Therefore, the da Vinci SP Surgical System was recently introduced in 2018 to overcome the limitations of RSSS using the da Vinci Si or Xi Surgical System. The new da Vinci SP System enabled sufficient articulation with fully wristed, double-jointed instruments, and included a flexible three-dimensional camera. The surgeons were able to perform meticulous sutures comfortably with all three instruments of the da Vinci SP Surgical System even through a single umbilical incision [10]. Preliminary data were reported that robotic singleport surgery (RSPS) using the da Vinci SP Surgical System might be an alternative surgical technique for various benign gynecologic diseases. Especially, robotic single-port myomectomy (RSPM) using the da Vinci SP Surgical System is a feasible surgical modality for women with symptomatic myoma and is expected to increase indications of single port myomectomy with following advantages (in submission). Single-port instruments have sufficient mechanical power to hold and suture thicker tissues than previous Single-site instruments. The utilization of three instruments se","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131373536","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 technology has recently come into widespread use to overcome the limitations of laparoscopic radical hysterectomy in the treatment of early-stage cervical cancer. Most comparative studies showed that blood loss and hospital stays for patients undergoing minimally invasive surgery, including robotic procedures, were superior compared to open surgery. Moreover, the survival outcomes of robotic radical hysterectomy were not inferior to open radical hysterectomy. Unexpectedly, the Laparoscopic Approach to Cervical Cancer (LACC) trial, a randomized, open-label, noninferiority study that compared minimally invasive radical hysterectomy with open radical hysterectomy, revealed that minimally invasive surgery was associated with a higher risk of recurrence and death compared with open surgery. Strict guidelines for robotic radical hysterectomy for the treatment of early-stage cervical cancer should be established in accordance with objective Korean data. In addition, it is recommended that further studies should be performed on how to avoid the use of uterine manipulators and the dissemination of cancer cells by ensuring a more effective vaginal closure using a standardized approach.
{"title":"Robotic radical hysterectomy for early-stage cervical cancer: A systematic literature review","authors":"G. Chong","doi":"10.36637/grs.2021.00038","DOIUrl":"https://doi.org/10.36637/grs.2021.00038","url":null,"abstract":"Robotic technology has recently come into widespread use to overcome the limitations of laparoscopic radical hysterectomy in the treatment of early-stage cervical cancer. Most comparative studies showed that blood loss and hospital stays for patients undergoing minimally invasive surgery, including robotic procedures, were superior compared to open surgery. Moreover, the survival outcomes of robotic radical hysterectomy were not inferior to open radical hysterectomy. Unexpectedly, the Laparoscopic Approach to Cervical Cancer (LACC) trial, a randomized, open-label, noninferiority study that compared minimally invasive radical hysterectomy with open radical hysterectomy, revealed that minimally invasive surgery was associated with a higher risk of recurrence and death compared with open surgery. Strict guidelines for robotic radical hysterectomy for the treatment of early-stage cervical cancer should be established in accordance with objective Korean data. In addition, it is recommended that further studies should be performed on how to avoid the use of uterine manipulators and the dissemination of cancer cells by ensuring a more effective vaginal closure using a standardized approach.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134428566","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}
We aim to discuss the development of Revo-i, the first new robotic medical device for laparoscopic surgery made in Korea, including the history of launching Revo-i in the global market, and the success results of the progression with the clinical data after launching the system. Revo-i has been commercialized in the global and domestic market, and it has been increasing the number of the procedures at the major specialties such as obstetrics and gynecology, urology and general surgery. This shows that Revo-i is one of the competitive robots in the global market to compete with the current worldwide robotic system.
{"title":"Revo-i: The competitive Korean surgical robot","authors":"Ho Kun Lee, Ka Eun Lee, Jiwon Ku, K. Lee","doi":"10.36637/grs.2021.00059","DOIUrl":"https://doi.org/10.36637/grs.2021.00059","url":null,"abstract":"We aim to discuss the development of Revo-i, the first new robotic medical device for laparoscopic surgery made in Korea, including the history of launching Revo-i in the global market, and the success results of the progression with the clinical data after launching the system. Revo-i has been commercialized in the global and domestic market, and it has been increasing the number of the procedures at the major specialties such as obstetrics and gynecology, urology and general surgery. This shows that Revo-i is one of the competitive robots in the global market to compete with the current worldwide robotic system.","PeriodicalId":240488,"journal":{"name":"Gynecologic Robotic Surgery","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130580451","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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