Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Original Paper

Robot-Assisted Endoscopic Surgery: A Four-Year Single-Center Experience

Ruurda J.P. · Draaisma W.A. · van Hillegersberg R. · Borel Rinkes I.H.M. · Gooszen H.G. · Janssen L.W.M. · Simmermacher R.K.J. · Broeders I.A.M.J.

Author affiliations

Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

Related Articles for ""

Dig Surg 2005;22:313–320

Do you have an account?

Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information











I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 17, 2005
Accepted: August 05, 2005
Published online: February 23, 2006
Issue release date: February 2006

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU

Abstract

Background: Robotic systems were introduced in the late 1990s with the objective to overcome the technical limitations of endoscopic surgery. In this prospective cohort study the potential safety, feasibility, pitfalls and challenges of robotic systems in gastrointestinal endoscopic surgery are assessed and our vision on future perspectives is presented. Methods:Between August 2000 and December 2004, 208 procedures were performed with support of the Intuitive Surgical da Vinci™ robotic system. We started with cholecystectomies (40) and Nissen fundoplications (41) to gain experience with robot-assisted surgery. In the following years more complex procedures were carried out, i.e. colorectal procedures (7), type III/IV paraesophageal hernia repair (32), redo Nissen fundoplications (9), Heller myotomies (24), esophageal resections (22), rectopexies (16) and aortobifemoral bypasses (3). Results:The median robotic set-up time was 13 min, and 7 min in the last 50 procedures. The median operating time for the total of procedures was 120 min (45–420) and the median blood loss was 30 ml (0–800). Fourteen procedures were converted to open surgery (6.7%). Equipment-related problems, such as start-up failures and positioning difficulties of the robotic arms, were encountered in 11 cases (5.3%). Postoperative complications were seen in 11 patients (11/176, 6.3%) after robot-assisted laparoscopic procedures. Pulmonary complications occurred in 11 patients, cardiac in 3, anastomic leakage in 3, chylous leakage in 3 and vocal cord paralysis in 3 after thoracoscopic esophagolymphadenectomy for esophageal cancer. One patient died 12 days after esophageal resection (0.5%). Conclusion:During the implementation of this robotic system, we experienced an obvious learning curve, particularly with regard to the positioning of the robot cart and communication between the surgeon and operating team. After 4 years, we have experienced that the merits of the current generation of this technology probably is preserved to complex endoscopic procedures with delicate dissection and suturing. In the nearby future we will focus on the treatment of motility disorders and malignancies of the esophagus and stomach. The position of the robot in the endoscopic operating room will have to be clarified by the outcome of prospective research. Furthermore, priorities have to be acclaimed on technical sophistication and cost reduction of these systems.

© 2005 S. Karger AG, Basel


References

  1. Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D: Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Br J Surg 1994;81:1362–1365.
  2. Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo, V: Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 2002;236:759–766.
  3. Bringman S, Ramel S, Heikkinen TJ, Englund T, Westman B, Anderberg B: Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein: A prospective randomized controlled trial. Ann Surg 2003;237:142–147.
  4. Cappuccino H, Cargill S, Nguyen T: Laparoscopic cholecystectomy: 563 cases at a community teaching hospital and a review of 12,201 cases in the literature. Monmouth Medical Center Laparoscopic Cholecystectomy Group. Surg Laparosc Endosc 1994;4:213–221.
  5. McMahon AJ, Russell IT, Baxter JN, Ross S, Anderson JR, Morran CG, Sunderland G, Galloway D, Ramsay G, O’Dwyer PJ: Laparoscopic versus minilaparotomy cholecystectomy: a randomised trial. Lancet 1994;343:135–138.
  6. Nilsson G, Larsson S, Johnsson F: Randomized clinical trial of laparoscopic versus open fundoplication: evaluation of psychological well-being and changes in everyday life from a patient perspective. Scand J Gastroenterol 2002;37:385–391.
  7. Pedersen AG, Petersen OB, Wara P, Ronning H, Qvist N, Laurberg S: Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 2001;88:200–205.
  8. Reynolds W Jr: The first laparoscopic cholecystectomy. JSLS 2001;5:89–94.
    External Resources
  9. Ros A, Gustafsson L, Krook H, Nordgren CE, Thorell A, Wallin G, Nilsson E: Laparoscopic cholecystectomy versus mini-laparotomy cholecystectomy: a prospective, randomized, single-blind study. Ann Surg 2001;234:741–749.
  10. Vanek VW, Rhodes R, Dallis DJ: Results of laparoscopic versus open cholecystectomy in a community hospital. South Med J 1995;88:555–566.
  11. Ruurda JP, van Vroonhoven TJ, Broeders IA: Robot-assisted surgical systems: a new era in laparoscopic surgery. Ann R Coll Surg Engl 2002;84:223–226.
  12. Bowersox JC, Shah A, Jensen J, Hill J, Cordts PR, Green PS: Vascular applications of telepresence surgery: initial feasibility studies in swine. J Vasc Surg 1996;23:281–287.
  13. Emam TA, Frank TG, Hanna GB, Cuschieri A: Influence of handle design on the surgeon’s upper limb movements, muscle recruitment, and fatigue during endoscopic suturing. Surg Endosc 2001;15:667–672.
  14. Bessler M, Whelan RL, Halverson A, Allendorf JD, Nowygrod R, Treat MR: Controlled trial of laparoscopic-assisted vs. open colon resection in a porcine model. Surg Endosc 1996;10:732–735.
  15. Kockerling F, Rose J, Schneider C, Scheidbach H, Scheuerlein H, Reymond MA, Reck T, Konradt J, Bruch HP, Zornig C, Barlehner E, Kuthe A, Szinicz G, Richter HA, Hohenberger W: Laparoscopic colorectal anastomosis: risk of postoperative leakage. Results of a multicenter study. Laparoscopic Colorectal Surgery Study Group (LCSSG). Surg Endosc 1999;13:639–644.
  16. Schob OM, Day PW, Josloff RK, Zucker KA: An experimental teaching model for laparoscopic choledochojejunostomy. Surg Laparosc Endosc 1996;6:341–347.
  17. Sweeney T, Rattner DW: Robotically assisted minimally invasive biliary surgery in a porcine model. Surg Endosc 2002;16:138–141.
  18. Melvin WS, Needleman BJ, Krause KR, Schneider C, Wolf RK, Michler RE, Ellison EC: Computer-enhanced robotic telesurgery. Initial experience in foregut surgery. Surg Endosc 2002;16:1790–1792.
  19. Meininger DD, Byhahn C, Heller K, Gutt CN, Westphal K: Totally endoscopic Nissen fundoplication with a robotic system in a child. Surg Endosc 2001;15:1360.
  20. Hanisch E, Markus B, Gutt C, Schmandra TC, Encke A: Robot-assisted laparoscopic cholecystectomy and fundoplication – initial experiences with the da Vinci system (in German). Chirurg 2001;72:286–288.
  21. Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J: Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 2001;25:1467–1477.
  22. Satava RM: Robotic surgery: from past to future – a personal journey. Surg Clin North Am 2003;83:1491–1500, xii.
  23. Ruurda JP, Broeders IA, Simmermacher RP, Rinkes IH, van Vroonhoven TJ: Feasibility of robot-assisted laparoscopic surgery: an evaluation of 35 robot-assisted laparoscopic cholecystectomies. Surg Laparosc Endosc Percutan Tech 2002;12:41–45.
  24. Melvin WS, Needleman BJ, Krause KR, Wolf RK, Michler RE, Ellison EC: Computer-assisted robotic Heller myotomy: initial case report. J Laparoendosc Adv Surg Tech A 2001;11:251–253.
  25. Marescaux J, Smith MK, Folscher D, Jamali F, Malassagne B, Leroy J: Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 2001;234:1–7.
  26. Lomanto D, Cheah WK, So JB, Goh PM: Robotically assisted laparoscopic cholecystectomy: a pilot study. Arch Surg 2001;136:1106–1108.
  27. Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman J: Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 1999;230:225–231.
  28. Horgan S, Vanuno D: Robots in laparoscopic surgery. J Laparoendosc Adv Surg Tech A 2001;11:415–419.
  29. Heller K, Gutt C, Schaeff B, Beyer PA, Markus B: Use of the robot system da Vinci for laparoscopic repair of gastro-oesophageal reflux in children. Eur J Pediatr Surg 2002;12:239–242.
  30. De Ugarte DA, Etzioni DA, Gracia C, Atkinson JB: Robotic surgery and resident training. Surg Endosc 2003;17:960–963.
  31. Kim VB, Chapman WH, Albrecht RJ, Bailey BM, Young JA, Nifong LW, Chitwood WR Jr: Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using da Vinci. Surg Laparosc Endosc Percutan Tech 2002;12:33–40.
  32. Himpens J, Leman G, Cadiere GB: Telesurgical laparoscopic cholecystectomy. Surg Endosc 1998;12:1091.
  33. Shah J, Rockall T, Darzi A: Robot-assisted laparoscopic Heller’s cardiomyotomy. Surg Laparosc Endosc Percutan Tech 2002;12:30–32.
  34. Cadiere GB, Himpens J, Vertruyen M, Bruyns J, Germay O, Leman G, Izizaw R: Evaluation of telesurgical (robotic) Nissen fundoplication. Surg Endosc 2001;15:918–923.
  35. Melvin WS, Needleman BJ, Krause KR, Schneider C, Ellison EC: Computer-enhanced vs. standard laparoscopic antireflux surgery. J Gastrointest Surg 2002;6:11–15.
  36. Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G: Robotics in general surgery: personal experience in a large community hospital. Arch Surg 2003;138:777–784.
  37. Nio D, Bemelman WA, Boer KT, Dunker MS, Gouma DJ, Gulik TM: Efficiency of manual versus robotical (Zeus) assisted laparoscopic surgery in the performance of standardized tasks. Surg Endosc 2002;16:412–415.
  38. Ruurda JP, Broeders IA: Robot-assisted laparoscopic intestinal anastomosis. Surg Endosc 2003;17:236–241.
  39. Ruurda JP, Wisselink W, Cuesta MA, Verhagen HJ, Broeders IA: Robot-assisted versus standard videoscopic aortic replacement. A comparative study in pigs. Eur J Vasc Endovasc Surg 2004;27:501–506.
  40. Ruurda JP, Broeders IAMJ: Evaluation of time-loss in robot-assisted surgery; in Lemke HU (ed): Proceedings in CARS, 2004, pp 335–340.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: March 17, 2005
Accepted: August 05, 2005
Published online: February 23, 2006
Issue release date: February 2006

Number of Print Pages: 8
Number of Figures: 4
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: https://www.karger.com/DSU


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.