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- Aardal Lönnerfors, Celine, et al.
(författare)
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The effect of increased experience on complications in robotic hysterectomy for malignant and benign gynecological disease.
- 2015
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Ingår i: Journal of Robotic Surgery. - : Springer Science and Business Media LLC. - 1863-2491 .- 1863-2483. ; 9:4, s. 321-330
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Tidskriftsartikel (refereegranskat)abstract
- The study objective was to assess the effect of increased experience on complications in robotic hysterectomy for malignant and benign gynecological disease. This is a retrospective cohort study. It is a Canadian Task Force classification II-2 study conducted at the University Hospital, Sweden. The patients were 949 women planned for robotic hysterectomy for malignant (75 %) and benign (25 %) gynecological disease between October 2005 and December 2013. They were continuously evaluated for the rate of intraoperative and postoperative complications up to 1-year post-surgery, the latter according to Clavien-Dindo classification following the introduction of robotic surgery with special awareness of complications possibly related to robot-specific risk factors, the description of refinement of practice and assessment of the effect of these measures. The rate of intraoperative complications, the overall rate of complications and the rate of ≥grade 3 complications decreased from the first to the last time period (4.8 vs 2.6 %, p = 0.037, 34 vs 19 %, p = 0.003 and 13.5 vs 3.2 %, p = 0.0003, respectively). The rate of intraoperative complications and the rate of postoperative complications possibly related to robot-specific risk factors was reduced from the first to the last time period (3.8 vs 0.6 %, p = 0.028 and 7.7 vs 1.5 %, p = 0.003, respectively). In patients undergoing robotic hysterectomy for malignant and benign gynecological disease intraoperative and postoperative complications and complications possibly related to the robotic approach diminish with training, experience and refinement of practice.
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| 2. |
- Anderberg, Magnus, et al.
(författare)
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Robot-assisted radical cystoprostatectomy in a small child with rhabdomyosarcoma: a case report
- 2008
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Ingår i: Journal of Robotic Surgery. - : Springer Science and Business Media LLC. - 1863-2483 .- 1863-2491. ; 2:2, s. 101-103
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Tidskriftsartikel (refereegranskat)abstract
- Abstract We report the first case of a robot-assisted radical cystoprostatectomy in a 22-month-old boy with embryonal rhabdomyosarcoma in his urinary bladder. Treatment according to international protocol CWS-2002 P (Cooperative Weichteilsarkom Studie) was given prior to surgery. The da Vinci S Surgical System from Intuitive Surgical (Sunnyvale, CA, USA) was used to laparoscopically remove the urinary bladder and prostate radically. The surgical procedure performed and the postoperative course were uneventful. This technique is safe and feasible also in small children. It seems to have advantages over open surgery and no disadvantages. We recommend this technique for further use.
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| 3. |
- Carbonnel, M., et al.
(författare)
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Adapting surgical skills from robotic-assisted radical hysterectomy in cervical cancer to uterine transplantation: a look to an optimistic future!
- 2020
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Ingår i: Journal of Robotic Surgery. - : Springer Science and Business Media LLC. - 1863-2483 .- 1863-2491. ; 14, s. 841-847
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Tidskriftsartikel (refereegranskat)abstract
- Uterus transplantation (UTx) is the first treatment for absolute uterine factor infertility. The first birth after human UTx in Sweden occurred in 2014 and very favourable results of the Swedish trial performed with laparotomy raised great hope. Several teams are leading their own trial among the world, but UTx is still in its experimental phase. Surgical intervention needs to be optimized. The long surgical duration (> 10 h), vascular dissection and risks of ureteral damages for live donors are major drawbacks. Minimal invasive surgery by means of robotic-assisted laparoscopy for live donors could become an improved option. Our collaborative Swedish-French team has initiated efforts to introduce minimal invasive surgery in one trial in Sweden and one in France. UTx is somewhat similar to a radical colpohysterectomy for arterial dissection. We describe a robotic-assisted radical colpohysterectomy and its transposition to uterus retrieval in a living donor. We report our experience on nine cases that were completed prior to our French UTx robot-assisted trial.
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| 7. |
- Nordenström, E, et al.
(författare)
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A prospective study of 100 roboticallyassisted laparoscopic adrenalectomies
- 2011
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Ingår i: Journal of Robotic Surgery. - : Springer Science and Business Media LLC. - 1863-2483 .- 1863-2491. ; 5:2, s. 31-127
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated robotically assisted laparoscopic adrenalectomy (RLA) in a prospective study of 100 consecutive patients (60 women and 40 men) undergoing unilateral adrenalectomy at the University Hospital. The median age was 59 (24-82) years and BMI 27.6 (17.1-40.9) kg/m(2). Preoperative diagnoses were Conn's syndrome 30%, pheochromocytoma 23%, Cushing syndrome 27% and non-functional tumor 20%. The median tumor size was 53 (10-106) mm. The majority of the 7% of the patients who were converted to open surgery were in the early phase after the introduction of the technique. The BMI of the patients who were converted to open surgery was significantly higher, 31.5 (range 25.3-37.8) compared to, 27.5 (range 17.1-40.9) in patients without conversion (P = 0.047). The median weight of the tumor was 51 g for patients with conversion (range 18-97 g) and 30 g (range 8-128 g) for patients without conversion (P = 0.066). The median console operation time for the whole series was 88 min (range 39-397 min). The console operation time decreased significantly with the numbers of patients operated (r = 0.372; P = 0.0003). There was an association between the weight of the specimen and operation time (r = 0.42; P = 0.0001). RLA is a safe and a feasible surgical alternative for treating all kind of adrenal disorders, particularly large tumors and more complex circumstances. The present study clearly shows that a learning curve is present for the console surgeon and assistants.
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| 10. |
- Wiklund, Erik, et al.
(författare)
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Lower need for allogeneic blood transfusion after robotic low anterior resection compared with open low anterior resection : a propensity score-matched analysis
- 2023
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Ingår i: Journal of robotic Surgery. - : Springer Nature. - 1863-2483 .- 1863-2491. ; 17:4, s. 1715-1720
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Tidskriftsartikel (refereegranskat)abstract
- Robotic low anterior resection (R-LAR) for rectal cancer may decrease estimated blood loss compared with open low anterior resection (O-LAR). The aim of this study was to compare estimated blood loss and blood transfusion within 30 days after O-LAR and R-LAR. This was a retrospective matched cohort study based on prospectively registered data from Vastmanland Hospital, Sweden. The first 52 patients operated on using R-LAR for rectal cancer at Vastmanland Hospital were propensity score-matched 1:2 with patients who underwent O-LAR for age, sex, ASA (American Society of Anesthesiology physical classification system), and tumor distance from the anal verge. In total, 52 patients in the R-LAR group and 104 patients in the O-LAR group were included. Estimated blood loss was significantly higher in the O-LAR group compared with R-LAR: 582.7 ml (SD +/- 489.2) vs. 86.1 ml (SD +/- 67.7); p < 0.001. Within 30 days after surgery, 43.3% of patients who received O-LAR and 11.5% who received R-LAR were treated with blood transfusion (p < 0.001). As a secondary post hoc finding, multivariable analysis identified O-LAR and lower pre-operative hemoglobin level as risk factors for the need of blood transfusion within 30 days after surgery. Patients who underwent R-LAR had significantly lower estimated blood loss and a need for peri- and post-operative blood transfusion compared with O-LAR. Open surgery was shown to be associated with an increased need for blood transfusion within 30 days after low anterior resection for rectal cancer.
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