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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. |
- Backman, Torbjörn, et al.
(författare)
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Pre- and postoperative vomiting in children undergoing video-assisted gastrostomy tube placement.
- 2014
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Ingår i: Surgery research and practice. - : Hindawi Limited. - 2356-7759 .- 2356-6124. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Background. The aim of this study was to determine the incidence of pre- and postoperative vomiting in children undergoing a Video-Assisted Gastrostomy (VAG) operation. Patients and Methods. 180 children underwent a VAG operation and were subdivided into groups based on their underlying diagnosis. An anamnesis with respect to vomiting was taken from each of the children's parents before the operation. After the VAG operation, all patients were followed prospectively at one and six months after surgery. All complications including vomiting were documented according to a standardized protocol. Results. Vomiting occurred preoperatively in 51 children (28%). One month after surgery the incidence was 43 (24%) in the same group of children and six months after it was found in 40 (22%). There was a difference in vomiting frequency both pre- and postoperatively between the children in the groups with different diagnoses included in the study. No difference was noted in pre- and postoperative vomiting frequency within each specific diagnosis group. Conclusion. The preoperative vomiting symptoms persisted after the VAG operation. Neurologically impaired children had a higher incidence of vomiting than patients with other diagnoses, a well-known fact, probably due to their underlying diagnosis and not the VAG operation. This information is useful in preoperative counselling.
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| 4. |
- Eriksson, Mikael, et al.
(författare)
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STATUS OF THE MAX IV LIGHT SOURCE PROJECT
- 2006
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Ingår i: European Particle Accelerator Conference 2006, Edinburgh, UK.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 5. |
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| 6. |
- Anderberg, Magnus
(författare)
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Computer-assisted surgery in children
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although positive in terms of patient trauma and recovery time, minimally invasive surgery has several technical drawbacks compared with open surgery. The new da Vinci® Surgical System from Intuitive Surgical® offers technical innovations aiming at overcoming these drawbacks and at improving the surgeon’s operating skills, such as the improved 3-D vision, tremor reduction and flexible instruments with a more natural and intuitive range of motion. In this thesis, the computer-assisted surgical instruments, and their application in paediatric surgery and paediatric urology, were investigated. In a prospective study of the first six fundoplications using the da Vinci® Surgical System, retrospective data from the open surgical procedure and the conventional laparoscopic technique were used as controls. Computer-assisted laparoscopic surgery (CALS) was safe and feasible. The operating time for the computer-assisted procedure was longer than the open one, but comparable to the laparoscopic procedure, and the need for postoperative morphine analgesics and the length of hospital stay were reduced with the two minimally invasive methods. The short-term clinical outcome did not differ, the symptoms of gastroesophageal reflux disease disappeared in all the children. The costs for CALS were compared with the costs for open and laparoscopic surgery in children. The total costs of CAL fundoplication amounted to EUR 9584. The costs for laparoscopic and open fundoplication amounted to EUR 8982 and EUR 10521, respectively. The cost of the CALS instruments per procedure (EUR 2081) accounted for the extra expense compared with laparoscopy. The increased costs for CALS due to longer operating time, were offset by the shorter hospital stay compared with open surgery, 3.8 and 7.9 days, respectively. An experimental study of students with no prior surgical experience and divided by gender was performed to test the hypothesis that maiden users master surgical tasks more quickly with computer-assisted than with standard laparoscopic instruments. Each surgical task was performed four times with one of the techniques before changing to the other. Speed and accuracy were measured. A cross-over technique was used to eliminate gender bias and the experience gained from carrying out the first part of the study. The more advanced task of tying a knot was performed faster with the computer-assisted than with the laparoscopic technique. Shorter time was observed when the change was made from laparoscopy to the computer-assisted technique. Gender did not influence the results. The lack of tactile feedback in computer-assisted laparoscopy seemed to matter. A case-control study of ten consecutive children undergoing computer-assisted retroperitoneoscopic nephrectomy due to a non- or malfunctioning kidney was performed. This prospectively gathered consecutive group of children was compared with a retrospectively collected group of all other children who had undergone open nephrectomy for benign renal disease at our centre between 2005 and 2009. All nephrectomies were performed with the retroperitoneal approach. Endpoints of this study were safety, the operating time, the number of postoperative doses of morphine, the length of hospital stay and the number of complications. Four out of ten patients in the CALS group had a total operating time within the range of the operating time for an open procedure but it was longer for the CALS procedure. The number of postoperative doses of morphine did not differ, but the hospital stay was shorter for the CALS group. The patient benefit from CALS, in the form of low morbidity, improved cosmetics and shorter hospitalisation was associated with the minimally invasive approach. Whether computer-assistance leads to better long-term results and fewer postoperative complications is too early to determine. However, considering all the potential benefits of the CALS instruments, the future will favour its use in paediatric surgery.
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| 7. |
- Anderberg, Magnus, et al.
(författare)
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Laparoskopi och robotassisterad kirurgi
- 2015
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Ingår i: Grottes Barnkirurgi och barnurologi. - 9789144071510 ; , s. 51-54
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Bokkapitel (populärvet., debatt m.m.)
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| 8. |
- Anderberg, Magnus, et al.
(författare)
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Morgagni Hernia Repair in a Small Child Using da Vinci Robotic Instruments - A Case Report.
- 2009
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Ingår i: European Journal of Pediatric Surgery. - : Georg Thieme Verlag KG. - 1439-359X .- 0939-7248. ; 19, s. 110-112
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The recently introduced use of robotic surgery in minimally invasive surgery procedures facilitates several steps in the operative procedure. We report the first case of a robot-assisted laparoscopic repair of a Morgagni hernia using the da Vinci(R) Surgical System from Intuitive Surgical(R) (Sunnyvale, CA, USA) in a 7.8 kg 18-month-old child. METHODS: Four trocars were used to gain access to the abdomen. The robot-enhanced instruments were used to close the hernia defect with interrupted, absorbable sutures, using intracorporeal knot tying. RESULTS: The operation was completed laparoscopically without a patch. The total setup time for the robotic system was 35 minutes including draping. The operating time at the robotic console was 80 minutes. The child tolerated an oral intake the day after surgery and was discharged home on the third postoperative day. CONCLUSION: Robot-assisted laparoscopic Morgagni hernia repair is feasible in small children.
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| 9. |
- Anderberg, Magnus, et al.
(författare)
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Paediatric computer-assisted retroperitoneoscopic nephrectomy compared with open surgery.
- 2011
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Ingår i: Pediatric Surgery International. - : Springer Science and Business Media LLC. - 1437-9813 .- 0179-0358. ; 27:7, s. 761-767
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Computer-assisted laparoscopic surgery (CALS) in children is increasingly used and has proven to be feasible and safe. However, its full potential remains unclear and clinical comparative studies hardly exist. The aim of this study was to prospectively evaluate our experience with CALS for performing retroperitoneal nephrectomies in children when compared with controls undergoing open surgery in terms of safety, operative time, blood loss, opoid requirements, the duration of hospital stay and complications. CHILDREN AND METHODS: Computer-assisted retroperitoneoscopic nephrectomy was undertaken in ten consecutive children, mean age at the time of surgery 6.4 (SD ± 4.5) years, and compared with a retrospectively collected control group of all other children, mean age 3.9 (SD ± 4.6) years, who underwent the same procedure by conventional open surgery between the years 2005 and 2009. The endpoint of the study was 1 month postoperatively. RESULTS: Nephrectomies were performed in all the children and no child was excluded from the study. There was no per-operative complication in any of the groups. The median (range) operative time was 202 (128-325) and 72 (44-160) min for the CALS and open group, respectively. The blood loss was minimal (<20 ml) for all the patients. The postoperative opoid requirements did not differ. The median (range) postoperative hospital stay was 1 (1-4) and 2 (1-7) days for the CALS and the open group, respectively. One complication in the form of an urinoma appeared 5 days after surgery in the CALS group. CONCLUSION: Computer-assisted retroperitoneoscopic nephrectomy is a safe, feasible and effective procedure in children. Even though operative times are longer the patients benefit from the lower morbidity, improved cosmetics and shorter hospitalization associated with the minimally invasive approach.
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| 10. |
- Anderberg, Magnus, et al.
(författare)
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Paediatric robotic surgery in clinical practice: a cost analysis.
- 2009
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Ingår i: European Journal of Pediatric Surgery. - : Georg Thieme Verlag KG. - 1439-359X .- 0939-7248. ; 19:5, s. 311-315
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Since 2006 we have used robotic assistance when performing minimally invasive laparoscopic fundoplications in children. We compared the costs of robotic surgery with the costs for open and laparoscopic surgery to test our hypothesis that the increased costs of the new technology are acceptable. METHOD: Costs were calculated using the regional hospital prices for our first 14 fundoplications in children, performed with the aid of the da Vinci Surgical System from Intuitive Surgical. We compared these costs with those of our ten latest fundoplications performed using open and laparoscopic surgery, respectively. There were no differences in the demographic data, work-up or indications for surgery between the three groups of children. RESULTS: The mean cost of robotic surgical fundoplications (EUR 9 584) was 7% higher than the mean cost of laparoscopic surgery (EUR 8 982) and 9% lower than the mean costs for open surgical procedures (EUR 10 521). These differences can be explained by the increased cost of robotic instruments (EUR 2 081 per operation). The duration of the operation and the duration of in-hospital stay are comparable to those of laparoscopic surgical interventions. The time required for the operative intervention was considerably longer than for the open surgical procedure; the duration of the in-hospital stay was only half of that of the open surgical procedure. The patients seemed to benefit from the use of robotic instruments with less morphine (as a marker of less postoperative pain) and a shorter hospital stay. CONCLUSION: The introduction of robotic assistance into surgical practice involves increased in-hospital costs, mainly because of the cost of the new instruments. This increase in cost can be offset by the shorter hospital stay compared to open surgery. After laparoscopic surgery the hospital stay is about the same as after operations performed with robotic assistance. Cheaper instruments and shorter operating time will make robotic surgery cost efficient in the future. The benefit for the patients is less trauma due to the use of minimally invasive surgery and a shorter hospital stay. Thus, the higher initial costs may be considered worthwhile.
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