Short-term outcomes in patients with colon cancer treated with robotic right colectomy.

PURPOSE: To report a single surgeon series of consecutive robotic right colectomies (RRC) performed for non-metastatic right colon cancer. METHODS: A retrospective review of a prospectively maintained database of patients who underwent elective robotic right colectomy for right colon adenocarcinoma was conducted. Patients with stage 0-III disease were included in the study. Outcomes evaluated included operative time, number of lymph nodes harvested, estimated blood loss, time to return of bowel function, length of hospital stay, complications and a minimum of 6-month follow up. RESULTS: Forty-five consecutive patients were included in this study. The mean operative time was 175 min, the mean lymph nodes harvested were 22 and the mean length of hospital stay was 5 days. The mean time to normal bowel function restoration and to discontinuation of patient-controlled analgesia was 2 days. The hospital post-operative courses were complicated in two patients by ileus and fever due to pulmonary atelectasia, respectively. No conversions to laparotomy, reoperations or 90-day deaths were recorded. CONCLUSIONS: Robotic colorectal surgery has gained a lot of supporters through the years although a debate still exists concerning the outcomes. The present study is one of the largest evaluating short-term results of RRCs performed by a single surgeon. We believe we demonstrated the safety and efficacy of RRC in the treatment of right colon nonmetastatic adenocarcinoma.

Laparoscopic total extraperitoneal inguinal hernia repair: Retrospective study on prosthetic materials, postoperative management, and quality of life.

Laparoscopic inguinal hernia repair is one of the most frequently performed operations. However, the search for the most appropriate prosthetic materials continues to occupy the surgical community. The purpose of this study was to evaluate the postoperative short- and mid-term effects (like duration of stay, number and type of complications, and inguinal pain) of laparoscopic inguinal hernia repair using the total extraperitoneal (TEP) approach. The evaluation encompassed different types of mesh and fixation devices, as well as medications prescribed during hospitalization.This retrospective study was conducted at the General, Laparoendoscopic, Bariatric, and Robotic Surgical Clinic of the Athens Medical Center. Clinical data from 524 patients were evaluated. The answers from an appropriately designed questionnaire completed from each individual were used to obtain information about their postoperative course. The statistical analysis was implemented in SPSS v 23.Analysis revealed that pain sensation on discharge decreased with increasing age (P < .05). No clear relationship was found between surgical clips and pain (P = .292), as well as mesh absorbability and chronic pain (P = .539). The major postoperative complications were annoyance and discomfort (15.9%). The recurrence rate was 1.7%.Postoperative complications following the TEP approach were mostly found to be minor; chronic pain, as an aspect of impaired quality of life, was not experienced in the majority (89.08%). The properties of prosthetic materials used and the type of medications prescribed were not found to exert a significant role in satisfactory postoperative outcomes.

R-LESS right colectomy with the single-site® robotic platform.

BACKGROUND: Use of robotics has exemplified single-site procedures by restoring the correct hand-instrument alignment and providing stable, stereoscopic visual field. Technique was initially introduced by the manufacturers for cholecystectomy, but experienced teams quickly extended the indications to more complex procedures. We hereby present a case of a patient that underwent robotic right colectomy and omentectomy through the single-site(®) platform. METHODS: A single-site procedure was offered to our 58-year-old male patient with carcinoma of the ascending colon and he gave written consent for it. The VESPA(®) single-site platform was used according to the standards of the manufacturing company. The single-site port(®) was placed at the umbilicus. Rest of setup and procedure steps were based on the multiport technique. An extended omentectomy accompanying the right colectomy has not previously reported to our knowledge. After sufficient mobilization specimen was exteriorized through the umbilicus, excised and the anastomosis was performed using linear staplers. RESULTS: Console time was 164 min and total operation time was 221 min. Intraoperatively, there was no need for conversion, additional ports or blood transfusions. Total console time was 164 min. Lacking of wristed instruments and bipolar energy were regarded as serious limitations. No drains were used. Patient did not require ICU stay and had no postoperative complaints. He was given liquid diet on PO day #2 and he was discharged on PO day #4. CONCLUSIONS: Robotic single-site right colectomy is safe and feasible in selected cases. Experience from single-site robotic cholecystectomy is a useful basis to expand the indications to more complex procedures. Further development of the instruments and large number of cases may justify the indications for using this technique in the future.