Navigation Links
Robot improves suture proficiency more rapidly for surgeons inexperienced in laparoscopic techniques
Date:4/20/2009

CHICAGO (April 20, 2009) New research published in the April issue of the Journal of the American College of Surgeons suggests that, among surgeons inexperienced in laparoscopic techniques, closing incisions using robotic-assisted laparoscopic surgery (RALS) requires less time to learn and results in improved outcomes compared with suturing done via traditional, "open" surgery or with freehand laparoscopy.

Laparoscopic suturing a minimally invasive operation in which suturing is performed using an instrument that is inserted through small incisions in the abdomen is a technically demanding skill that traditionally has required a significant amount of time to master. In some cases, proficiency may not be achieved in a reasonable amount of time because of the infrequency of cases that require its use. With RALS, the robot's full range of motion and three-dimensional, enhanced visualization helps surgeons to maneuver complex anatomy and gives them more precision during delicate operations.

"Our findings show that, over a relatively short time, even inexperienced surgeons can perform RALS with efficiency and results comparable to open surgery," said Hiep Nguyen, MD, FAAP, Director of Robotic Surgery and Research, Children's Hospital Boston. "RALS is allowing us to perform suturing more quickly and safely, and we hope that ultimately this will allow for patients to recover faster and with reduced pain."

Researchers evaluated the learning curve associated with a pyeloplasty an operation that removes a blockage at the connection of the kidney with the ureter using an open surgical procedure, freehand laparoscopic surgery and RALS. Using 57 swine models, the operative time was measured for pyeloplasties performed by three non-urologic surgeons who did not have any experience in freehand laparoscopy or RALS and two experienced urologic surgeons, one of whom had no experience in laparoscopic techniques and the other of whom had very limited experience. Each surgeon performed at random five freehand laparoscopies and four to five RALS. After gaining more experience by completing the five freehand laparoscopies and five RALS, the urologic surgeon who had started the study with limited technical knowledge performed an additional nine freehand laparoscopies, nine RALS and four open pyeloplasties. The study also evaluated the quality of the suture (for example, water tightness and patency) immediately after the operation and two weeks after the operation. The degree of inflammation was assessed 15 days after the procedure by measuring the amount of collagen III deposited on the ureteral wall. Only those sutures performed by the surgeon with limited laparoscopic experience and the last four sutures in each group for the other two surgeons were assessed to control for variability.

Study results showed that RALS had a shorter procedural time and a flatter learning curve compared with freehand laparoscopy (p < 0.01), even despite user differences in familiarity with laparoscopic techniques. Combining all the surgeons' times for each group, the mean suture time for RALS was 40.913.4 minutes, compared with 62.214.9 minutes with freehand laparoscopy (p>0.01) and 22.44.1 minutes with open surgery (p<0.01). With experience, the mean suture time for RALS of 22.34.6 minutes approached that of open surgery (p=0.80); the mean operative time for freehand laparoscopy also improved to 31.43.4 minutes (p>0.10 compared with open surgery).

Measurements for water tightness of the suture and patency of the unblocked connection between the kidney and the ureter were comparable to those in the open operation group. However, with experience, both the RALS and freehand laparoscopy procedural times and the measurements for water tightness and patency of the suture approached those of the open surgical procedure group. Histologic evaluation demonstrated that there was significantly less collagen III deposited on the ureteral walls of the RALS group compared with the freehand laparoscopy and open operation groups (p = 0.01).


'/>"/>

Contact: Sally Garneski
pressinquiry@facs.org
312-202-5409
Weber Shandwick Worldwide
Source:Eurekalert

Related medicine news :

1. St. Davids Medical Center Implements New Robotic Technology to Treat Common Heart Rhythm Disorders
2. Babies Driving Robots at University
3. Primus Innovations and Health Robotics Launch Strategic Partnership to Accelerate Transformation in Chemotherapy Compounding
4. Cardiogenesis Receives FDA Approval for PEARL 5.0 Robotic Hand Piece
5. Robotics lab helps stroke patients with recovery
6. Cardica Announces Live Webcast Demonstrating Breakthrough Device to Facilitate Beating Heart and Robotic Coronary Revascularization Surgery
7. Robotic device appears useful for surgical removal of cancer involving the tonsils
8. Robotic Surgery Treats Tonsil Cancer
9. Just hours apart, 2 brothers undergo robotic prostate cancer surgery
10. Scientists from Europe, Israel and the US develop robotic rats to aid in rescue missions
11. NOVADAQs SPY System to be Featured During Live Broadcast of Robotic Surgery
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... 2016 , ... TherapySites, the leading website and ... Tennessee Counseling Association. This new relationship allows TherapySites to continue to extend ... exclusive benefits and promotional offers. , "TCA is extremely excited about this new ...
(Date:6/26/2016)... ... 2016 , ... On June 10-11, 2016, A Forever Recovery, a holistic treatment ... Longest Breakfast Table in Battle Creek, MI, where the rehabilitation facility is located. This ... of the world’s leading providers of cereal and other breakfast foods. Its residents often ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... ... health policy issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, 2016, ... work on several important health care topics including advance care planning, healthcare costs ...
(Date:6/25/2016)... ... 2016 , ... As a lifelong Southern Californian, Dr. Omkar Marathe earned his ... David Geffen School of Medicine at UCLA. He trained in Internal Medicine at Scripps ... in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had the opportunity to ...
(Date:6/24/2016)... Marne, Michigan (PRWEB) , ... June 24, 2016 , ... ... To deal with these feelings, many turn to unhealthy avenues, such as drug or ... Center of Marne, Michigan, has released tools for healthy coping following a traumatic event. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 23, 2016 Roche (SIX: RO, ROG; OTCQX: ... its Elecsys BRAHMS PCT (procalcitonin) assay as a dedicated ... shock. With this clearance, Roche is the first IVD ... solution for sepsis risk assessment and management. ... and PCT levels in blood can aid clinicians in ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on ... today announced that patient enrollment in its ongoing ... Duchenne) has exceeded 50% of its 24-patient target. ... in the third quarter of 2016, and to ...
(Date:6/23/2016)... , June 23, 2016 Bracket , a ... its next generation clinical outcomes platform, Bracket eCOA (SM) ... on June 26 – 30, 2016 in Philadelphia ... electronic Clinical Outcome Assessment product of its kind to fully ... Bracket eCOA 6.0 is a flexible platform for ...
Breaking Medicine Technology: