Navigation Links
Robot improves suture proficiency more rapidly for surgeons inexperienced in laparoscopic techniques

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
Weber Shandwick Worldwide

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:
(Date:11/24/2015)... ... November 24, 2015 , ... Eric C. Seidel, DMD and ... of the revolutionary BIOLASE WaterLase iPlus 2.0™ system. This advanced laser technology uses ... a dentist in Gettysburg, PA . From routine visits to cosmetic treatments, ...
(Date:11/24/2015)... ... November 24, 2015 , ... New patients who wish to seek ... dental implants at her Mississauga, ON practice. Dr. Williams has been providing ... of dental implants. , Missing teeth can lead to a variety of complications ...
(Date:11/24/2015)... Dallas, Texas (PRWEB) , ... November 24, 2015 , ... ... of all charitable donations are made in the last five weeks of the year ... #GivingTuesday was created in 2012 to connect the nation’s charities with those individuals who ...
(Date:11/24/2015)... , ... November 24, 2015 , ... In an ... restrictions and variables that determine which patients are or are not eligible for bariatric ... have a BMI over 40, are more than 100 pounds overweight, or have a ...
(Date:11/24/2015)... ... November 24, 2015 , ... DMG Productions announced that they will feature ... quarter 2016 via Discovery Channel. Dates and show times TBA. , Aphria, Inc., is ... the business of producing and supplying medical marijuana pursuant to the Marijuana for Medical ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... 2015 ... the  "Global Drug Device Combination Products ... offering.  --> ) ... "Global Drug Device Combination Products Market ... --> Research and Markets ( ...
(Date:11/24/2015)... CARLOS, Calif. , Nov. 24, 2015 ... a leader in non-invasive genetic testing and ... announced that it will present at the ... in New York on Wednesday, December 2, 2015 at 1:00 p.m. ET.  Matthew ... the Company,s financial results, business activities and ...
(Date:11/24/2015)... Nueva York , 24 de noviembre de ... del Avery Breathing Pacemaker System, se complace anunciar ... Ph.D. como consultor clínico. ... Foto -   ... Jonzon es un fisiólogo y consultor en neonatología ...
Breaking Medicine Technology: