Nonlinear Analysis Quantifies Learning in Robot-Assisted Laparoscopic Surgery
To determine the proficiency of surgical skills in robot-assisted laparoscopy is important to identify the learning pattern. Traditional measurements, such as time to task completion (TTC), does not quantify accuracy and quality of learning. The aim of this study was to find a better measure to evaluate quality of learning. Lyapunov Exponent (LyE) is a… Continue Reading
Complex Pediatric Robotic Surgery: A Single-institution’s Experience
Purpose: For advanced laparoscopists, the greatest benefit of robotic surgical technology is in its use for complex procedures, ones that require significant dexterity in limited workspace and are challenging with conventional instrumentation. We present our 3-year institutional experience using robotic-assisted laparoscopic surgery for complex pediatric surgical procedures. Methods: Retrospective review from 2003 to 2006 of… Continue Reading
Robotic Splenectomy in Children: A Single Institutional Review
Purpose: Robotic surgery is a new technology which may facilitate minimally invasive surgery (MIS). The main advantages of robotic surgery include three-dimensional visualization, complete camera control, tremor filtration, absence of the fulcrum effect, and articulating instruments with additional degrees of freedom. We report our experience with robotic splenectomies in our first seventeen consecutive pediatric splenectomies.Methods:… Continue Reading
Impact of Iq, Computer-gaming Skills, General Dexterity and Laparoscopic Experience on the Performance with the Da Vinci® Surgical System
BACKGROUND:Due to improved ergonomics and dexterity, robotic surgery is supposed to be very easy to perfom for all individuals and no special premises should be necessary. We have tested the above hypothesis by measering IQ-elements, computer-gaming-skills, general dexterity with chop sticks and evaluating laparoscopic experience in correlation to the performance with the da Vinci robot®… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Robotics
Using the Cellular Space for Telemedicine Applications-First Remote Presence Sessions
Introduction: Telemedicine applications are necessary developments in today’s “stressed” healthcare environment. Remote Presence® applications for tele-rounding and tele-mentoring using the Wireless Local Area Network-WLAN (802.11) portion of the radio-frequency spectrum and the public internet, have been previously reported by our group. This report documents the first use of a different part of the spectrum, the… Continue Reading
Robotic Thoracoscopic Radical Thymectomy for Myasthenia Gravis
Introduction: A complete, radical "phrenic-to phrenic" thymectomy is the standard of care for myasthenia gravis. Patients with myasthenia gravis (MG) are often poor candidates for median sternotomy because of their significant doses of immunosuppresive drugs and/or compromised respiratory function secondary to their MG. We hypothesized that a complete, radical thymectomy could be performed thoracoscopically using… Continue Reading
Robotic Pancreatic Surgery: A Single Institution Experience
The overall activity of robotic pancreatic surgery at Misericordia Hospital in Grosseto has been reviewed. From October 2000 to March 2007, has been performed 68 robotic pancreatic resections: 35 pancreatoduodenectomies (PD) (25Whipple, 10 Longmire procedures), 28distal pancreatectomies (DP) (13 spleen-preserving), 3 middle segment pancreatectomies and 2 insulinoma enucleations.The etiology of 35 PD were:11 ductal cancer,… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Robotics
Robotic-Assisted Treatment of Visceral Artery Aneurysms: New Standard of Care?
This study is a retrospective review of all patients treated with a robotic-assisted mininvasive surgery for visceral artery aneurysms (VAA) at a single Institution. Robotic surgery seems to offer an important alternative to the traditional treatment.Materials and Methods: between September 2001 and June 2007, 12 patients aged 41-78 (mean = 59.25) underwent minimally invasive robotic… Continue Reading
Mesh Complications after Prosthetic Reinforcement of Hiatal Closure. A 29 Case Series.
Background:Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0-24%). However, mesh complications have been reported. Methods:We compiled three cases and our senior author contacted other experienced esophageal surgeons who provided… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Outcomes and Quality
Dysphagia after using a Biological Mesh to Repair a Recurrent Hiatal Hernia
Introduction: It has been recently demonstrated in a controlled trial that reinforcement of the crura with a biological mesh decreases the incidence of recurrence of paraesophageal hernias after hiatal repair. This technique is therefore increasing in popularity. Complications from this type of mesh have not been reported, but an animal study has suggested that a… Continue Reading
- Topic:
- Outcomes and Quality
Outcomes in Laparoscopicc Cholecystectomy (LS) done with or without using Energy Sources (ES): Results of a Prospective Randomized Controlled Study
Objectives of study :Structured training, skill's evaluation,regulated granting of privileges, systems approach & judicious use of ES haven’t alleviated the concerns of unfavorable outcomes in LC. Biliary injuries, an index of adverse outcome evaluation have been linked to use of ES. LC can be done without using ES as reported by us earlier. The aim… Continue Reading
- Type:
- Posters
- Topic:
- Outcomes and Quality
A novel laparoscopic approach to gastrostomy salvage following early dislodgment
Introduction: Gastrostomy tube dislodgment shortly after placement may lead to a gastric perforation if a gastrocutaneous fistula tract did not have time to form. The current standard approach to this problem is immediate laparotomy and creation of a new gastrostomy. We report a novel, incision-free approach to this problem that involves grasping the gastric perforation… Continue Reading
- Type:
- Posters
- Topic:
- Outcomes and Quality
Peritonitis from PEG tube insertion and ensuing complications in Surgical ICU patients: Identification of risk factors and clinical outcome
OBJECTIVE - Percutaneous Endoscopic Gastrostomy (PEG) tubes are routinely placed in Surgical Intensive Care Unit (SICU). Poor tissue healing or technical issues after tube insertion can lead to peritonitis requiring a laparotomy. Risk factors leading to this major complication are not identified.METHODS - We conducted a retrospective review of all PEG tubes inserted in SICU… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Outcomes and Quality
Esophageal Perforation after Gastric Balloon Extraction
The use of the BioEnterics intragastric balloon® is generally considered to be safe and efficacious for short-term weight loss, however complications have been reported. The most commonly reported complications include balloon intolerance requiring early removal, gastric erosions, gastric ulcerations, esophagitis, and early deflation of the device.We report a case of a esophageal perforation following endoscopic… Continue Reading
- Type:
- Posters
- Topic:
- Outcomes and Quality
The perforation of the gallbladder in cases of incidental gallbladder cancer- And the indication for the use of isolation bags.
Introduction: The accidental intraoperative perforation of the gallbladder is a problem of the laparoscopic surgery, if an incidental gallbladder carcinoma exists at the time of operation.According to the literature this complication comes up to 30% of the laparoscopic operations.In order to prevent the dissemination of tumourcells the use of an isolation bag is proclaimed.The question… Continue Reading
- Type:
- Posters
- Topic:
- Outcomes and Quality