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  1. Article ; Online: Establishment of Zebrafish Patient-derived Xenografts from Pancreatic Cancer for Chemosensitivity Testing.

    Usai, Alice / Di Franco, Gregorio / Gabellini, Chiara / Morelli, Luca / Raffa, Vittoria

    Journal of visualized experiments : JoVE

    2023  , Issue 195

    Abstract: Cancer is one of the main causes of death worldwide, and the incidence of many types of cancer continues to increase. Much progress has been made in terms of screening, prevention, and treatment; however, preclinical models that predict the ... ...

    Abstract Cancer is one of the main causes of death worldwide, and the incidence of many types of cancer continues to increase. Much progress has been made in terms of screening, prevention, and treatment; however, preclinical models that predict the chemosensitivity profile of cancer patients are still lacking. To fill this gap, an in vivo patient-derived xenograft model was developed and validated. The model was based on zebrafish (Danio rerio) embryos at 2 days post fertilization, which were used as recipients of xenograft fragments of tumor tissue taken from a patient's surgical specimen. It is also worth noting that bioptic samples were not digested or disaggregated, in order to maintain the tumor microenvironment, which is crucial in terms of analyzing tumor behavior and the response to therapy. The protocol details a method for establishing zebrafish-based patient-derived xenografts (zPDXs) from primary solid tumor surgical resection. After screening by an anatomopathologist, the specimen is dissected using a scalpel blade. Necrotic tissue, vessels, or fatty tissue are removed and then chopped into 0.3 mm x 0.3 mm x 0.3 mm pieces. The pieces are then fluorescently labeled and xenotransplanted into the perivitelline space of zebrafish embryos. A large number of embryos can be processed at a low cost, enabling high-throughput in vivo analyses of the chemosensitivity of zPDXs to multiple anticancer drugs. Confocal images are routinely acquired to detect and quantify the apoptotic levels induced by chemotherapy treatment compared to the control group. The xenograft procedure has a significant time advantage, since it can be completed in a single day, providing a reasonable time window to carry out a therapeutic screening for co-clinical trials.
    MeSH term(s) Humans ; Animals ; Zebrafish ; Heterografts ; Pancreatic Neoplasms/drug therapy ; Adipose Tissue ; Disease Models, Animal ; Tumor Microenvironment ; Pancreatic Neoplasms
    Language English
    Publishing date 2023-05-12
    Publishing country United States
    Document type Journal Article ; Video-Audio Media ; Research Support, Non-U.S. Gov't
    ZDB-ID 2259946-0
    ISSN 1940-087X ; 1940-087X
    ISSN (online) 1940-087X
    ISSN 1940-087X
    DOI 10.3791/63744
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Minimally Invasive Surgery for the Treatment of Moderate to Critical Acute Pancreatitis: A Case-matched Comparison With the Traditional Open Approach Over 10 years.

    Morelli, Luca / Guadagni, Simone / Palmeri, Matteo / Bechini, Bianca / Gianardi, Desirée / Furbetta, Niccolò / Di Franco, Gregorio / Di Candio, Giulio

    Surgical laparoscopy, endoscopy & percutaneous techniques

    2023  Volume 33, Issue 2, Page(s) 191–197

    Abstract: Purpose: The purpose of this study is to compare short-term and midterm outcomes between patients with acute pancreatitis (AP) treated with minimally invasive surgery (MIS) and patients treated with open necrosectomy (ON).: Materials and methods: We ... ...

    Abstract Purpose: The purpose of this study is to compare short-term and midterm outcomes between patients with acute pancreatitis (AP) treated with minimally invasive surgery (MIS) and patients treated with open necrosectomy (ON).
    Materials and methods: We compared data of all patients who had undergone MIS for AP with a similar group of patients with ON patients between January 2012 and June 2021 using a case-matched methodology based on AP severity and patient characteristics. Inhospital and midterm follow-up variables, including quality-of-life assessment, were evaluated.
    Results: Starting from a whole series of 79 patients with moderate to critical AP admitted to our referral center, the final study sample consisted of 24 patients (12 MIS and 12 ON). Postoperative (18.7±10.9 vs. 30.3±21.7 d; P =0.05) and overall hospitalization (56.3±17.4 vs. 76.9±39.4 d; P =0.05) were lower in the MIS group. Moreover, the Short-Form 36 scores in the ON group were statistically significantly lower in role limitations because of emotional problems ( P =0.002) and health changes ( P =0.03) at 3 and 6 months and because of emotional problems ( P =0.05), emotional well-being ( P =0.02), and general health ( P =0.007) at 1 year.
    Conclusions: MIS for the surgical management of moderate to critical AP seems to be a good option, as it could provide more chances for a better midterm quality of life compared with ON. Further studies are needed to confirm our findings.
    MeSH term(s) Humans ; Treatment Outcome ; Quality of Life ; Acute Disease ; Pancreatitis/surgery ; Minimally Invasive Surgical Procedures/methods ; Retrospective Studies
    Language English
    Publishing date 2023-04-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1475108-2
    ISSN 1534-4908 ; 1530-4515 ; 1051-7200
    ISSN (online) 1534-4908
    ISSN 1530-4515 ; 1051-7200
    DOI 10.1097/SLE.0000000000001157
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Use of 3D models for planning, simulation, and training in vascular surgery.

    Moglia, Andrea / Di Franco, Gregorio / Morelli, Luca

    Updates in surgery

    2019  Volume 71, Issue 1, Page(s) 185–186

    MeSH term(s) Imaging, Three-Dimensional ; Printing, Three-Dimensional ; Vascular Surgical Procedures
    Language English
    Publishing date 2019-02-25
    Publishing country Italy
    Document type Letter ; Comment
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-019-00636-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Alternative uses of virtual simulators for laparoscopy and robot-assisted surgery for medical students.

    Di Franco, Gregorio / Gianardi, Desirée / Berchiolli, Raffaella

    Updates in surgery

    2019  Volume 71, Issue 2, Page(s) 397–398

    MeSH term(s) Clinical Competence ; Computer Simulation ; Education, Medical/methods ; Humans ; Laparoscopy/education ; Robotic Surgical Procedures/education ; Students, Medical ; Virtual Reality
    Language English
    Publishing date 2019-01-08
    Publishing country Italy
    Document type Letter
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-018-00621-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Should we use virtual simulators for surgical resident selection?

    Morelli, Luca / Di Franco, Gregorio / Moglia, Andrea / Cuschieri, Alfred

    Journal of robotic surgery

    2019  Volume 13, Issue 4, Page(s) 605–606

    MeSH term(s) Clinical Competence ; Computer Simulation ; Humans ; Internship and Residency ; Robotic Surgical Procedures
    Language English
    Publishing date 2019-01-03
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-018-00918-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Use of Experimental Microsurgery to Improve Resident Autonomy and Training.

    Di Cataldo, Antonio / Latino, Rosalia / Perrotti, Salvatore / Di Franco, Gregorio / Gianardi, Desirée / Morelli, Luca

    Journal of the American College of Surgeons

    2020  Volume 231, Issue 5, Page(s) 606–607

    MeSH term(s) Humans ; Internship and Residency ; Microsurgery ; Professional Autonomy ; Simulation Training
    Language English
    Publishing date 2020-09-19
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2020.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Robotic Hepatectomy plus Biliary Reconstruction for Bismuth Type III and Type IV Hilar Cholangiocarcinoma: State of the Art and Literature Review.

    Guadagni, Simone / Comandatore, Annalisa / Furbetta, Niccolò / Di Franco, Gregorio / Carpenito, Cristina / Bechini, Bianca / Vagelli, Filippo / Ramacciotti, Niccolò / Palmeri, Matteo / Di Candio, Giulio / Morelli, Luca

    Journal of personalized medicine

    2023  Volume 14, Issue 1

    Abstract: Background: In Bismuth type III and IV Hilar Cholangiocarcinoma (III-IV HC), surgical resection is the only chance for long-term survival. As the surgical procedure is complex and Robotic-Assisted Surgery (RAS) may be particularly suitable in this ... ...

    Abstract Background: In Bismuth type III and IV Hilar Cholangiocarcinoma (III-IV HC), surgical resection is the only chance for long-term survival. As the surgical procedure is complex and Robotic-Assisted Surgery (RAS) may be particularly suitable in this setting, the aim of this study is to evaluate the potential benefits of RAS in III-IV HC in terms of post-operative outcomes.
    Methods: We conducted a systematic review using the PRISMA checklist for article selection. We searched the PubMed database and included only studies with clinical data about the treatment of III-IV HC using RAS.
    Results: A total of 12 papers involving 50 patients were included. All cases were Bismuth IIIa (
    Conclusions: RAS for III-IV HC is safe and feasible, at least if performed by experienced surgeons on selected cases. The oncological outcomes appear acceptable, given the aggressiveness of this pathology, but further studies are needed to fully elucidate the exact role of robotics in this setting.
    Language English
    Publishing date 2023-12-21
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm14010012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Initial 50 consecutive full-robotic pancreatoduodenectomies without conversion by a single surgeon: a learning curve analysis from a tertiary referral high-volume center.

    Morelli, Luca / Furbetta, Niccolò / Palmeri, Matteo / Guadagni, Simone / Di Franco, Gregorio / Gianardi, Desirée / Cervelli, Rosa / Lorenzoni, Valentina / Comandatore, Annalisa / Carpenito, Cristina / Di Candio, Giulio / Cuschieri, Alfred

    Surgical endoscopy

    2023  Volume 37, Issue 5, Page(s) 3531–3539

    Abstract: Background: Several studies report on a learning curve for robotic pancreatoduodenectomy (R-PD) ranging between 20 and 80 operations, with conversion rates varying between 1.1 and 35%. However, as these publications mostly refer to initial robotic ... ...

    Abstract Background: Several studies report on a learning curve for robotic pancreatoduodenectomy (R-PD) ranging between 20 and 80 operations, with conversion rates varying between 1.1 and 35%. However, as these publications mostly refer to initial robotic experiences and do not take into account the previous surgical background in pancreatic surgery (PS) and in robotic-assisted surgery (RAS), the center's volume, as well as the platform used, we aimed to perform a surgical outcomes analysis with a particular view to these aspects.
    Methods: Intraoperative and perioperative outcomes of the first 50 consecutive R-PD performed with the da Vinci Xi by the same surgeon, within a tertiary referral high-volume center, between January 2018 and March 2022, were analyzed. The surgeon was previously experienced in both PS and RAS. Shewhart control chart and cumulative sum (CUSUM) analysis were used to evaluate the learning curve of R-PD.
    Results: All the operations were performed with a full-robotic technique, without any conversion to open surgery. Twenty of 50 patients (40%) had a BMI ≥ 25 kg/m
    Conclusions: An extensive prior experience in both PS and RAS, within a tertiary referral high-volume center with availability of the da Vinci Xi platform, can significantly flatten the learning curve and, therefore, enable safe performance of challenging operations, i.e., pancreatoduodenectomies with a minimally invasive approach, with very low risk of conversion to open surgery, even in the first 50 operations.
    MeSH term(s) Humans ; Learning Curve ; Pancreaticoduodenectomy ; Referral and Consultation ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Surgeons/education
    Language English
    Publishing date 2023-01-03
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-022-09784-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy: Comparison between traditional open surgery and full-robotic approach with da Vinci Xi.

    Morelli, Luca / Di Franco, Gregorio / Furbetta, Niccolò / Palmeri, Matteo / Guadagni, Simone / Gianardi, Desirée / Carpenito, Cristina / Comandatore, Annalisa / Giovannetti, Elisa / Di Candio, Giulio / Cuschieri, Alfred

    The international journal of medical robotics + computer assisted surgery : MRCAS

    2023  , Page(s) e2571

    Abstract: Introduction: Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy, especially after pylorus preservation (Pp). We evaluated the effect of a fully robotic approach with da Vinci Xi on DGE after PpPD.: Methods: Open ... ...

    Abstract Introduction: Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy, especially after pylorus preservation (Pp). We evaluated the effect of a fully robotic approach with da Vinci Xi on DGE after PpPD.
    Methods: Open and robotic PDs were performed in 353 and 50 cases, respectively, from January 2009 to March 2022. We compared the clinical outcomes and incidence of clinically relevant DGE between robotic PpPD (R-PpPD) and open PpPD after one-to-one case-control matching.
    Results: Each group consisted of 30 patients. Clinically relevant DGE was less common after R-PpPD (3/30 [10%] vs. 10/30 cases [33.3%], p = 0.028). The median length of hospital stay (LoS) was significantly lower in the R-PpPD group (10 vs. 15 days, p = 0.013).
    Conclusion: The reduced tissue trauma by the minimally invasive robotic approach is associated with a lower incidence of DGE, reducing the LoS and encouraging PpPD performed using the fully robotic approach.
    Language English
    Publishing date 2023-09-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2151860-9
    ISSN 1478-596X ; 1478-5951
    ISSN (online) 1478-596X
    ISSN 1478-5951
    DOI 10.1002/rcs.2571
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Comment on: 'Money for nothing'. The role of robotic-assisted laparoscopy for the treatment of endometriosis.

    Palmeri, Matteo / Di Franco, Gregorio / Furbetta, Niccolò / Morelli, Luca

    Journal of robotic surgery

    2018  Volume 13, Issue 3, Page(s) 529–530

    MeSH term(s) Endometriosis/surgery ; Female ; Humans ; Laparoscopy ; Robotic Surgical Procedures ; Treatment Outcome
    Language English
    Publishing date 2018-12-10
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-018-00908-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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