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  1. Article ; Online: Step by step surgical technique for robotic Kono-S anastomosis after small bowel resection for Crohn's disease - A Video Vignette.

    Suarez Pazos, Natalia / Cagigas Fernandez, Carmen / Cristobal Poch, Lidia / Gómez Ruiz, Marcos

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2023  Volume 25, Issue 7, Page(s) 1548–1549

    MeSH term(s) Humans ; Crohn Disease/surgery ; Robotic Surgical Procedures ; Intestines/surgery ; Colon/surgery ; Anastomosis, Surgical/methods ; Recurrence ; Ileum/surgery
    Language English
    Publishing date 2023-04-10
    Publishing country England
    Document type Video-Audio Media ; Letter
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16565
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  2. Article ; Online: Surgical anatomy of the rectum: a series of video tutorials - a video vignette.

    Wedel, Thilo / Gómez Ruiz, Marcos / Tou, Samson / Stelzner, Sigmar / Matzel, Klaus E

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2022  Volume 25, Issue 5, Page(s) 1047–1050

    MeSH term(s) Humans ; Rectum/surgery ; Pelvis ; Robotic Surgical Procedures
    Language English
    Publishing date 2022-12-11
    Publishing country England
    Document type Video-Audio Media ; Letter
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16419
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    Zs.A 5799: Show issues Location:
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  3. Article ; Online: Robotic surgery for locally advanced T4 rectal cancer: feasibility and oncological quality.

    Gomez Ruiz, Marcos / Ballestero Diego, Roberto / Tejedor, Patricia / Cagigas Fernandez, Carmen / Cristobal Poch, Lidia / Suarez Pazos, Natalia / Castillo Diego, Julio

    Updates in surgery

    2023  Volume 75, Issue 3, Page(s) 589–597

    Abstract: For T4 rectal tumours and local recurrences (LR) of rectal cancer, a radical resection beyond TME, sometimes by multi-visceral resection, is important to obtain safe margins and improve survival. The use of the laparoscopic approach (LA) for these cases ... ...

    Abstract For T4 rectal tumours and local recurrences (LR) of rectal cancer, a radical resection beyond TME, sometimes by multi-visceral resection, is important to obtain safe margins and improve survival. The use of the laparoscopic approach (LA) for these cases is still controversial and associated with a high rate of conversion. However, robotic surgery might offer some advantages that can overcome some of the limitations of LA. Therefore, we aimed to analyse the postoperative outcomes and medium-term oncological results of robotic surgery for locally advanced rectal cancer (pathological T4) and LR. A retrospective analysis was performed including patients who had undergone robotic rectal resection in a single institution over an 11-year period, and had a T4 tumour confirmed in the pathological report. Primary endpoint was to analyse postoperative complications (30-day) and the rate of conversion. Secondary endpoints include pathological assessment of the quality of the specimen, local recurrence and survival [2-year disease-free survival (DFS) and overall survival (OS)]. A total of 41 patients were analysed, including a total of 24 patients (60%) that required a multivisceral resection. The median distance from the tumour to the anorectal junction was 7 (4-12) cm. Conversion to open surgery was necessary in 2 cases (5%). The overall morbidity rate was 78% (n = 32), with 37% of major complications, most of them urinary (n = 7). Median length of hospital stay (LOS) was 13 (7-27) days. The 30-day mortality rate was 7% (n = 3). An R0 resection was achieved in 85.4% of the cases (n = 35) due to 6 cases of the positive circumferential resection margin. 2-year disease-free survival (DFS) and overall survival (OS) for the T4 tumours were 72% and 85%, respectively. There were 8 cases of local recurrence (22.2%); 6 of them met the selection criteria for salvage surgery. Robotic surgery for locally advanced T4 rectal cancer and multi-visceral resections is safe and feasible, with a low rate of conversion and an acceptable rate of postoperative morbidity in this subgroup of patients. Oncological results have shown to be comparable with the laparoscopic series published, preserving a good quality of the resected specimen. However, comparative studies and a longer follow-up period is needed to confirm the oncologic findings and to support the general adoption of the robotic system for these complex interventions.
    MeSH term(s) Humans ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Feasibility Studies ; Rectum/surgery ; Rectal Neoplasms/surgery ; Laparoscopy/methods ; Treatment Outcome
    Language English
    Publishing date 2023-02-10
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01450-6
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  4. Article ; Online: Panproctocolectomy, ileoanal reservoir and protective ileostomy: Step by step-A video vignette.

    Suárez Pazos, Natalia / Gómez Ruiz, Marcos / Cagigas Fernández, Carmen / Cristóbal Poch, Lidia / Serrano-Navidad, Mónica / Del Castillo Diego, Julio

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2023  Volume 26, Issue 1, Page(s) 203

    MeSH term(s) Humans ; Ileostomy ; Colonic Pouches ; Proctocolectomy, Restorative ; Ileum/surgery ; Colitis, Ulcerative/surgery ; Anal Canal/surgery
    Language English
    Publishing date 2023-11-23
    Publishing country England
    Document type Video-Audio Media ; Letter
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16784
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  5. Article ; Online: Robotic total mesorectal excision with rectal stump transabdominal purse string and single-stapled anastomosis technique-a video vignette.

    Suárez Pazos, Natalia / Gómez Ruiz, Marcos / Cagigas Fernández, Carmen / Cristóbal Poch, Lidia / Del Castillo Diego, Julio

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2023  Volume 25, Issue 6, Page(s) 1293–1294

    MeSH term(s) Humans ; Robotic Surgical Procedures ; Rectum/surgery ; Anastomosis, Surgical ; Rectal Neoplasms/surgery ; Laparoscopy
    Language English
    Publishing date 2023-01-27
    Publishing country England
    Document type Video-Audio Media ; Letter
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16474
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  6. Article ; Online: European Society of Coloproctology guideline on training in robotic colorectal surgery (2024).

    Tou, Samson / Au, Stephanie / Clancy, Cillian / Clarke, Steven / Collins, Danielle / Dixon, Frances / Dreher, Elizabeth / Fleming, Christina / Gallagher, Anthony G / Gomez-Ruiz, Marcos / Kleijnen, Jos / Maeda, Yasuko / Rollins, Katie / Matzel, Klaus E

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2024  Volume 26, Issue 4, Page(s) 776–801

    MeSH term(s) Robotic Surgical Procedures/education ; Robotic Surgical Procedures/standards ; Robotic Surgical Procedures/methods ; Humans ; Colorectal Surgery/education ; Colorectal Surgery/standards ; Europe ; Societies, Medical
    Language English
    Publishing date 2024-03-01
    Publishing country England
    Document type Journal Article ; Practice Guideline
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.16904
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  7. Article ; Online: A probabilistic model for the prediction of intra-abdominal infection after colorectal surgery.

    Cagigas Fernández, Carmen / Palazuelos, Camilo / Cristobal Poch, Lidia / Gomez Ruiz, Marcos

    International journal of colorectal disease

    2021  Volume 36, Issue 11, Page(s) 2481–2488

    Abstract: Aim: Predicting intra-abdominal infections (IAI) after colorectal surgery by means of clinical signs is challenging. A naïve logistic regression modeling approach has some limitations, for which reason we study two potential alternatives: the use of ... ...

    Abstract Aim: Predicting intra-abdominal infections (IAI) after colorectal surgery by means of clinical signs is challenging. A naïve logistic regression modeling approach has some limitations, for which reason we study two potential alternatives: the use of Bayesian networks, and that of logistic regression model.
    Methods: Data from patients that had undergone colorectal procedures between 2010 and 2017 were used. The dataset was split into two subsets: (i) that for training the models and (ii) that for testing them. The predictive ability of the models proposed was tested (i) by comparing the ROC curves from days 1 and 3 with all the subjects in the test set and (ii) by studying the evolution of the abovementioned predictive ability from day 1 to day 5.
    Results: In day 3, the predictive ability of the logistic regression model achieved an AUC of 0.812, 95% CI = (0.746, 0.877), whereas that of the Bayesian network was 0.768, 95% CI = (0.695, 0.840), with a p-value for their comparison of 0.097. The ability of the Bayesian network model to predict IAI does present significant difference in predictive ability from days 3 to 5: AUC(Day 3) = 0.761, 95% CI = (0.680, 0.841) and AUC(Day 5) = 0.837, 95% CI = (0.769, 0.904), with a p-value for their comparison of 0.006.
    Conclusions: Whereas at postoperative day 3, a logistic regression model with imputed data should be used to predict IAI; at day 5, when the predictive ability is almost identical, the Bayesian network model should be used.
    MeSH term(s) Bayes Theorem ; Colorectal Surgery/adverse effects ; Digestive System Surgical Procedures/adverse effects ; Humans ; Intraabdominal Infections/diagnosis ; Intraabdominal Infections/etiology ; Logistic Models ; Predictive Value of Tests
    Language English
    Publishing date 2021-06-03
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-021-03955-1
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    Zs.A 2121: Show issues Location:
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  8. Article ; Online: Intraoperative robotic-assisted low anterior rectal resection performance assessment using procedure-specific binary metrics and a global rating scale.

    Gómez Ruiz, Marcos / Tou, Samson / Gallagher, Anthony G / Cagigas Fernández, Carmen / Cristobal Poch, Lidia / Matzel, Klaus E

    BJS open

    2022  Volume 6, Issue 3

    Abstract: Background: This study aimed to evaluate the use of binary metric-based (proficiency-based progression; PBP) performance assessments and global evaluative assessment of robotic skills (GEARS) of a robotic-assisted low anterior rectal resection (RA-LAR) ... ...

    Abstract Background: This study aimed to evaluate the use of binary metric-based (proficiency-based progression; PBP) performance assessments and global evaluative assessment of robotic skills (GEARS) of a robotic-assisted low anterior rectal resection (RA-LAR) procedure.
    Method: A prospective study of video analysis of RA-LAR procedures was carried out using the PBP metrics with binary parameters previously developed, and GEARS. Recordings were collected from five novice surgeons (≤30 RA-LAR previously performed) and seven experienced surgeons (>30 RA-LAR previously performed). Two consultant colorectal surgeons were trained to be assessors in the use of PBP binary parameters to evaluate the procedure phases, surgical steps, errors, and critical errors in male and female patients and GEARS scores. Novice and experienced surgeons were categorized and assessed using PBP metrics and GEARS; mean scores obtained were compared for statistical purpose. Also, the inter-rater reliability (IRR) of these assessment tools was evaluated.
    Results: Twenty unedited recordings of RA-LAR procedures were blindly assessed. Overall, using PBP metric-based assessment, a subgroup of experienced surgeons made more errors (20 versus 16, P = 0.158) and critical errors (9.2 versus 7.8, P = 0.417) than the novice group, although not significantly. However, during the critical phase of RA-LAR, experienced surgeons made significantly fewer errors than the novice group (95% CI of the difference, Lower = 0.104 - Upper = 5.155, df = 11.9, t = 2.23, p = 0.042), and a similar pattern was observed for critical errors. The PBP metric and GEARS assessment tools distinguished between the objectively assessed performance of experienced and novice colorectal surgeons performing RA-LAR (total error scores with PBP metrics, P = 0.019-0.008; GEARS scores, P = 0.029-0.025). GEARS demonstrated poor IRR (mean IRR 0.49) and weaker discrimination between groups (15-41 per cent difference). PBP binary metrics demonstrated good IRR (mean 0.94) and robust discrimination particularly for total error scores (58-64 per cent).
    Conclusions: PBP binary metrics seem to be useful for metric-based training for surgeons learning RA-LAR procedures.
    MeSH term(s) Benchmarking ; Clinical Competence ; Colorectal Neoplasms ; Female ; Humans ; Male ; Prospective Studies ; Reproducibility of Results ; Robotic Surgical Procedures/education
    Language English
    Publishing date 2022-05-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2474-9842
    ISSN (online) 2474-9842
    DOI 10.1093/bjsopen/zrac041
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  9. Article ; Online: The Application of Indocyanine Green (ICG) Staining Technique During Robotic-Assisted Right Hepatectomy: with Video.

    Marino, Marco Vito / Builes Ramirez, Sergio / Gomez Ruiz, Marcos

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2019  Volume 23, Issue 11, Page(s) 2312–2313

    Abstract: Introduction: The application of indocyanine green (icg) properties in the field of HPB surgery is gaining momentum. The adoption of the staining technique for the visualization of hepatic liver parenchyma is still preliminary.: Methods: We performed ...

    Abstract Introduction: The application of indocyanine green (icg) properties in the field of HPB surgery is gaining momentum. The adoption of the staining technique for the visualization of hepatic liver parenchyma is still preliminary.
    Methods: We performed a 1:1 case- matched comparison among 20 patients who underwent robotic liver resection with or without the application of icg fluorescence.
    Results: The icg enabled the reduction of postoperative liver abscess and bile leakage rate. The staining technique was not time-consuming and provided excellent enhancement of liver transection line.
    Conclusion: The routine use of icg-fluorescence could potentially reduce the postoperative complications during robotic liver surgery.
    MeSH term(s) Coloring Agents/pharmacology ; Hepatectomy/methods ; Humans ; Indocyanine Green/pharmacology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/surgery ; Robotic Surgical Procedures/methods ; Surgery, Computer-Assisted/methods
    Chemical Substances Coloring Agents ; Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2019-06-13
    Publishing country United States
    Document type Journal Article ; Technical Report ; Video-Audio Media
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-019-04280-3
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    Zs.A 5207: Show issues Location:
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    Zs.MO 354: Show issues

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  10. Article ; Online: Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center.

    Marino, Marco Vito / Mirabella, Antonello / Gomez Ruiz, Marcos / Komorowski, Andrzej Lech

    Digestive surgery

    2019  Volume 37, Issue 3, Page(s) 229–239

    Abstract: Background: Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive ... ...

    Abstract Background: Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive distal pancreatectomy.
    Methods: We performed a 1:1 retrospective case-matched comparison among 2 groups of 35 patients who underwent robotic-assisted distal pancreatectomy (RDP) or LDP from August 2014 to April 2017.
    Results: The operative time was similar in both groups (230 RDP vs. 205 LDP min, p = 0.382). The robotic group had a lower estimated blood loss (95 vs. 275 mL, p = 0.035). The spleen preservation rate was higher in the RDP group (100 vs. 66.7%, p = 0.027), while the conversion rate to open surgery was higher in the laparoscopic group (14.3 vs. 2.9%, p = 0.048). The overall complication rate was lower in the robotic group (25.7 vs. 37.1%, p = 0.044). There was no statistically significant difference in oncologic outcomes between the groups in terms of R0 resection rate (100% RDP vs. 85% LDP, p = 0.233) and number of harvested lymph nodes (14.4 RDP vs. 10.8 LDP, p = 0.678).
    Conclusions: The RDP showed a lower estimated blood loss, conversion, and morbidity rate. It offered a higher spleen preservation rate in comparison to LDP while maintaining comparable oncologic outcomes.
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Pancreatectomy/methods ; Pancreatic Neoplasms/surgery ; Retrospective Studies ; Robotic Surgical Procedures
    Language English
    Publishing date 2019-07-03
    Publishing country Switzerland
    Document type Comparative Study ; Journal Article
    ZDB-ID 605888-7
    ISSN 1421-9883 ; 0253-4886
    ISSN (online) 1421-9883
    ISSN 0253-4886
    DOI 10.1159/000501428
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