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Article ; Online: Dual console operating in robotic surgery - a show off or a real necessity?

Piozzi, Guglielmo Niccolò / Khan, Jim S

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

2023 Volume 25, Issue 7, Page(s) 1327–1329

MeSH term(s)	Humans ; Robotic Surgical Procedures
Language	English
Publishing date	2023-07-25
Publishing country	England
Document type	Editorial
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16670
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Article: Robotic Approach to Paediatric Gastrointestinal Diseases: A Systematic Review.

Duhoky, Rauand / Claxton, Harry / Piozzi, Guglielmo Niccolò / Khan, Jim S

Children (Basel, Switzerland)

2024 Volume 11, Issue 3

Abstract: Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for ... ...

Abstract	Introduction: The use of minimally invasive surgery (MIS) for paediatric surgery has been on the rise since the early 2000s and is complicated by factors unique to paediatric surgery. The rise of robotic surgery has presented an opportunity in MIS for children, and recent developments in the reductions in port sizes and single-port surgery offer promising prospects. This study aimed to present a systematic overview and analysis of the existing literature around the use of robotic platforms in the treatment of paediatric gastrointestinal diseases. Materials and methods: In accordance with the PRISMA Statement, a systematic review on paediatric robotic gastrointestinal surgery was conducted on Pubmed, Cochrane, and Scopus. A critical appraisal of the study was performed using the Newcastle Ottawa Scale. Results: Fifteen studies were included, of which seven were on Hirschsprung's disease and eight on other indications. Included studies were heterogeneous in their populations, age, and sex, but all reported low incidences of intraoperative complications and conversions in their robotic cohorts. Only one study reported on a comparator cohort, with a longer operative time in the robotic cohort (180 vs. 152 and 156 min, Conclusions: Robotic surgery may play a role in the treatment of paediatric gastrointestinal diseases. There is limited data available on modern robotic platforms and almost no comparative data between any robotic platforms and conventional minimally invasive approaches. Further technological developments and research are needed to enhance our understanding of the potential that robotics may hold for the field of paediatric surgery.
Language	English
Publishing date	2024-02-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11030273
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Article ; Online: Robotic beyond total mesorectal excision (TME) for locally advanced or recurrent rectal cancer: a systematic review protocol.

Panagiotopoulou, Ioanna Georgiou / Przedlacka, Anna / Piozzi, Guglielmo Niccolò / Mills, Graham A / Harper, Mick / Khan, Jim S

BMJ open

2024 Volume 14, Issue 1, Page(s) e080043

Abstract: Introduction: The surgical treatment for locally advanced or recurrent rectal cancer requires oncological clearance with a pelvic exenteration or a beyond total mesorectal excision (TME). The aim of this systematic review is to explore the safety and ... ...

Abstract	Introduction: The surgical treatment for locally advanced or recurrent rectal cancer requires oncological clearance with a pelvic exenteration or a beyond total mesorectal excision (TME). The aim of this systematic review is to explore the safety and feasibility of robotic surgery in locally advanced and recurrent rectal cancer by evaluating perioperative outcomes, oncological clearance rates, and survival and recurrence rates postrobotic beyond TME surgery. Methods: The systematic review will include studies published until the end of December 2023. The MEDLINE, EMBASE and Scopus databases will be searched. The screening process, study selection, data extraction, quality assessment and analysis will be performed by two independent reviewers. Discrepancies will be resolved by consensus with a third independent reviewer. The risk of bias will be assessed with validated scores. The primary outcomes will be oncological clearance, overall and disease-free survival, and local and systemic recurrence rates post robotic or robot-assisted beyond TME surgery for locally advanced or recurrent rectal cancer. Secondary outcomes will include perioperative outcomes. Ethics and dissemination: No ethical approval is required for this systematic review as no individual patient cases are studied requiring access to individual medical records. The results of the systematic review will be disseminated with conference presentations and peer-reviewed paper publications. Prospero registration of the study: CRD42023408098.
MeSH term(s)	Humans ; Robotics ; Robotic Surgical Procedures ; Treatment Outcome ; Laparoscopy/methods ; Systematic Reviews as Topic ; Rectal Neoplasms/surgery
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-080043
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Article: Laparoscopic versus Open Emergency Surgery for Right Colon Cancers.

Hussain, Mohammad Iqbal / Piozzi, Guglielmo Niccolò / Sakib, Najmu / Duhoky, Rauand / Carannante, Filippo / Khan, Jim S

Diagnostics (Basel, Switzerland)

2024 Volume 14, Issue 4

Abstract: Background: A laparoscopic approach to right colectomies for emergency right colon cancers is under investigation. This study compares perioperative and oncological long-term outcomes of right colon cancers undergoing laparoscopic or open emergency ... ...

Abstract	Background: A laparoscopic approach to right colectomies for emergency right colon cancers is under investigation. This study compares perioperative and oncological long-term outcomes of right colon cancers undergoing laparoscopic or open emergency resections and identifies risk factors for survival. Methods: Patients were identified from a prospectively maintained institutional database between 2009 and 2019. Demographics, clinicopathological features, recurrence, and survival were investigated. Cox regression analysis was performed for risk factor analysis. Results: A total of 202 right colectomies (114 open and 88 laparoscopic) were included. ASA III-IV was higher in the open group. The conversion rate was 14.8%. Laparoscopic surgery was significantly longer (156 vs. 203 min, Conclusions: A laparoscopic approach to right colon cancers in an emergency setting is safe in terms of perioperative and long-term oncological outcomes. Randomized control trials are required to further investigate these results.
Language	English
Publishing date	2024-02-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics14040407
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Article: Robotic Lateral Pelvic Lymph Node Dissection in Rectal Cancer: A Feasibility Study from a European Centre.

Chang, Tou Pin / Ali, Oroog / Tsimogiannis, Kostas / Sica, Giuseppe S / Khan, Jim S

Journal of clinical medicine

2023 Volume 13, Issue 1

Abstract: Introduction: The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of ... ...

Abstract	Introduction: The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of robotic LPLND by utilising a well-established totally robotic TME protocol. Methods: We conducted a retrospective study on 17 consecutive patients who underwent robotic LPLND for LPND ± TME for rectal cancer between 2015 and 2021. A single docking totally robotic approach from the left hip with full splenic mobilisation was performed using the X/Xi da Vinci platform. All patients underwent a tri-compartmental robotic en bloc excision of LPND with preservation of the obturator nerve and pelvic nerve plexus, leaving a well-skeletonised internal iliac vessel and its branches. Results: The median operative time was 280 min, which was 40 min longer than our standard robotic TME. The median BMI was 26, and there were no conversions. The median inpatient stay was 7 days with no Clavien-Dindo > 3 complications. One patient (6%) developed local recurrence and metastatic disease within 5 months. The proportion of histologically confirmed LPND was 41%, of which 94% were well to moderately differentiated adenocarcinoma. Median pre-operative lateral pelvic node size was significantly higher in positive nodes (14 mm vs. 8 mm ( Discussion: Robotic LPLND is safe and feasible with good peri-operative and short-term outcomes, with the ergonomic advantages of a robotic TME docking protocol readily transferrable in LPLND.
Language	English
Publishing date	2023-12-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13010090
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Article ; Online: Robotic Abdominoperineal Excision with Lateral Pelvic Lymph Node Dissection.

Siddiqi, Najaf N / Stefan, Samuel S / Khan, Jim S

Diseases of the colon and rectum

2021 Volume 64, Issue 3, Page(s) e58–e59

MeSH term(s)	Aged ; Female ; Humans ; Indocyanine Green/administration & dosage ; Ligation/methods ; Lymph Node Excision/methods ; Lymph Nodes/surgery ; Mesenteric Artery, Inferior/surgery ; Pelvis/pathology ; Proctectomy/methods ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Robotic Surgical Procedures/instrumentation ; Surgical Wound Infection ; Treatment Outcome
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2021-01-07
Publishing country	United States
Document type	Journal Article ; Webcast
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001943
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Article ; Online: Robotic Low Anterior Resection.

Mykoniatis, Ioannis / Siddiqi, Najaf N / Khan, Jim S

Diseases of the colon and rectum

2021 Volume 64, Issue 2, Page(s) e32–e33

MeSH term(s)	Humans ; Intraoperative Complications/prevention & control ; Laparoscopy/methods ; Postoperative Complications/prevention & control ; Proctectomy/methods ; Rectal Neoplasms/surgery ; Robotic Surgical Procedures/methods
Language	English
Publishing date	2021-02-25
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001893
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Article ; Online: The Use of Enhanced Technologies in Robotic Surgery and Its Impact on Outcomes in Rectal Cancer: A Systematic Review.

Tejedor, Patricia / Sagias, Filippos / Khan, Jim S

Surgical innovation

2020 Volume 27, Issue 4, Page(s) 384–391

Abstract: The main advantage of the robotic approach is the surgical precision that the technology offers. It is particularly useful in rectal cancer as this is a technically challenging procedure. The technological advantage of the robot leads to better ... ...

Abstract	The main advantage of the robotic approach is the surgical precision that the technology offers. It is particularly useful in rectal cancer as this is a technically challenging procedure. The technological advantage of the robot leads to better postoperative outcomes. Apart from the 3D vision and endowrist instrumentation in comparison to laparoscopy, the options of using fluorescence imaging, endowrist stapler, and table motion have revolutionised the way of performing an anterior resection. Thus, the true benefit of these advances will be the quality of the surgery, which leads to better postoperative outcomes. This article focuses on the current status of applications of new modalities and technology development in robotic rectal surgery. A systematic literature search was performed using PubMed, MEDLINE, and cochrane database. The studies included were considered based on the following (1) articles written in English, (2) full text is available, (3) whether the topic is related to the use of novel technologies during robotic rectal surgery, and (4) sample: adult patients and malignant rectal disease. The primary end point was to analyse the current use of technological advances in robotic rectal surgery. Only a few studies are currently available on the use of these different technologies in robotic colorectal surgery. Many of these reports describe promising results, although with short-term outcomes. The use of technologies in robotic colorectal surgery is safe and feasible and can be used together to improve short-term outcomes. Intraoperative fluorescence angiography has demonstrated to reduce the rate of anastomotic leak, whereas the robotic stapler and the table motion simplify anatomic resection.
MeSH term(s)	Adult ; Anastomotic Leak ; Humans ; Laparoscopy ; Rectal Neoplasms/surgery ; Rectum ; Robotic Surgical Procedures ; Treatment Outcome
Language	English
Publishing date	2020-06-02
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350620928277
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Article ; Online: The role of transanal total mesorectal excision.

Rutgers, Marieke L W / Bemelman, Willem A / Khan, Jim S / Hompes, Roel

Surgical oncology

2021 Volume 43, Page(s) 101695

Abstract: At inception, transanal total mesorectal excision (TaTME) was hypothesized to be a solution for several problems encountered in pelvic surgery, particularly for distal rectal cancer. The transanal part of the procedure is less hampered by patient related ...

Abstract	At inception, transanal total mesorectal excision (TaTME) was hypothesized to be a solution for several problems encountered in pelvic surgery, particularly for distal rectal cancer. The transanal part of the procedure is less hampered by patient related factors such as visceral obesity and a narrow bony pelvis and can thus overcome access and visualization problems encountered with a pure abdominal approach. Clearly, as for any new technique, a learning curve needs to be negotiated, ideally without unacceptable harm to patients. In experienced hands, TaTME might overcome challenges found in anatomically challenging rectal cancer patients as well as for other indications. The role of TaTME is not to replace, but rather complement its abdominal counterpart.
MeSH term(s)	Humans ; Laparoscopy/methods ; Proctectomy/methods ; Rectal Neoplasms/surgery ; Rectum/surgery ; Transanal Endoscopic Surgery/methods
Language	English
Publishing date	2021-12-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1107810-8
ISSN	1879-3320 ; 0960-7404
ISSN (online)	1879-3320
ISSN	0960-7404
DOI	10.1016/j.suronc.2021.101695
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Article ; Online: Robotic CME in obese patients: advantage of robotic ultrasound scan for vascular dissection.

Maertens, Vicky / Stefan, Samuel / Mykoniatis, Ioannis / Siddiqi, Najaf / David, Gerald / Khan, Jim S

Journal of robotic surgery

2022 Volume 17, Issue 1, Page(s) 155–161

Abstract: Complete mesocolic excision (CME) in right-sided colon cancers appears to confer oncological benefits compared to conventional colectomy. Identification of the superior mesenteric vein (SMV) remains challenging. We describe the novel use of intra- ... ...

Abstract	Complete mesocolic excision (CME) in right-sided colon cancers appears to confer oncological benefits compared to conventional colectomy. Identification of the superior mesenteric vein (SMV) remains challenging. We describe the novel use of intra-operative robotic ultrasound scan (rUSS) in obese patients (BMI ≥ 29). All consecutive patients having robotic CME for colon cancer between 2014 and 2017 were included in this retrospective cohort study. Data were recorded on an ethics approved prospective database and included patient demographics, clinical and oncological outcomes. Patients were divided into group 1 (BMI ≤ 28) and group 2 (BMI ≥ 29). SMV first approach was employed in all cases and SMV detection was aided using rUSS in group 2. Primary outcome was postoperative morbidity. Secondary outcomes included conversion rate, operative time and length of stay (LOS). 41 (group 1, median 66 years) were compared to 32 patients (group 2, median 63 years). There were no conversions to laparoscopy or laparotomy. Median operative times for group 2 were 30 min longer (186 vs. 216 min, p = 0.05). Overall morbidity was similar (20% vs. 19% in group 1 and 2, p = 0.26). There was no significant difference between the two groups with regard to LOS (median 7 vs. 6 days, p = 0.48), readmissions (2 vs. 5, p = 0.13), R0 resection rate (98% vs. 94%, p = 0.43) and lymph node harvest (median 31 vs. 30, p = 0.28).CME can be technically more challenging than conventional colectomy in obese patients and is associated with longer operative times. The use of rUSS in obese patients can help to identify SMV and allow safer dissection.
MeSH term(s)	Humans ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Robotics ; Colonic Neoplasms/diagnostic imaging ; Colonic Neoplasms/surgery ; Colonic Neoplasms/pathology ; Dissection ; Lymph Node Excision ; Laparoscopy ; Colectomy ; Operative Time ; Treatment Outcome
Language	English
Publishing date	2022-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-022-01398-6
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