Ebook Emerging technologies in surgery: Part 2
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Ebook Emerging technologies in surgery: Part 2
PartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2uction9.2CholecystectomyThe world of surgery, having so long been isolated from computers, is evolving. The adoption of robotic technology is widespread. It covers the spectrum of surgical specialties and crosses international boundaries. More than 10,000 operations have been performed using the da Ebook Emerging technologies in surgery: Part 2Vinci* surgical system. General surgeons, urologists, neurosurgeons, thoracic surgeons, cardiovascular surgeons, gynecologists, and vascular surgeonsEbook Emerging technologies in surgery: Part 2
alike are using the system. The range of robotic cases ranges from the simplest cholecystectomy to the most complex mitral valve repair. An informal sPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2currently in clinical use. At the University of Illinois at Chicago, we have performed more than 300 robotic-assisted procedures (Table 9.1). In this chapter, we review the current application of robotics in general surgery.Table 9.1 Robotic-assisted procedures performed at the University of Illinoi Ebook Emerging technologies in surgery: Part 2sProcedureNumber of casesCholecystectomy1Roux en-Y gastric bypassnoAdjustable gastric banding30Heller myotomysoNissen fundopl lent ion5Epiphrenic diveEbook Emerging technologies in surgery: Part 2
rt iculectomy6Total esophagectomy18Esophageal leiomyoma resection3Pyloroplasty1Castroyeyunostomy2Transduodenal sphincteroplasty2Adrenalectomy10Donor nPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2d in the literature [2, 3]. The authors of these studies did not find any significant advantages over conventional laparoscopic surgery when using the robotic system to perform the operation. They stated that the need for a specially trained operating room staff was an unnecessary hindrance for a lo Ebook Emerging technologies in surgery: Part 2w-complexity procedure. They also stated that the operating room costs were higher with the robotic system, due to more expensive instrumentation, robEbook Emerging technologies in surgery: Part 2
ot time, and longer case time. In addition, they indicated that it was extremely difficult to perform a cholangio-gram with the system in place due toPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2 expected decrease in complications of cholecystectomy, such as common bile duct (CBD) injury. In conclusion, we postulate that the advantages of robotic technology may have potential use in advanced procedures such as repair of the common bile duct after injury, but that current evidence does not s Ebook Emerging technologies in surgery: Part 2upport the routine application of this technology in laparoscopic cholecystectomy.9.3Bariatric SurgeryThe field of bariatric surgery benefited greatlyEbook Emerging technologies in surgery: Part 2
from the introduction of minimally invasive techniques. Robot ic-assisted surgery represents a small but growing subset of minimally invasive surgicaPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2 of surgeons in 2003 showed that only 11 surgeons in the United States were currently using a robotic surgical system for bariatric surgery |4]. The reason for this is the small number of bariatric cases performed laparoscopically (10%) in the United States and the limited number of institutions76 I Ebook Emerging technologies in surgery: Part 2II Robotics and Novel Surgical Approacheswith a robotic system. Hie first robotic-assisted adjustable gastric banding was reported in 1999 [5], and thEbook Emerging technologies in surgery: Part 2
e first-ever robotically assisted gastric bypass in September 2000 by our group [6].9.3.1Robotic-Assisted Roux-en-Y Gastric BypassThe procedure that bPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2-assisted, hand-sewn gastrojejunostomy for completion of the laparoscopic Roux-en-Y gastric bypass procedure. The operative room is set up as shown in (Fig. 9.1). The first part of the opera-tion is performed laparoscopically; a small pouch and a 120-cm limb are created. After this, the robot is put Ebook Emerging technologies in surgery: Part 2 in place and a running two-layer, hand-sewn antecolic antegastric gastrojejunal anastomosis is performed. We believe that performing a hand-sewn anasEbook Emerging technologies in surgery: Part 2
tomosis offers the best method to decrease the risk of leak. We recently completed analyzing the data of our robotic bariatric surgeon and a surgeon aPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 Introdu Ebook Emerging technologies in surgery: Part 2e now completed close to 200 procedures without an anastomotic leak. They have also experienced significantly fewer strictures than the 9-14% expected rate of circular stapler anastomotic techniques [7, 8]. Performing a hand-sewn anastomosis also eliminates the requirement of passing a stapler anvil Ebook Emerging technologies in surgery: Part 2 down the esophagus (avoiding the risk of esopha-Conỉrol towerFig. 9.1 Operating room set up for esophageal surgery and gastric bypassPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 IntroduPartinPart IIIRobotics and Novel Surgical ApproachesChapterRobotics in General Surgery:Today and TomorrowFederico Moser and Santiago Horgan9.1 IntroduGọi ngay
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