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Robotic surgery for colorectal cancer

Minimally invasive surgery has demonstrated many benefits in general surgery, particularly in colon and rectal procedures. On the other hand, it has some limitations that must be taken into account, especially technical drawback. Robotic surgery has incorporated many improvements to overcome this di...

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Autores principales: Gómez Ruiz, Marcos, Lainez Escribano, Mario, Cagigas Fernández, Carmen, Cristobal Poch, Lidia, Santarrufina Martínez, Sandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726686/
https://www.ncbi.nlm.nih.gov/pubmed/33319154
http://dx.doi.org/10.1002/ags3.12401
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author Gómez Ruiz, Marcos
Lainez Escribano, Mario
Cagigas Fernández, Carmen
Cristobal Poch, Lidia
Santarrufina Martínez, Sandra
author_facet Gómez Ruiz, Marcos
Lainez Escribano, Mario
Cagigas Fernández, Carmen
Cristobal Poch, Lidia
Santarrufina Martínez, Sandra
author_sort Gómez Ruiz, Marcos
collection PubMed
description Minimally invasive surgery has demonstrated many benefits in general surgery, particularly in colon and rectal procedures. On the other hand, it has some limitations that must be taken into account, especially technical drawback. Robotic surgery has incorporated many improvements to overcome this disadvantage, such as 3D visualization, articulating instruments assisting complex and precise movements. As a result, robotic colorectal surgery shows less intraoperative blood loss, shorter time to oral tolerance and initial flatus (particularly associated with “Enhanced Recovery After Surgery” protocol), less conversion rate to open surgery, shortened hospital stay, and longer distal margins compared to laparoscopic and open surgery. This approach also shows a shorter learning curve. Some studies suggest that it could decrease perioperatively or 30 days after the intervention's mortality, raise overall survival, reduce wound infection, and improve functional results, while others show no significant difference. However, it lengthens surgical time. Otherwise, the studies included do not show statistically significant changes in the number of resected lymph nodes and anastomotic leaks. Economic costs remain one of the major concerns, although to date there are no large‐scale studies that have evaluated this aspect from a global point of view. Robotic surgery represents a qualitative leap in surgical instruments and, although there is no strong evidence in favor of the use of robotic surgery over laparoscopic or open surgery, there is enough evidence to support its use in colorectal surgery, with potential advantages for patients.
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spelling pubmed-77266862020-12-13 Robotic surgery for colorectal cancer Gómez Ruiz, Marcos Lainez Escribano, Mario Cagigas Fernández, Carmen Cristobal Poch, Lidia Santarrufina Martínez, Sandra Ann Gastroenterol Surg Review Articles Minimally invasive surgery has demonstrated many benefits in general surgery, particularly in colon and rectal procedures. On the other hand, it has some limitations that must be taken into account, especially technical drawback. Robotic surgery has incorporated many improvements to overcome this disadvantage, such as 3D visualization, articulating instruments assisting complex and precise movements. As a result, robotic colorectal surgery shows less intraoperative blood loss, shorter time to oral tolerance and initial flatus (particularly associated with “Enhanced Recovery After Surgery” protocol), less conversion rate to open surgery, shortened hospital stay, and longer distal margins compared to laparoscopic and open surgery. This approach also shows a shorter learning curve. Some studies suggest that it could decrease perioperatively or 30 days after the intervention's mortality, raise overall survival, reduce wound infection, and improve functional results, while others show no significant difference. However, it lengthens surgical time. Otherwise, the studies included do not show statistically significant changes in the number of resected lymph nodes and anastomotic leaks. Economic costs remain one of the major concerns, although to date there are no large‐scale studies that have evaluated this aspect from a global point of view. Robotic surgery represents a qualitative leap in surgical instruments and, although there is no strong evidence in favor of the use of robotic surgery over laparoscopic or open surgery, there is enough evidence to support its use in colorectal surgery, with potential advantages for patients. John Wiley and Sons Inc. 2020-12-10 /pmc/articles/PMC7726686/ /pubmed/33319154 http://dx.doi.org/10.1002/ags3.12401 Text en © 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Articles
Gómez Ruiz, Marcos
Lainez Escribano, Mario
Cagigas Fernández, Carmen
Cristobal Poch, Lidia
Santarrufina Martínez, Sandra
Robotic surgery for colorectal cancer
title Robotic surgery for colorectal cancer
title_full Robotic surgery for colorectal cancer
title_fullStr Robotic surgery for colorectal cancer
title_full_unstemmed Robotic surgery for colorectal cancer
title_short Robotic surgery for colorectal cancer
title_sort robotic surgery for colorectal cancer
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726686/
https://www.ncbi.nlm.nih.gov/pubmed/33319154
http://dx.doi.org/10.1002/ags3.12401
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