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Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics

(1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most compl...

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Autores principales: Andras, Iulia, Territo, Angelo, Telecan, Teodora, Medan, Paul, Perciuleac, Ion, Berindean, Alexandru, Stanca, Dan V., Buzoianu, Maximilian, Coman, Ioan, Crisan, Nicolae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122613/
https://www.ncbi.nlm.nih.gov/pubmed/33919290
http://dx.doi.org/10.3390/jcm10091812
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author Andras, Iulia
Territo, Angelo
Telecan, Teodora
Medan, Paul
Perciuleac, Ion
Berindean, Alexandru
Stanca, Dan V.
Buzoianu, Maximilian
Coman, Ioan
Crisan, Nicolae
author_facet Andras, Iulia
Territo, Angelo
Telecan, Teodora
Medan, Paul
Perciuleac, Ion
Berindean, Alexandru
Stanca, Dan V.
Buzoianu, Maximilian
Coman, Ioan
Crisan, Nicolae
author_sort Andras, Iulia
collection PubMed
description (1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases.
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spelling pubmed-81226132021-05-16 Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics Andras, Iulia Territo, Angelo Telecan, Teodora Medan, Paul Perciuleac, Ion Berindean, Alexandru Stanca, Dan V. Buzoianu, Maximilian Coman, Ioan Crisan, Nicolae J Clin Med Article (1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases. MDPI 2021-04-21 /pmc/articles/PMC8122613/ /pubmed/33919290 http://dx.doi.org/10.3390/jcm10091812 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Andras, Iulia
Territo, Angelo
Telecan, Teodora
Medan, Paul
Perciuleac, Ion
Berindean, Alexandru
Stanca, Dan V.
Buzoianu, Maximilian
Coman, Ioan
Crisan, Nicolae
Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title_full Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title_fullStr Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title_full_unstemmed Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title_short Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
title_sort role of the laparoscopic approach for complex urologic surgery in the era of robotics
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122613/
https://www.ncbi.nlm.nih.gov/pubmed/33919290
http://dx.doi.org/10.3390/jcm10091812
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