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Hybrid Robot-Assisted Surgery

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The SAGES Atlas of Robotic Surgery

Abstract

Hybrid robot-assisted surgery is a planned operative approach that integrates multiple access methods for various specific portions of a procedure. Initially used as a bridge for the transition from other approaches (open or laparoscopic) to a totally robotic procedure, hybrid approaches still retain patient benefits of minimally invasive surgery. While surgeons have reported diverse operative procedures using only the robotic surgical instruments, many of the more complex procedures are taking advantage of hybrid methods, conceived to address the two main concerns associated with robotic operations in certain circumstances: safety and speed. In this chapter we will discuss factors that play a role in the selection of a hybrid robot-assisted approach, and the many ways in which hybrid surgery has allowed minimally invasive, complex surgery not otherwise considered feasible. Both the novice and the expert robotic surgeon can benefit from concepts and operations developed in hybrid surgery. Hybrid approaches capitalize on the philosophy that the robot is just another surgical instrument, to be integrated with open and laparoscopic instruments, for the optimal care of patients.

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References

  1. Jacob M, Chappell D, Rehm M. The ‘third space’—fact or fiction? Best Pract Res Clin Anaesthesiol. 2009;23(2):145–57.

    Article  PubMed  Google Scholar 

  2. Gholami S, Cassidy MR, Strong VE. Minimally invasive surgical approaches to gastric resection. Surg Clin North Am. 2017;97(2):249–64.

    Article  PubMed  Google Scholar 

  3. Bosio RM, Pigazzi A. Emerging and evolving technology in colon and rectal surgery. Clin Colon Rectal Surg. 2015;28(3):152–7.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20(10):1521–5.

    Article  CAS  PubMed  Google Scholar 

  5. Choi SH, Kang CM, Kim DH, Lee WJ, Chi HS. Robotic pylorus preserving pancreaticoduodenectomy with mini-laparotomy reconstruction in patient with ampullary adenoma. J Korean Surg Soc. 2011;81(5):355–9.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Lin JC, Reddy DJ, Eun D, Fumo M, Menon M. Robotic-assisted laparoscopic dissection of the infrarenal aorta and iliac artery: a technical description and early results. Ann Vasc Surg. 2009;23(3):298–302.

    Article  PubMed  Google Scholar 

  7. Nassour I, Polanco PM. Minimally invasive liver surgery for hepatic colorectal metastases. Curr Colorectal Cancer Rep. 2016;12(2):103–12.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Gudjonsson S, Hilmarsson R, Patschan O, Liedberg F. Does incision length matter? Robotic assisted extracorporeal urinary diversion via mini-laparotomy using the Alexis O-ring retractor. Eur Urol. 2015;67(1):179–80.

    Article  PubMed  Google Scholar 

  9. Fornalik H, Brooks H, Moore ES, Flanders NL, Callahan MJ, Sutton GP. Hand-assisted robotic surgery for staging of ovarian cancer and uterine cancers with high risk of peritoneal spread: a retrospective cohort study. Int J Gynecol Cancer. 2015;25(8):1488–93.

    Article  PubMed  Google Scholar 

  10. Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, et al. Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery. Cochrane Database Syst Rev. 2010;(10):CD006585.

    Google Scholar 

  11. Marcello PW, Fleshman JW, Milsom JW, Read TE, Arnell TD, Birnbaum EH, et al. Hand-assisted laparoscopic vs. laparoscopic colorectal surgery: a multicenter, prospective, randomized trial. Dis Colon Rectum. 2008;51(6):818–26. discussion 826–8

    Article  PubMed  Google Scholar 

  12. Zhang GT, Zhang XD, Xue HZ. Open versus hand-assisted laparoscopic total gastric resection with D2 lymph node dissection for adenocarcinoma: a case-control study. Surg Laparosc Endosc Percutan Tech. 2017;27(1):42–50.

    PubMed  Google Scholar 

  13. Vitobello D, Fattizzi N, Santoro G, Rosati R, Baldazzi G, Bulletti C, et al. Robotic surgery and standard laparoscopy: a surgical hybrid technique for use in colorectal endometriosis. J Obstet Gynaecol Res. 2013;39(1):217–22.

    Article  PubMed  Google Scholar 

  14. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.

    Article  PubMed  Google Scholar 

  15. van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14(3):210–8.

    Article  PubMed  Google Scholar 

  16. Scarpinata R, Aly EH. Does robotic rectal cancer surgery offer improved early postoperative outcomes? Dis Colon Rectum. 2013;56(2):253–62.

    Article  PubMed  Google Scholar 

  17. Sohn W, Lee HJ, Ahlering TE. Robotic surgery: review of prostate and bladder cancer. Cancer J. 2013;19(2):133–9.

    Article  PubMed  Google Scholar 

  18. Orady M, Hrynewych A, Nawfal AK, Wegienka G. Comparison of robotic-assisted hysterectomy to other minimally invasive approaches. JSLS. 2012;16(4):542–8.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Bokhari MB, Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM. Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc. 2011;25(3):855–60.

    Article  PubMed  Google Scholar 

  20. Park JS, Choi GS, Lim KH, Jang YS, Jun SH. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol. 2010;17(12):3195–202.

    Article  PubMed  Google Scholar 

  21. Park YA, Kim JM, Kim SA, Min BS, Kim NK, Sohn SK, et al. Totally robotic surgery for rectal cancer: from splenic flexure to pelvic floor in one setup. Surg Endosc. 2010;24(3):715–20.

    Article  PubMed  Google Scholar 

  22. Hellan M, Stein H, Pigazzi A. Totally robotic low anterior resection with total mesorectal excision and splenic flexure mobilization. Surg Endosc. 2009;23(2):447–51.

    Article  PubMed  Google Scholar 

  23. Farello GA, Cerofolini A, Rebonato M, Bergamaschi G, Ferrari C, Chiappetta A. Congenital choledochal cyst: video-guided laparoscopic treatment. Surg Laparosc Endosc. 1995;5(5):354–8.

    CAS  PubMed  Google Scholar 

  24. Gagner M, Pomp A. Laparoscopic pancreatic resection: is it worthwhile? J Gastrointest Surg. 1997;1(1):20–5. discussion 25–6

    Article  CAS  PubMed  Google Scholar 

  25. Kendrick ML. Laparoscopic and robotic resection for pancreatic cancer. Cancer J. 2012;18(6):571–6.

    Article  PubMed  Google Scholar 

  26. Liao CH, Wu YT, Liu YY, Wang SY, Kang SC, Yeh CN, et al. Systemic review of the feasibility and advantage of minimally invasive pancreaticoduodenectomy. World J Surg. 2016;40(5):1218–25.

    Article  PubMed  Google Scholar 

  27. Cirocchi R, Partelli S, Trastulli S, Coratti A, Parisi A, Falconi M. A systematic review on robotic pancreaticoduodenectomy. Surg Oncol. 2013;22(4):238–46.

    Article  PubMed  Google Scholar 

  28. Eyraud R, Laydner H, Autorino R, Hillyer S, Long J-A, Panumatrassamee K, et al. Robot-assisted transrectal hybrid natural orifice translumenal endoscopic surgery nephrectomy and adrenalectomy: initial investigation in a cadaver model. Urology. 2013;81(5):1090–4.

    Article  PubMed  Google Scholar 

  29. Zou X, Zhang G, Xiao R, Yuan Y, Wu G, Wang X, et al. Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience. Surg Endosc. 2011;25(12):3767–72.

    Article  PubMed  Google Scholar 

  30. Leung U, Kuk D, D’Angelica MI, Kingham TP, Allen PJ, DeMatteo RP, et al. Long-term outcomes following microwave ablation for liver malignancies. Br J Surg. 2015;102(1):85–91.

    Article  CAS  PubMed  Google Scholar 

  31. Nadler RB, Perry KT, Smith ND. Hybrid laparoscopic and robotic ultrasound-guided radiofrequency ablation-assisted clampless partial nephrectomy. Urology. 2009;74(1):202–5.

    Article  PubMed  Google Scholar 

  32. Rimar K, Khambati A, McGuire BB, Rebuck DA, Perry KT, Nadler RB. Radiofrequency ablation-assisted zero-ischemia robotic laparoscopic partial nephrectomy: oncologic and functional outcomes in 49 patients. Adv Urol. 2016;2016:8045210.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Wu SD, Viprakasit DP, Cashy J, Smith ND, Perry KT, Nadler RB. Radiofrequency ablation-assisted robotic laparoscopic partial nephrectomy without renal hilar vessel clamping versus laparoscopic partial nephrectomy: a comparison of perioperative outcomes. J Endourol. 2010;24(3):385–91.

    Article  PubMed  Google Scholar 

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Correspondence to Aaron Lewis MD .

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Lewis, A., Woo, Y., Fong, Y. (2018). Hybrid Robot-Assisted Surgery. In: Fong, Y., Woo, Y., Hyung, W., Lau, C., Strong, V. (eds) The SAGES Atlas of Robotic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-91045-1_10

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  • DOI: https://doi.org/10.1007/978-3-319-91045-1_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-91043-7

  • Online ISBN: 978-3-319-91045-1

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