P Stádler1, L Dvoracek, P Vitasek, P Matous. 1. Department of Vascular Surgery, Na Homolce Hospital, Prague, Czech Republic. petr.stadler@homolka.cz
Abstract
BACKGROUND: Based on their experience of 150 robot-assisted vascular reconstructions, the authors not only reflect on the current uses of the da Vinci robotic system in vascular surgery, but also discuss options for the further expansion of this cutting-edge technology in their area of expertise. METHODS: To date there has not been the same level of development in laparoscopy in vascular surgery as in general surgery and, despite the numbers of published studies showing interesting results, laparoscopic vascular surgery has never been generally accepted. Robot-assisted surgery represents a new stage of progress in mini-invasive methods. During the period November 2005-September 2009, the authors performed 150 robot-assisted vascular reconstructions in the aortoiliac area. The most significant include aortofemoral reconstructions and surgery on aneurysms of the abdominal aorta, the pelvic arteries and the splenic artery, as well as their first attempts to perform hybrid interventions. RESULTS: Four cases (2.7%) required conversion to standard surgery and four patients (2.7%) experienced more serious postoperative complications. On one occasion (0.7%) the robotic equipment broke down during the operation and surgery had to be completed laparoscopically. In one case (0.7%) the operation had to be abandoned because the finding on the aorta proved to be inoperable. In the cohort under consideration, the median operating time was 228 min, the median time taken to suture the anastomosis was 27 min and the median clamp time was 39 min. CONCLUSIONS: Robotic operating systems improve the precision, control and dexterity of the surgical procedure and offer patients a higher quality of operating interventions.
BACKGROUND: Based on their experience of 150 robot-assisted vascular reconstructions, the authors not only reflect on the current uses of the da Vinci robotic system in vascular surgery, but also discuss options for the further expansion of this cutting-edge technology in their area of expertise. METHODS: To date there has not been the same level of development in laparoscopy in vascular surgery as in general surgery and, despite the numbers of published studies showing interesting results, laparoscopic vascular surgery has never been generally accepted. Robot-assisted surgery represents a new stage of progress in mini-invasive methods. During the period November 2005-September 2009, the authors performed 150 robot-assisted vascular reconstructions in the aortoiliac area. The most significant include aortofemoral reconstructions and surgery on aneurysms of the abdominal aorta, the pelvic arteries and the splenic artery, as well as their first attempts to perform hybrid interventions. RESULTS: Four cases (2.7%) required conversion to standard surgery and four patients (2.7%) experienced more serious postoperative complications. On one occasion (0.7%) the robotic equipment broke down during the operation and surgery had to be completed laparoscopically. In one case (0.7%) the operation had to be abandoned because the finding on the aorta proved to be inoperable. In the cohort under consideration, the median operating time was 228 min, the median time taken to suture the anastomosis was 27 min and the median clamp time was 39 min. CONCLUSIONS: Robotic operating systems improve the precision, control and dexterity of the surgical procedure and offer patients a higher quality of operating interventions.