Marco Milone1, Nicola de'Angelis2,3, Nassiba Beghdadi2,3, Francesco Brunetti2,3, Michele Manigrasso4, Giuseppe De Simone5, Giuseppe Servillo5, Sara Vertaldi4, Giovanni Domenico De Palma1. 1. Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy. 2. Unit of Digestive and Hepato-Pancreato-Biliary Surgery, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France. 3. EA7375 (EC2M3 Research Team), Université Paris Est, Créteil, France. 4. Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Naples, Italy. 5. Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples, Italy.
Abstract
BACKGROUND: An advantage of robotic surgery over laparoscopy is the lower rate of unplanned conversion. One of the implicated reasons for conversion is adhesions from previous abdominal surgeries (PASs). METHODS: A comparative analysis of 98 patients with history of open PAS treated by laparoscopic or robotic surgery was performed. Primary endpoint was the rate of conversion to open surgery related to adhesiolysis. Secondary endpoints were short-term outcomes and complications. RESULTS: Conversion rate specifically related to adhesiolysis was significantly lower in robotic group (13 for laparoscopic group vs. 2 for robotic group; p = 0.046). Conversions occurred during adhesiolysis were significantly related to severity of adhesions expressed by peritoneal adhesion index (PAI) score (p < 0.001), number of abdominal areas involved by adhesions (p < 0.001) and severity of PAI into the target area of surgical intervention (p = 0.021). CONCLUSIONS: Benefits of robotic surgery are more noticeable in performing procedures with increasing technical difficulties.
BACKGROUND: An advantage of robotic surgery over laparoscopy is the lower rate of unplanned conversion. One of the implicated reasons for conversion is adhesions from previous abdominal surgeries (PASs). METHODS: A comparative analysis of 98 patients with history of open PAS treated by laparoscopic or robotic surgery was performed. Primary endpoint was the rate of conversion to open surgery related to adhesiolysis. Secondary endpoints were short-term outcomes and complications. RESULTS: Conversion rate specifically related to adhesiolysis was significantly lower in robotic group (13 for laparoscopic group vs. 2 for robotic group; p = 0.046). Conversions occurred during adhesiolysis were significantly related to severity of adhesions expressed by peritoneal adhesion index (PAI) score (p < 0.001), number of abdominal areas involved by adhesions (p < 0.001) and severity of PAI into the target area of surgical intervention (p = 0.021). CONCLUSIONS: Benefits of robotic surgery are more noticeable in performing procedures with increasing technical difficulties.
Authors: Linda Feldbrügge; Santiago Andres Ortiz Galindo; Oliver Frisch; Christian Benzing; Felix Krenzien; Anna Riddermann; Anika Kästner; Nora Franziska Nevermann; Thomas Malinka; Wenzel Schöning; Johann Pratschke; Moritz Schmelzle Journal: Surg Endosc Date: 2021-06-02 Impact factor: 4.584