Robotic single port cholecystectomy (R-LESS-C): Experience in 36 patients

Laparoendoscopic single-site surgery (LESS) has emerged as a result of a search for “pain-less” and “scar-less” surgery. Laparoendoscopic single-site cholecystectomy (LESS-C) is probably the most common application in general surgery, although it harbors certain limitations. It was proposed that the da Vinci Single-Site (Si) robotic system may overcome some of the difficulties experienced during LESS, providing three dimensional views and the ability to work in a right-handed fashion. Thirty-six robotic single port cholecystectomies (R-LESS-C) performed with the da Vinci Si robotic system are evaluated in this paper R-LESS-C performed in 36 patients were reviewed. The data related to the perioperative period (i.e., anesthesia time, operation time, docking time, and console time) was recorded prospectively, whereas the hospitalization period, postoperative visual analogue scale (VAS) pain scores were collected retrospectively. A total number of 36 patients, with a mean age of 40.1 years (21–64 years), underwent R-LESS-C. There were five men and 31 women. The mean anesthesia and operation times were 79.3 minutes (45–130 minutes) and 61.8 minutes (34–110 minutes), respectively. The mean docking time was 9.8 minutes (4–30 minutes) and the mean console time was 24.9 minutes (7–60 minutes). The mean hospital stay was 1.05 days (1–2 days) and the mean pain score (VAS) was 3.6 (2–8) in the first 24 hours. Incisional hernia was recorded in one patient. R-LESS-C can be performed reliably with acceptable operative times and safety. The da Vinci Si robotic system may ease LESS-C. Two issues should be considered for routine use: expensive resources are needed and the incidence of incisional hernia may increase

Total laparoscopic approach for the treatment of right colon cancer: A technical critique

Total laparoscopic surgery is not a new concept, but it is not preferred generally for right colectomy. The aim of the study is to evaluate the outcomes, which are related with surgical technique after total laparoscopic right colectomy (TLRC) and laparoscopic-assisted right colectomy (LARC) for right colon cancer in 30 consecutive patients. Thirty patients with right colon cancer, half of which were treated with TLRC and half of which were treated with LARC, were compared with regard to patient demographics, operative and postoperative data, histopathologic findings, follow-up data, and the complications related to the surgical technique. There were 16 men and 14 women, median age was 63 years (range 41–86) with a body mass index (BMI) of 27 kg/m2 (range 20–33). There were no differences between the groups for BMI, harvested lymph node number, or distal and radial margins. The length of the incision and the length of the postoperative stay was shorter in the TLRC group (p = 0.000). Overall complications were higher in the LARC group than in the TLRC group (p = 0.014). The median follow-up was 28 months (range 5–99). In the late period, two patients in the LARC group were reoperated on. The cause of reoperation was internal herniation in one patient due to ileal twisting and incisional hernia in the other one. Our preliminary data indicate that TLRC could result in better outcomes for right colon cancer patients than LARC

Total laparoscopic approach for the treatment of right colon cancer: A technical critique

Background and aims: Total laparoscopic surgery is not a new concept, but it is not preferred generally for right colectomy. The aim of the study is to evaluate the outcomes, which are related with surgical technique after total laparoscopic right colectomy (TLRC) and laparoscopic-assisted right colectomy (LARC) for right colon cancer in 30 consecutive patients. Materials and methods: Thirty patients with right colon cancer, half of which were treated with TLRC and half of which were treated with LARC, were compared with regard to patient demographics, operative and postoperative data, histopathologic findings, follow-up data, and the complications related to the surgical technique. Results: There were 16 men and 14 women, median age was 63 years (range 41–86) with a body mass index (BMI) of 27 kg/m2 (range 20–33). There were no differences between the groups for BMI, harvested lymph node number, or distal and radial margins. The length of the incision and the length of the postoperative stay was shorter in the TLRC group (p = 0.000). Overall complications were higher in the LARC group than in the TLRC group (p = 0.014). The median follow-up was 28 months (range 5–99). In the late period, two patients in the LARC group were reoperated on. The cause of reoperation was internal herniation in one patient due to ileal twisting and incisional hernia in the other one. Conclusion: Our preliminary data indicate that TLRC could result in better outcomes for right colon cancer patients than LARC

Robotic Surgery for Rectal Cancer: Initial Experience from 30 Consecutive Patients

Background Robotic surgery offers 3D visualization and the advantage of the usage of multi-articulated instruments with superior dexterity. Theoretically, it can overcome many limitations of laparoscopic rectal surgery in the narrow pelvis

What Have We Gained by Performing Robotic Rectal Resection? Evaluation of 64 Consecutive Patients Who Underwent Laparoscopic or Robotic Low Anterior Resection for Rectal Adenocarcinoma

Background: Robotic surgery is thought to be a solution to overcome the limitations of laparoscopy in sphincter-saving resections. In this study, we present our results on patients undergoing robotic and laparoscopic low anterior resection (LAR) consecutively for rectal adenocarcinoma

Increased Caseload Volume is Associated With Better Oncologic Outcomes After Laparoscopic Resections for Colorectal Cancer

Purpose: To evaluate the impact of caseload volume on the outcomes of open and laparoscopic surgery for colorectal cancer

GPR56 homozygous nonsense mutation p.R271*associated with phenotypic variability in bilateral frontoparietal polymicrogyria

Polymicrogyria is a disorder of neuronal migration characterized by excessive cortical folding and partially fused gyri separated by shallow sulci. Homozygous mutations in the GPR56 gene, which regulates migration of neural precursor cells, are associated with bilateral frontoparietal polymicrogyria (BFPP) syndrome including white matter changes, brainstem and cerebellar involvement. Herein, we describe three siblings of consanguineous parents with a homozygous germline mutation (p.R271*) located in the seventh exon of the GPR56 gene that was previously detected in only one Portuguese patient. Phenotypic/genotypic relationships were analysed according to the clinical characteristics in only index patient. While earlier reported patient was exhibiting seizures provoked by hot water, macrocephaly, cerebellar/brainstem hypoplasia and corpus callosum abnormalities, the index patient showed only hypoplasia of brainstem, focal onset bilateral tonic clonic seizure. Despite the phenotypic similarities in two patients, the potential causes of the variation in the expression of the p.R271* variant between the two affected families might be genetic or epigenetic factors beyond the GPR56 gene. Consequently, the present findings show that the same mutation in GPR56 gene can have different phenotypic effects. Therefore, additional functional studies are needed to detect the phenotypic spectrum of the p.R271* mutation in GPR56, and provide insight into the mechanism of normal cortical development and regional patterning of the cerebral cortex

Fall Of Another Myth For Colon Cancer: Duration Of Symptoms Does Not Differ Between Right- Or Left-Sided Colon Cancers

Background/Aims: Patients with colorectal cancer continue to present with relatively advanced tumors that are associated with poor oncological outcomes. The aim of the present study was to assess the association between localization, symptom duration, and tumor stage. Materials and Methods: A prospective, multicenter cohort study was conducted on patients newly diagnosed with a histologically proven colorectal adenocarcinoma. Standardized questionnaire-interviews were performed. Data were collected on principal presenting symptoms, duration of symptoms (time to first presentation to a doctor and time to diagnosis) and treatment, diagnostic procedures, tumor site, and stage of the tumor (tumor, node, and metastasis (TNM)). Results: A total of 1795 patients with colorectal cancer were interviewed (mean age: 60.76 +/- 13.50 years, male patients: 1057, patients aged >50 years: 1444, colon/rectal cancer: 899/850, right side/left side: 383/1250, stage 0-1-2/stage 3-4: 746/923). No statistically significant correlations were found between duration of symptoms and either tumor site or stage. Principal presenting symptoms were significantly associated with left colon cancer. Patients who had “anemia,” “change in bowel habits,” “anal pruritus or discharge,” “ weight loss,” and “tumor in right colon” had a significantly longer symptom time. Conclusion: Symptom duration is not associated with localization, nor is the tumor stage. Diagnosis of colorectal cancer at an earlier stage may be best achieved by screening of the population.WoSPubMe