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Zwart, Maurice J. W.; Jones, Leia R.; Fuente, Ignacio; Balduzzi, Alberto; Takagi, Kosei; Novak, Stephanie; Stibbe, Luna A.; de Rooij, Thijs; van Hilst, Jony; van Rijssen, L. Bengt; van Dieren, Susan; Vanlander, Aude; van den Boezem, Peter B.; Daams, Freek; Mieog, J. Sven D.; Bonsing, Bert A.; Rosman, Camiel; Festen, Sebastiaan; Luyer, Misha D.; Lips, Daan J.; Moser, Arthur J.; Busch, Olivier R.; Abu Hilal, Mohammad; Hogg, Melissa E.; [...]

Performance with robotic surgery versus 3D- and 2D­laparoscopy during pancreatic and biliary anastomoses in a biotissue model: pooled analysis of two randomized trials

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  • Medientyp: E-Artikel
  • Titel: Performance with robotic surgery versus 3D- and 2D­laparoscopy during pancreatic and biliary anastomoses in a biotissue model: pooled analysis of two randomized trials
  • Beteiligte: Zwart, Maurice J. W.; Jones, Leia R.; Fuente, Ignacio; Balduzzi, Alberto; Takagi, Kosei; Novak, Stephanie; Stibbe, Luna A.; de Rooij, Thijs; van Hilst, Jony; van Rijssen, L. Bengt; van Dieren, Susan; Vanlander, Aude; van den Boezem, Peter B.; Daams, Freek; Mieog, J. Sven D.; Bonsing, Bert A.; Rosman, Camiel; Festen, Sebastiaan; Luyer, Misha D.; Lips, Daan J.; Moser, Arthur J.; Busch, Olivier R.; Abu Hilal, Mohammad; Hogg, Melissa E.; [...]
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: Surgical Endoscopy, 36 (2022) 6, Seite 4518-4528
  • Sprache: Englisch
  • DOI: 10.1007/s00464-021-08805-3
  • ISSN: 0930-2794; 1432-2218
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Robotic surgery may improve surgical performance during minimally invasive pancreatoduodenectomy as compared to 3D- and 2D-laparoscopy but comparative studies are lacking. This study assessed the impact of robotic surgery versus 3D- and 2D-laparoscopy on surgical performance and operative time using a standardized biotissue model for pancreatico- and hepatico-jejunostomy using pooled data from two randomized controlled crossover trials (RCTs).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Pooled analysis of data from two RCTs with 60 participants (36 surgeons, 24 residents) from 11 countries (December 2017–July 2019) was conducted. Each included participant completed two pancreatico- and two hepatico-jejunostomies in biotissue using 3D-robotic surgery, 3D-laparoscopy, or 2D-laparoscopy. Primary outcomes were the objective structured assessment of technical skills (OSATS: 12–60) rating, scored by observers blinded for 3D/2D and the operative time required to complete both anastomoses. Sensitivity analysis excluded participants with excess experience compared to others.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 220 anastomoses were completed (robotic 80, 3D-laparoscopy 70, 2D­laparoscopy 70). Participants in the robotic group had less surgical experience [median 1 (0–2) versus 6 years (4–12), <jats:italic>p</jats:italic> &lt; 0.001], as compared to the laparoscopic group. Robotic surgery resulted in higher OSATS ratings (50, 43, 39 points, <jats:italic>p</jats:italic> = .021 and <jats:italic>p</jats:italic> &lt; .001) and shorter operative time (56.5, 65.0, 81.5 min, <jats:italic>p</jats:italic> = .055 and <jats:italic>p</jats:italic> &lt; .001), as compared to 3D- and 2D­laparoscopy, respectively, which remained in the sensitivity analysis.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In a pooled analysis of two RCTs in a biotissue model, robotic surgery resulted in better surgical performance scores and shorter operative time for biotissue pancreatic and biliary anastomoses, as compared to 3D- and 2D-laparoscopy.</jats:p> </jats:sec>