Surgical endoscopy
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Comparative Study
Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries.
The introduction of minimally invasive platforms for colorectal surgery-laparoscopy and more recently robotics-allows for smaller incisions, shortened hospital stay, less postoperative pain, and quicker return to normal activity. There exists a lack of evidence-based knowledge comparing the clinical outcomes and cost-benefit analysis of the different types of minimally invasive surgery. The aim of this study was to analyze and compare the short-term clinical outcomes and overall hospital costs between laparoscopic and robotic colorectal surgery. ⋯ Robotic colectomies were comparable to laparoscopic colectomies in terms of overall hospital charges and short-term clinical outcomes, including length of stay and conversion rates. Robotic surgery was favored for left-sided colectomy. With shorter learning curves and wider availability, robotic approach offers a safe and economically feasible minimally invasive platform for complex colorectal resections.
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Case Reports
Robot-assisted hepatectomy and complete excision of the extrahepatic bile duct for type IV-A choledochal cysts.
Complete removal of the dilated biliary tree is regarded as inevitable in choledochal cysts due to its malignant potential. However, technical difficulty and the high risk of postoperative complications as well as the various presentations of the disease make the surgical options for type IV-A cysts challenging and controversial. We report the first case of a type IV-A choledochal cyst treated using a robot-assisted approach. ⋯ Hepatectomy and complete excision of the extrahepatic bile duct for type IV-A choledochal cysts requires fine and delicate surgical techniques. The wrist-like movement of the working instruments and the firefly imaging of the robot surgical system allowed this advanced minimally invasive surgery to be successfully performed on this patient.