Robotic-Assisted Surgery in Cancers: New Technologies and New Strategies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 1169

Special Issue Editor


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Guest Editor
Oncologic Colorectal Surgical Unit and Robotic Surgery Unit, Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy
Interests: indocyanine green fluorescence; anastomotic leak; robotic surgery; colorectal surgery

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is the third most common tumor in men and the second most common in women. Actually, it is the fourth most common cancer-related cause of death globally. To obtain the state of the art, CRC treatment must be multidisciplinary in order to ensure personalized therapies according to the disease’s evolution. Nevertheless, colorectal surgery represents the cornerstone in CRC treatment. It alone has proved to be sufficient in terms of OS and DFS in the lower stages, while in the advanced stages, it retains its role in combination with chemotherapy, radiotherapy, and, in limited cases, with metastasis surgery. Colorectal surgery can be followed by complications such as bleeding, infections, and stenosis, but anastomotic leak (AL) remains the most feared by surgeons.

Anastomotic leak is one of the most severe complications in colorectal surgery, with it having correlations to a higher mortality rate. It has several risk factors, but the vascularization of the colic stumps plays a central role in the onset process. With the development of minimally invasive surgery, many studies have noted the benefits of indocyanine green fluorescence and demonstrated its efficacy and safety in the evaluation of visceral ischemia. The limits of this method are linked to operator dependence in the evaluation of arterial perfusion and venous outflow, but the arrival of robotic surgery and new generation systems represent a hope of overcoming them.

Dr. Marcello Gasparrini
Guest Editor

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Keywords

  • indocyanine green fluorescence
  • anastomotic leak
  • robotic surgery
  • colorectal surgery

Published Papers (1 paper)

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Research

11 pages, 1647 KiB  
Article
The Transabdominal Lumbar Approach (TALA) for Robotic Renal Surgery—A Retrospective Single-Center Comparative Study and Step-by-Step Description of a Novel Approach
by Franziska Maria Heining, Uwe Bieri, Tilo Niemann, Philipp Maletzki, Christopher Tschung, Jean-Pascal Adank, Fabian Rössler, Antonio Nocito and Lukas John Hefermehl
Cancers 2024, 16(2), 446; https://doi.org/10.3390/cancers16020446 - 20 Jan 2024
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Abstract
The transperitoneal approach (TP) and the retroperitoneal approach (RP) are two common methods for performing nephrectomy or partial nephrectomy. However, both approaches face difficulties, such as trocar placement and limited working space (RP). TP is impaired in the case of dorsal tumors and [...] Read more.
The transperitoneal approach (TP) and the retroperitoneal approach (RP) are two common methods for performing nephrectomy or partial nephrectomy. However, both approaches face difficulties, such as trocar placement and limited working space (RP). TP is impaired in the case of dorsal tumors and dissection of the renal artery can be challenging due to the anatomic localization dorsally to the renal vein. A hybrid approach that combines both methods has been previously reported in a case series, but not evaluated systematically. This study proposes a modified hybrid approach, which we call the transabdominal lumbar approach (TALA), involving late robotic docking after elaborating the retroperitoneum using conventional laparoscopy. The study compares the last 20 consecutive patients who underwent RP and the last 20 patients who underwent TALA at our institution. The investigated variables include operative time and amount of blood loss, hospitalization duration, postoperative analgesia requirement, and postoperative complications. The study found no significant difference in operative time, blood loss, ischemia time, or hospital stay between the two groups. The TALA group had fewer complications regarding Clavien–Dindo category 3, but one complication of category 4. In Conclusion, TALA is a safe and promising approach that combines the advantages of RP and TP. Full article
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