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Robot-Assisted Surgery: New Trends and Solutions
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Robot-Assisted Surgery: New Trends and Solutions

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (20 February 2025) | Viewed by 3940

Special Issue Editors

Dr. Davide Ghinolfi

E-Mail Website
Guest Editor
Division of Hepatic Surgery and Liver Transplantation, University of Pisa Hospital, Pisa, Italy
Interests: liver transplantation; machine perfusion; organ therapeutics; extended criteria grafts; ischemia reperfusion injury
Dr. Felipe Boff Maegawa

E-Mail Website
Guest Editor
Division of General & Gastrointestinal Surgery, Department of Surgery, Emory University, Atlanta, GA, USA
Interests: general and hepatopancreatobiliary surgery

Special Issue Information

Dear Colleagues,

Robot-assisted surgery represents a breakthrough comparable to the advent of laparoscopic surgery in the 1980s and the introduction of anesthesia.

Despite its revolutionary potential, its spreading is still uneven across hospitals and countries, and is confined to the wealthiest countries and tertiary medical facilities due to its economic burden and the need for extensive surgical expertise and prolonged training.

In the next few years, a broader dissemination of robotic surgery is expected, involving in this revolution both less affluent countries and spoke hospitals.

An increased diffusion of these facilities will allow patients to access state-of-the-art treatments, presently reserved for patients who seek care at third-level departments, but will also extend surgical indication, allowing for otherwise limited surgeries to fit and young patients.

This Special Issue aims to shed light on this revolution and how robotic surgery will spread around the country and the world. Additionally, it will explore how robotic surgery may extend surgical indications in minimally invasive surgery, which new devices will be developed, how they will be used in a robotic setting and how tutoring and teaching will change.

In conclusion, we will attempt to analyze how the repercussions of this paradigm shift will impact the daily lives of healthcare workers and patients.

Dr. Davide Ghinolfi
Dr. Felipe Boff Maegawa
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • robotic surgery
  • minimally invasive abdominal surgery
  • minimally invasive liver surgery
  • minimally invasive pancreatic surgery

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Published Papers (3 papers)

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Research

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12 pages, 4705 KiB  
Article
Transabdominal Robotic-Assisted Partial Nephrectomy and CT-Guided Percutaneous Cryoablation for the Treatment of De Novo Kidney Tumors After Liver Transplantation
by Emanuele Balzano, Lorenzo Bernardi, Gianvito Candita, Arianna Trizzino, Lorenzo Petagna, Elena Bozzi, Paola Scalise, Alessandra Cristaudi, Giovanni Tincani, Daniele Pezzati, Davide Ghinolfi and Laura Crocetti
Life 2025, 15(2), 254; https://doi.org/10.3390/life15020254 - 7 Feb 2025
Viewed by 526
Abstract
The management of de novo kidney tumors (DKTs) after liver transplantation (LT) is challenging due to previous transplant surgery and calcineurin inhibitors (CNI)-related nephrotoxicity. Minimally invasive renal-sparing strategies like robot-assisted partial nephrectomy (RPN) are favored, but a transperitoneal approach may be limited by [...] Read more.
The management of de novo kidney tumors (DKTs) after liver transplantation (LT) is challenging due to previous transplant surgery and calcineurin inhibitors (CNI)-related nephrotoxicity. Minimally invasive renal-sparing strategies like robot-assisted partial nephrectomy (RPN) are favored, but a transperitoneal approach may be limited by the previous transplant surgery and the location of the DKT; in such cases, CT-guided cryoablation may be an alternative option. In this retrospective cohort study, we aimed to compare RPN and cryoablation for the treatment of DKT in LT recipients. The primary endpoints were the efficacy (R0 resection in RPN, absence of the tumor at first follow-up for cryoablation) and the safety of the procedures (postoperative morbidity and increase in creatine level). The periprocedural costs and the oncologic efficacy (recurrence and overall survival) were the secondary endpoints. Twelve LT recipients (91.7% males, mean age 65 years) underwent RPN (n = 6) or cryoablation (n = 6) for DKT; the median interval between LT and diagnosis of DKT was 142.5 vs. 117.5 months, respectively. Efficacy was obtained in all patients after RPN and cryoablation. Postoperative morbidity was 16.7% in each group, and the postoperative increase in creatinine values was similar. Hospital stay was shorter following cryoablation vs. RPN (3.1 vs. 6.7 days; p = 0.03). The mean procedural costs were higher for RPN. There was no mortality and none of the patients had signs of recurrence after a median follow-up of 40.5 months. Both RPN and CT-guided cryoablation were safe and effective for the treatment of selected patients with DKT after LT. When applicable, cryoablation may be cost-effective and provide faster recovery. Full article
(This article belongs to the Special Issue Robot-Assisted Surgery: New Trends and Solutions)
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11 pages, 2014 KiB  
Article
The Combination of Laparoscopic and Robotic Surgery: First Experience with the Dexter Robotic System™ in Visceral Surgery
by Pernilla Virginia Conrad, Anne-Sophie Mehdorn, Ibrahim Alkatout, Thomas Becker, Jan Henrik Beckmann and Julius Pochhammer
Life 2024, 14(7), 874; https://doi.org/10.3390/life14070874 - 12 Jul 2024
Cited by 1 | Viewed by 1421
Abstract
Introduction: For over two decades, abdominal surgical procedures have been safely performed robotically. After the first patent expiration, alternative robotic systems entered the market. The Dexter Robotic System™ is a small-format, modular, and robotic platform consisting of a surgeon’s console, two patient carts [...] Read more.
Introduction: For over two decades, abdominal surgical procedures have been safely performed robotically. After the first patent expiration, alternative robotic systems entered the market. The Dexter Robotic System™ is a small-format, modular, and robotic platform consisting of a surgeon’s console, two patient carts with instrument arms, and one endoscope arm. We report our initial experiences with Dexter since its installation at our visceral surgery department. Methods: The system and surgical setup are described. Demographic and perioperative data of all operated patients as well as the system docking times were analyzed. Results: From 56 procedures performed with Dexter, the most common ones included cholecystectomy (n = 15), inguinal hernia repair (TAPP; unilateral n = 15; bilateral n = 3), and right oncologic hemicolectomy (n = 15). The median docking time was 6 min (2–16 min) and was reduced to 4 min in the last tertile of procedures performed. Conclusions: In our experience, Dexter can be implemented without any major challenges, and visceral surgical procedures of simple to medium complexity can be performed safely. The simplicity and accessibility of the system along with the ease of switching between robotics and laparoscopy could be particularly suitable for beginners in robotic surgery Full article
(This article belongs to the Special Issue Robot-Assisted Surgery: New Trends and Solutions)
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10 pages, 619 KiB  
Systematic Review
The Current Role of Single-Site Robotic Approach in Liver Resection: A Systematic Review
by Simone Guadagni, Annalisa Comandatore, Niccolò Furbetta, Gregorio Di Franco, Bianca Bechini, Filippo Vagelli, Niccolò Ramacciotti, Matteo Palmeri, Giulio Di Candio, Elisa Giovannetti and Luca Morelli
Life 2024, 14(7), 894; https://doi.org/10.3390/life14070894 - 19 Jul 2024
Cited by 1 | Viewed by 1211
Abstract
Background: Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable [...] Read more.
Background: Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable ergonomic vision. Among robotic techniques, the single-site approach has garnered increasing attention due to its potential to minimize surgical trauma and improve cosmetic outcomes. However, the full extent of its utility and efficacy in liver resection has yet to be thoroughly explored. Methods: We conducted a comprehensive systematic review to evaluate the current role of the single-site robotic approach in liver resection. A detailed search of PubMed was performed to identify relevant studies published up to January 2024. Eligible studies were critically appraised, and data concerning surgical outcomes, perioperative parameters, and post-operative complications were extracted and analyzed. Results: Our review synthesizes evidence from six studies, encompassing a total of seven cases undergoing robotic single-site hepatic resection (SSHR) using various versions of the da Vinci© system. Specifically, the procedures included five left lateral segmentectomy, one right hepatectomy, and one caudate lobe resection. We provide a summary of the surgical techniques, indications, selection criteria, and outcomes associated with this approach. Conclusion: The single-site robotic approach represents an option among the minimally invasive approaches in liver surgery. However, although the feasibility has been demonstrated, further studies are needed to elucidate its optimal utilization, long-term outcomes, and comparative effectiveness against the other techniques. This systematic review provides valuable insights into the current state of single-site robotic liver resection and underscores the need for continued research in this rapidly evolving field. Full article
(This article belongs to the Special Issue Robot-Assisted Surgery: New Trends and Solutions)
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