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| 1 | Laparoscopic colorectal surgery:current status andimplementation of the latest technological innovations显示文摘The introduction of laparoscopy is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of controlled studiesand meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits than other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. On the other hand, despite initial concerns about oncological safety, well-designed prospective randomized multicentre trials have demonstrated that oncological outcomes of laparoscopy and open surgery are similar. Although the use of laparoscopy in colorectal surgery has increased in recent years, the percentages of patients treated with surgery using minimally invasive techniques are still reduced and there are also substantial differences among centres. It has been argued that the limiting factor for the use of laparoscopic procedures is the number of surgeons with adequate skills to perform a laparoscopic colectomy rather than the tumour of patients' characteristics. In this regard, future efforts to increase the use of laparoscopic techniques in colorectal surgery will necessarily require more efforts in teaching surgeons. We here present a review of recent controversies of the use of laparoscopy in colorectal surgery, such as in rectal cancer operations, the possibility of reproducing complete mesocolon excision, and the benefits of intracorporeal anastomosis after right hemicolectomy. We also describe the results of latest innovations such as single incision laparoscopic surgery, robotic surgery and natural orifice transluminal endoscopic surgery for colon and rectal diseases. | Marta Pascual Silvia Salvans Miguel Pera | 2016 | World Journal of Gastroenterology2016，22，2： | 32 |
| 2 | Laparoscopic and robot-assisted laparoscopic digestivesurgery:Present and future directions显示文摘Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen's fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric resection, the laparoscopic approach is frequently used and its usefulness is unquestionable. More complex procedures, such as esophageal, liver or pancreatic resections are, however, more infrequently performed, due to the high grade of skill necessary. As a result, there is less clinical evidence to support its implementation. In the recent years, robot-assisted laparoscopic surgery has been increasingly applied, again with little evidence for comparison with the conventional laparoscopic approach. This review will focus on the complex digestive procedures as well as those whose use in standard practice could be more controversial. Also novel robot-assisted procedures will be updated. | Juan C Rodríguez-Sanjuán Marcos Gómez-Ruiz Soledad Trugeda-Carrera Carlos Manuel-Palazuelos Antonio López-Useros Manuel Gómez-Fleitas | 2016 | World Journal of Gastroenterology2016，22，6： | 27 |
| 3 | Neoadjuvant radiotherapy for rectal cancer management显示文摘Thirty per cent of all colorectal tumours develop in the rectum.The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions.Most patients with early rectal cancer can be adequately managed by surgery alone.However,a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery.Neoadjuvant therapy involves a variety of options including radiotherapy,chemotherapy used alone or in combination.Neoadjuvant radiotherapy in rectal cancer has been shown to be effective in reducing tumour burden in advance of curative surgery.The gold standard surgical rectal cancer management aims to achieve surgical removal of the tumour and all draining lymph nodes,within an intact mesorectal package,in order to minimise local recurrence.It is critically important that all rectal cancer cases are discussed at a multidisciplinary meeting represented by all relevant specialties.Pre-operative staging including CT thorax,abdomen,pelvis to assess for distal disease and magnetic resonance imaging to assess local involvement is essential.Staging radiology and MDT discussion are integral in identifying patients who require neoadjuvant radiotherapy.While Neoadjuvant radiotherapy is potentially beneficial it may also result in morbidity and thus should be reserved for those patients who are at a high risk of local failure,which includes patients with nodal involvement,extramural venous invasion and threatened circumferential margin.The aim of this review is to discuss the role of neoadjuvant radiotherapy in the management of rectal cancer. | Gerard Feeney Rishabh Sehgal Margaret Sheehan Aisling Hogan Mark Regan Myles Joyce Michael Kerin | 2019 | World Journal of Gastroenterology2019，25，33： | 28 |
| 4 | Robot-assisted one-stage resection of rectal cancer with liver and lung metastases显示文摘The Da Vinci Surgical System may help to overcome some of the difficulties of laparoscopy for complicated abdominal surgery.The authors of this article present a case of robot-assisted, one-stage radical resection of three tumors, including robotic anterior resection for rectal cancer, segmental hepatectomy for liver metastasis, and wedge-shaped excision for lung metastasis.A 59-year-old man with primary rectal cancer and liver and lung metastases was operated upon with a one-stage radical resection approach using the Da Vinci Surgical System.Resection and anastomosis of rectal cancer were performed extracorporeally afterundocking the robot.The procedure was successfully completed in 500 min.No surgical complications occurred during the intervention and postoperative period, and no conversion to laparotomy or additional trocars were required.To the best of our knowledge, this is the first case of simultaneous resection for rectal cancer with liver and lung metastases using the Da Vinci Surgery System to be reported.The procedure is feasible and safe and its main advantages for patient are avoiding repeated operation, reducing surgical trauma, shortening recovery time, and early implementation of postoperative adjuvant therapy. | Jian-Min Xu Ye Wei Xiao-Ying Wang Hong Fan Wen-Ju Chang Li Ren Wei Jiang Jia Fan Xin-Yu Qin | 2015 | World Journal of Gastroenterology2015，21，9： | 23 |
| 5 | Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery显示文摘AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision(TME) with curative intent between January 2008 and December 2014(robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage?Ⅰ-Ⅲ disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME(L-TME) and 342 min for robotic TME(R-TME)(P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. Thepatients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients(8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group(18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients(1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies. | Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi Giampaolo Formisano Marco Scatizzi | 2016 | World Journal of Gastroenterology2016，22，13： | 22 |
| 6 | Full robot-assisted gastrectomy with intracorporeal robot-sewn anastomosis produces satisfying outcomes显示文摘AIM:To evaluate the feasibility and safety of full robotassisted gastrectomy with intracorporeal robot handsewn anastomosis in the treatment of gastric cancer.METHODS:From September 2011 to March 2013,110consecutive patients with gastric cancer at the authors’institution were enrolled for robotic gastrectomies.According to tumor location,total gastrectomy,distal or proximal subtotal gastrectomy with D2 lymphadenectomy was fully performed by the da Vinci Robotic Surgical System.All construction,including Roux-en-Y jejunal limb,esophagojejunal,gastroduodenal and gastrojejunal anastomoses were fully carried out by the intracorporeal robot-sewn method.At the end of surgery,the specimen was removed through a 3-4 cm incision at the umbilicus trocar point.The details of the surgical technique are well illustrated.The benefits in terms of surgical and oncologic outcomes are well documented,as well as the failure rate and postoperative complications.RESULTS:From a total of 110 enrolled patients,radical gastrectomy could not be performed in 2 patients due to late stage disease;1 patient was converted to laparotomy because of uncontrollable hemorrhage,and1 obese patient was converted due to difficult exposure;2 patients underwent extra-corporeal anastomosis by minilaparotomy to ensure adequate tumor margin.Robot-sewn anastomoses were successfully performed for 12 proximal,38 distal and 54 total gastrectomies.The average surgical time was 272.52±53.91 min and the average amount of bleeding was 80.78±32.37 mL.The average number of harvested lymph nodes was 23.1±5.3.All specimens showed adequate surgical margin.With regard to tumor staging,26,32 and 46 patients were staged asⅠ,ⅡandⅢ,respectively.The average hospitalization time after surgery was 6.2 d.One patient experienced a duodenal stump anastomotic leak,which was mild and treated conservatively.One patient was readmitted for intra-abdominal infection and was treated conservatively.Jejunal afferent loop obstruction occurred in 1 patient,who underwent re-operation and recovered quickly.CONCLUSION:This technique is feasible and can produce satisfying postoperative outcomes.It is also convenience and reliable for anastomoses in gastrectomy.Full robotic hand-sewn anastomosis may be a minimally invasive technique for gastrectomy surgery. | Xin-Xin Liu Zhi-Wei Jiang Ping Chen Yan Zhao Hua-Feng Pan Jie-Shou Li | 2013 | World Journal of Gastroenterology2013，19，38： | 15 |
| 7 | Robotic gastrectomy with transvaginal specimen extraction for female gastric cancer patients显示文摘AIM: To describe the application of complete robotic gastrectomy with transvaginal specimen extraction(TVSE) for gastric cancer patients.METHODS: Between July and November 2014, eight female patients who were diagnosed with gastric adenocarcinoma underwent a TVSE following a full robot-sewn gastrectomy. According to the tumor location, the patients were allocated to two different groups; two patients received robotic total gastrectomy with TVSE and the other six received robotic distal gastrectomy with TVSE.RESULTS: Surgical procedures were successfully performed in all eight cases without conversion. The mean age was 55.3(range, 42-69) years, and the mean body mass index was 23.2(range, 21.6-26.0) kg/m2. The mean total operative time and blood loss were 224(range, 200-298) min and 62.5(range, 50-150) m L, respectively. The mean postoperative hospital stay was 3.6(range, 3-5) d. The mean number of lymph nodes resected was 23.6(range, 17-27). None was readmitted within 30 d of postoperation. During the follow-up, no stricture developed nor was any anastomotic leakage detected.CONCLUSION: It is possible to perform a TVSE following a full robot-sewn gastrectomy with standard D2 lymph node resection for female gastric cancer patients. | Shu Zhang Zhi-Wei Jiang Gang Wang Xiao-Bo Feng Jiang Liu Jian Zhao Jie-Shou Li | 2015 | World Journal of Gastroenterology2015，21，47： | 12 |
| 8 | Robotic surgical systems in maxillofacial surgery:a review显示文摘Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery.However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless,robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems. | Hang-Hang Liu Long-Jiang Li Bin Shi Chun-Wei Xu En Luo | 2017 | International Journal of Oral Science2017，9，2： | 11 |
| 9 | Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery显示文摘AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: 'rectal cancer' or 'colorectal cancer' and robot* or 'da Vinci' and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726(54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and threesexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required. | Sofoklis Panteleimonitis Jamil Ahmed Mick Harper Amjad Parvaiz | 2016 | World Journal of Gastrointestinal Surgery2016，8，11： | 7 |
| 10 | Application of robotics in gastrointestinal endoscopy:Areview显示文摘Multiple robotic flexible endoscope platforms have been developed based on cross specialty collaboration between engineers and medical doctors. However, significant number of these platforms have been developed for the natural orifice transluminal endo-scopic surgery paradigm. Increasing amount of evidence suggest the focus of development should be placed on advanced endolumenal procedures such as endoscopic submucosal dissection instead. A thorough literature analysis was performed to assess the current status of robotic flexible endoscopic platforms designed for advanced endolumenal procedures. Current efforts are mainly focused on robotic locomotion and robotic instrument control. In the future, advances in actuation and servoing technology, optical analysis, augmented reality and wireless power transmission technology will no doubt further advance the field of robotic endoscopy. Globally, health systems have become increasingly budget conscious; widespread acceptance of robotic endoscopy will depend on careful design to ensure its delivery of a cost effective service. | Baldwin Po Man Yeung Philip Wai Yan Chiu | 2016 | World Journal of Gastroenterology2016，22，5： | 6 |
| 11 | Robotic-assisted surgery for pediatric choledochal cyst: Case report and literature review显示文摘Our paper describes the key surgical points of pediatric choledochocystectomy performed completely by Da Vinci robotic system. A choledochocystectomy was safely carried out for a girl at our hospital, and without any complication. Then systematic literature review was done to discuss the methods of intestine surgery and intestinal anastomosis, the use of 3 rd robotic arm, the surgical safety and advantages comparing open and laparoscopic surgery. We systematically reviewed choledochocystectomy for children performed by robotic surgery. We included a total of eight domestic and foreign reports and included a total of 86 patients, whose average age was 6.3(0.3-15.9) years; the maleto-female ratio was 1:3.5(19:67). Seven patients experienced conversion to open surgery, and the surgery success rate was 91.9%(79/86). The average total operation time was 426(180-520) min, the operation time on the machine was 302(120-418) min, 11 cases used the number 3 arm, and the remaining mainly used the hitch-stitch technique to suspend the stomach wall and liver. Forty-seven patients underwent pull-through intestine and intestinal anastomosis, and 39 patients underwent complete robotic intestine surgery and intestinal anastomosis. The hospitalization time of roboticassisted choledochocystectomy was 8.8 d. Eight patientshad biliary fistula and were all cured by conservative treatment and continuous observation. One patient had anastomotic stenosis, and one patient had wound dehiscence, both cured by surgery. Choledochocystectomy for children performed by completely robotic surgery and Roux-en-Y hepaticojejunostomy is safe and feasible. The initial experience shows that this surgical approach has a clearer field than the traditional endoscopy, and its operation is more flexible, the surgery is more accurate, and the injury is smaller. With the advancement of technology and the accumulation of surgeons' experience, robotic surgery may become a new trend in this surgical procedure. | Xian-Qiang Wang Shu-Juan Xu Zheng Wang Yuan-Hong Xiao Jing Xu Zhen-Dong Wang Di-Xiang Chen | 2018 | World Journal of Clinical Cases2018，6，7： | 5 |
| 12 | Robot-assisted gallbladder-preserving hepatectomy for treating S5 hepatoblastoma in a child: A case report and review of the literature显示文摘BACKGROUND Hepatoblastoma(HB) is the most common hepatic malignant tumour in children,accounting for approximately 50%-60% of primary hepatic malignant tumours in children, mostly in children under 3 years old. In Western countries, the incidence of hepatoblastoma is approximately 1-2/100000. Da Vinci surgical system is fast becoming a key instrument in microinvasive surgery. The past decade has seen the rapid development of robot-assisted laparoscopy, which expends many fields including the liver surgery. This paper discusses the significance and feasibility of robot-assisted gallbladder-preserving hepatectomy for treating S5 hepatoblastoma in children. The aim of this essay is to compare the safety and effectiveness of robotic surgery with conventional laparoscopic surgery, and explore the meaning of preservation of the gallbladder by sharing this case.CASE SUMMARY A 3-year-old child with a liver mass in the 5 th segment was treated using the Da Vinci surgical system, and the gallbladder was retained. The child was admitted to the hospital for 20 d for the discovery of the right hepatic lobe mass.Ultrasonography revealed a low echo mass, 46 mm × 26 mm × 58 mm in size,indicating hepatoblastoma in the right lobe, and enhanced computed tomography showed continuous enhancement of iso-low-density lesions with different sizes and nodules and unclear boundaries, without the dilation of the intrahepatic bile duct, no enlargement of the gallbladder, and uniform thickness of the wall. The diagnosis was 'liver mass, hepatoblastoma'. It was decided to perform S5 liver tumour resection. During surgery, the tumour and gallbladder were isolated first, and the gallbladder could be completely separated from the tumour surface without obvious infiltration; therefore, the gallbladder was preserved. The cutting line was marked with an electric hook. The hepatic duodenal ligament was blocked with a urethral catheter using the Pringle method, and the tumour and part of the normal liver tissue were completely resected with an ultrasound knife along the incision. The hepatic portal interdiction time was approximately 25 min. An abdominal drainage tube was inserted. The auxiliary hole was connected to the lens, and the specimen was removed. The patient's status was uneventful, and the operation time was 166 min. The robotic time was 115 min, and the bleeding amount was approximately 200 mL. In total, 300 mL of red blood cell suspension and 200 mL of plasma were injected. No serious complications occurred. Pathological findings confirmed fetal hepatoblastoma and R0 resection. A gallbladder contraction test was performed two weeks after surgery.CONCLUSION Robot-assisted S5 hepatectomy with gallbladder preservation is safe and feasible for specific patients. | Di-Xiang Chen Shan-Jie Wang Ya-Nan Jiang Mu-Chuan Yu Jun-Zhen Fan Xian-Qiang Wang | 2019 | World Journal of Clinical Cases2019，7，7： | 5 |
| 13 | Present laparoscopic surgery for colorectal cancer in Japan显示文摘In many clinical studies,laparoscopic surgery(LS) for colon cancer has been shown to be less invasive than open surgery(OS) while maintaining similar safety.Furthermore,there are no significant differences between LS and OS in long-term outcomes.Thus,LS has been accepted as one of the standard treatments for colon cancer.In the treatments of rectal cancer as well,LS has achieved favorable outcomes,with many reports showing long-term outcomes comparable to those of OS.Furthermore,the magnification in laparoscopy improves visualization in the pelvic cavity and facilitates precise manipulation,as well as providing excellent educational effects.For these reasons,rectal cancer has seemed to be well indicated for LS,as has been colon cancer.The indication for LS in the treatment of locally advanced rectal cancer,which is relatively unresectable(e.g.,cancer invading other organs),remains an open issue.In recent years,new techniques such as singleport and robotic surgery have begun to be introduced for LS.Presently,various clinical studies in our country as well as in most Western countries have demonstrated that LS,with these new techniques,are gradually showing long-term outcomes. | Takeo Sato Masahiko Watanabe | 2016 | World Journal of Clinical Oncology2016，7，2： | 5 |
| 14 | Totally robotic vs 3D laparoscopic colectomy: A single centers preliminary experience显示文摘AIM: to compare robotic and three-dimensional(3D) laparoscopic colectomy based on the literature and our preliminary experience.METHODS: This retrospective observational study compared operative measures and postoperative outcomes between laparoscopic 3D and robotic colectomy for cancer. From September 2013 to September 2014,24 robotic colectomies and 23 3D laparoscopic colectomy were performed at our Department. Data were analyzed and reported both by approach and by colectomy side. Robotic left colectomy(RL) vs laparoscopic 3D left colectomy(LL 3D) and Robotic right colectomy(RR) vs laparoscopic 3D(LR 3D). Rectal cancer procedures were not included.RESULTS: There were 18 RR and 11 LR 3D,6 RL and 12 LL 3D. As regards LR 3D,extracorporeal anastomosis(EA) was performed in 7 patients and intracorporeal anastomosis(IA) in 4; the RR group included 14 IA and 4 EA. There was no mortality. Median operative time was higher for the robotic group while conversion rate(12.5% vs 13%) and lymph nodes removed(14 vs 13) were similar for both. First flatus time was 1 d for RR and 2 d the other patient groups. Oral intake was resumed in 1 d by LR and in 2 d by the other patients(P = 0.012). Overall cost was €4950 and €1950 for RL and LL 3D,and €4450 and €1450 for RR and LR 3D,respectively. CONCLUSION: There were no differences betweenRR and LR 3D,except that IA was easier with RR,and probably contributed with the learning curve to the longer operative time recorded. Both techniques offer similar advantages for the patient with significantly different costs. In left colectomies robotic colectomy provided better outcomes,especially in resections approaching the rectum. | Mario Guerrieri Roberto Campagnacci Pierluigi Sperti Giulio Belfiori Rosaria Gesuita Roberto Ghiselli | 2015 | World Journal of Gastroenterology2015，21，46： | 5 |
| 15 | Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer显示文摘BACKGROUND Pelvic recurrence after rectal cancer surgery is still a significant problem despite the introduction of total mesorectal excision and chemoradiation treatment(CRT),and one of the most common areas of recurrence is in the lateral pelvic lymph nodes.Hence,there is a possible role for lateral pelvic lymph node dissection(LPND)in rectal cancer.AIM To evaluate the short-term outcomes of patients who underwent minimally invasive LPND during rectal cancer surgery.Secondary outcomes were to evaluate for any predictive factors to determine lymph node metastases based on pre-operative scans.METHODS From October 2016 to November 2019,22 patients with stage II or III rectal cancer underwent minimally invasive rectal cancer surgery and LPND.These patients were all discussed at a multidisciplinary tumor board meeting and most of them received neoadjuvant chemoradiation prior to surgery.All patients had radiologically positive lateral pelvic lymph nodes on the initial staging scans,defined as lymph nodes larger than 7 mm in long axis measurement,or abnormal radiological morphology.LPND was only performed on the involved side.RESULTS Majority of the patients were male(18/22,81.8%),with a median age of 65 years(44-81).Eighteen patients completed neoadjuvant CRT pre-operatively.18 patients(81.8%)had unilateral LPND,with the others receiving bilateral surgery.The median number of lateral pelvic lymph nodes harvested was 10(3-22)per pelvic side wall.8 patients(36.4%)had positive metastases identified in the lymph nodes harvested.The median pre-CRT size of these positive lymph nodes was 10 mm.Median length of stay was 7.5 d(3-76),and only 2 patients failed initial removal of their urinary catheter.Complication rates were low,with only 1 lymphocele and 1 anastomotic leak.There was only 1 mortality(4.5%).There have been no recurrences so far.CONCLUSION Chemoradiation is inadequate in completely eradicating lateral wall metastasis and there are still technical limitations in accurately diagnosing metastases in these areas.A pre-CRT lymph node size of≥10 mm is suggestive of metastases.LPND may be performed safely with minimally invasive surgery. | Kar Yong Wong Aloysius MN Tan | 2020 | World Journal of Gastrointestinal Surgery2020，12，4： | 4 |
| 16 | Dealing with robot-assisted surgery for rectal cancer:current status and perspectives显示文摘The laparoscopic approach for treatment of rectal cancer has been proven feasible and oncologically safe, and is able to offer better short-term outcomes than traditional open procedures, mainly in terms of reduced length of hospital stay and time to return to working activity. In spite of this, the laparoscopic technique is usually practised only in high-volume experienced centres, mainly because it requires a prolonged and demanding learning curve. It has been estimated that over 50 operations are required for an experienced colorectal surgeon to achieve proficiency with this technique. Robotic surgery enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, thus promising to overcome some of the technical difficulties associated with standard laparoscopy. It has high-definition threedimensional vision, it translates the surgeon's hand movements into precise movements of the instruments inside the patient, the camera is held and moved by the first surgeon, and a fourth robotic arm is available as a fixed retractor. The aim of this review is to summarise the current data on clinical and oncologic outcomes of robot-assisted surgery in rectal cancer, focusing on short- and long-term results, and providing original data from the authors' centre. | Roberto Biffi Fabrizio Luca Paolo Pietro Bianchi Sabina Cenciarelli Wanda Petz Igor Monsellato Manuela Valvo Maria Laura Cossu Tiago Leal Ghezzi Kassem Shmaissany | 2016 | World Journal of Gastroenterology2016，22，2： | 3 |
| 17 | Minimally invasive surgery for inflammatory bowel disease: Review of current developments and future perspectives显示文摘Patients with inflammatory bowel disease(IBD)com-prise a population of patients that have a high likelihood of both surgical treatment at a young age and repetitive operative interventions.Therefore surgical procedures need to aim at minimizing operative trauma with bestpostoperative recovery.Minimally invasive techniques have been one of the major advancements in surgery in the last decades and are nowadays almost routinely performed in colorectal resections irrespective of underlying disease.However due to special disease related characteristics such as bowel stenosis,interen-teric fistula,abscesses,malnutrition,repetitive sur-geries,or immunosuppressive medications,patients with IBD represent a special cohort with specific needs for surgery.This review summarizes current evidence of minimally invasive surgery for patients with Crohn’s disease or ulcerative colitis and gives an outlook on the future perspective of technical advances in this highly moving field with its latest developments in single port surgery,robotics and trans-anal techniques. | Philipp--Alexander Neumann Emile Rijcken | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，2： | 3 |
| 18 | Short-term efficacy of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy via Huang’s three-step maneuver for advanced upper gastric cancer: Results from a propensity scorematched study显示文摘BACKGROUND Robotic surgery has been considered to be significantly better than laparoscopic surgery for complicated procedures.AIM To explore the short-term effect of robotic and laparoscopic spleen-preserving splenic hilar lymphadenectomy(SPSHL)for advanced gastric cancer(GC)by Huang’s three-step maneuver.METHODS A total of 643 patients who underwent SPSHL were recruited from April 2012 to July 2017,including 35 patients who underwent robotic SPSHL(RSPSHL)and 608 who underwent laparoscopic SPSHL(LSPSHL).One-to-four propensity score matching was used to analyze the differences in clinical data between patients who underwent robotic SPSHL and those who underwent laparoscopic SPSHL.RESULTS In all,175 patients were matched,including 35 patients who underwent RSPSHL and 140 who underwent LSPSHL.After matching,there were no significant differences detected in the baseline characteristics between the two groups.Significant differences in total operative time,estimated blood loss(EBL),splenic hilar blood loss(SHBL),splenic hilar dissection time(SHDT),and splenic trunk dissection time were evident between these groups(P<0.05).Furthermore,no significant differences were observed between the two groups in the overall noncompliance rate of lymph node(LN)dissection(62.9%vs 60%,P=0.757),number of retrieved No.10 LNs(3.1±1.4 vs 3.3±2.5,P=0.650),total number of examined LNs(37.8±13.1 vs 40.6±13.6,P=0.274),and postoperative complications(14.3%vs 17.9%,P=0.616).A stratified analysis that divided the patients receiving RSPSHL into an early group(EG)and a late group(LG)revealed that the LG experienced obvious improvements in SHDT and length of stay compared with the EG(P<0.05).Logistic regression showed that robotic surgery was a significantly protective factor against both SHBL and SHDT(P<0.05).CONCLUSION RSPSHL is safe and feasible,especially after overcoming the early learning curve,as this procedure results in a radical curative effect equivalent to that of LSPSHL. | Jia-Bin Wang Zhi-Yu Liu Qi-Yue Chen Qing Zhong Jian-Wei Xie Jian-Xian Lin Jun Lu Long-Long Cao Mi Lin Ru-Hong Tu Ze-Ning Huang Ju-Li Lin Hua-Long Zheng Si-Jin Que Chao-Hui Zheng Chang-Ming Huang Ping Li | 2019 | World Journal of Gastroenterology2019，25，37： | 2 |
| 19 | Robot-assisted surgery for gastric cancer显示文摘Minimally invasive surgery for gastric cancer is a rela-tively new research field, with convincing results mostly stemming from Asian countries. The use of the robotic surgery platform, thus far assessed as a safe procedure, which is also easier to learn, sets the background for a wider spread of minimally invasive technique in the treatment of gastric cancer. This review will cover the literature published so far, analyzing the pros and cons of robotic surgery and highlighting the remaining study questions. | livia procopiuc stefan tudor mircea manuc mircea diculescu catalin vasilescu | 2016 | World Journal of Gastrointestinal Oncology2016，8，1： | 2 |
| 20 | Robotic surgery of the pancreas显示文摘Pancreatic surgery is one of the most challenging and complex fields in general surgery.While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion.This is attributed to the retroperitoneal location of the pancreas,its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy.Herein,we describe the application of robotic technology to minimally invasive pancreatic surgery.The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes(e.g.,decreased length of stay,less surgical site infections)to conventional open surgery.However,it is unclear whether the robotic approach is truly superior to traditional laparoscopy;this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities. | Daniel Joyce Gareth Morris-Stiff Gavin A Falk Kevin El-Hayek Sricharan Chalikonda R Matthew Walsh | 2014 | World Journal of Gastroenterology2014，20，40： | 2 |
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