Showing papers by "Thomas Schmid published in 2005"
TL;DR: Various general surgical procedures have proved feasible and safe when performed with the da Vinci robot, but robotic surgery does not at the moment represent a general alternative to conventional minimally invasive surgery.
Abstract: Principles The recently introduced robotic surgical systems were developed to overcome the limitations of conventional minimally invasive surgery. We analyse the impact of the da Vinci robotic system on general surgery. Methods The da Vinci operating robot is a telemanipulation system consisting of a surgical arm cart, a master console and a conventional monitor cart. Since its purchase in June 2001, 128 patients have undergone surgery using the da Vinci robot in our department. The mean age of the 78 female and 50 male patients was 52 (range 18-78) years. Results The procedures included 29 cholecystectomies, 16 partial fundoplications, 16 extended thymectomies, 14 colonic interventions, 10 splenectomies, 10 bariatric procedures, 7 hernioplasties, 6 oesophageal interventions, 5 adrenalectomies, 5 lower lobectomies, 4 neurinomectomies and 6 others. 122 of 128 procedures (95%) were completed successfully with the da Vinci robot. Open conversion proved necessary in 4 patients due to surgical problems, and two other procedures were completed by conventional laparoscopy due to robot system technical errors. 30-day mortality was 0%, one redo-operation was necessary and two lower complications not requiring surgical re-intervention occurred. The resection margins of all tumour specimens were histologically tumour free. Conclusions Various general surgical procedures have proved feasible and safe when performed with the da Vinci robot. The advantage of the system is best seen in tiny areas difficult of access and when dissecting delicate, vulnerable anatomical structures. However, in view of longer operating times, higher costs and the lack of adequate instruments, robotic surgery does not at the moment represent a general alternative to conventional minimally invasive surgery.
79 citations
TL;DR: This first series of minimally invasive splenectomies with a robotic surgical system suggests that robotic splenectomy with the da Vinci surgical system is technically feasible and safe and provides an alternative to the conventional laparoscopic procedure.
Abstract: Background: We report our first series of minimally invasive splenectomies with a robotic surgical system. Methods: From August 2001 to October 2003, laparoscopic splenectomies with the da Vinci® operating robot were performed in 7 patients (five females and two males, ages 20 to 74 years). Results: Indications for splenectomy were hematologic disorders in four patients and hypersplenism in three patients. Median dimensions of the resected spleens were 140 ± 34 mm × 80 ± 11 mm × 50 ± 17 mm and median weight was 307 ± 193 g. Median total operative time was 147 ± 58 minutes including 107 ± 49 minutes for the robotic act. There were no intraoperative complications and no conversions to open surgery. The median postoperative hospital stay was 7 days. Conclusion: This first series suggests that robotic splenectomy with the da Vinci surgical system is technically feasible and safe. It provides an alternative to the conventional laparoscopic procedure. Nevertheless, justification for this new technique will requ...
26 citations
TL;DR: The first robotic resection of an ectopic mediastinal thyroid adenoma in a 72-year-old woman was reported, which was part of staged management for excessive bilateral cervical goiter with intrathoracic dispersion.
Abstract: We report the first robotic resection of an ectopic mediastinal thyroid adenoma in a 72-year-old woman. This intervention was part of staged management for excessive bilateral cervical goiter with intrathoracic dispersion. The robotic resection was found to be feasible and safe. The robotic operating system offers better visual control and operative accuracy than does conventional thoracoscopy.
20 citations