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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1369_Библиотеки_им_академика_М_И_Перельмана.pdf
314
Index
®
da Vinci Xi
da Vinci
, 75
®
robotic system, 80
Defense Advanced Research Projects Agency
(DARPA), 295
Denonvillier’s fascia, 53, 188
Diabetes, 116
Digital rectal exam (DRE), 251
Diverting loop ileostomy, 102
Dual docking method
conventional laparoscopic splenic flexure
mobilization, 71
operative outcome, 74, 75
patient cart positioning and docking, 72–75
port placement, 71–72
splenic flexure mobilization versus
conventional laparoscopy, 71
Dynamic colpocystoproctography (DCP), 131
Dyspareunia, 247
E
Electromyography (EMG), 174–175
Emphysema, 263–264
Endometriosis
COCs, 248
diagnosis, 247
disease severity, 244
DRE, 251
endometrium, 243
epidemiology, 244
GNRH, 249
infertility, 250
medical treatments, 249
monopolar scissor, 253
pathophysiology, 244
reproductive medicine, 245
robotic approach, 252
surgical management, 252
symptoms, 243, 247
transillumination, 253
transvaginal ultrasonography, 248
treatment algorithms, 248
Endometriosis fertility index (EFI), 246
Endometriotic lesions, 246
Endoscopic rectal ultrasonography, 50
Endoscopy, 2
Endotics, 305, 306
EndoWrist
®
, 26, 29, 31, 32, 42, 176
Enterocele, 142
Ergonomic strain, 179
Ergonomics, 172
camera control, 173
complexity of tasks, 172
components, 171–177
cost labor, 170
EMG, 174
endo-wristed instrumentation, 172
factors, 170
minimally invasive surgery, 175, 177
occupational injury, 169
operating room lighting, 172
posture, 173–174
robotic surgical platform, 169
robotics, 177–178
screen location, 173
surgical assistance, 170
tissue manipulation, 175
traditional laparoscopic, 169
tremor damping, 169
visualization, 171–173
Estimated blood loss (EBL), 41, 200
F
Fecal incontinence (FI), 251
Female sexual function index (FSFI), 215
Fluorescence image-guided surgery
(FIGS), 106
Food and Drug Administration (FDA),
272, 296
Fundamentals of laparoscopic surgery
(FLS), 17, 19
Fundamentals of robotic surgery (FRS), 20
G
GelPOINT, 166
GelPoint Laparoscopic System, 272
GelPOINT© path transanal access
platform, 99
Georg Kelling’s apparatus, 4
GI View Ltd., 307, 308
Gonadotropin releasing hormone (GNRH)
agonists, 249
H
Heineke–Mikulicz stricturoplasty, 166
Human factors, 170
Hybrid technique
multiquadrant operations, 60
operative outcomes, 63–66
patient cart positioning and docking, 62
patient positioning and preparation,
60, 61
port placement, 60, 61
procedure steps, 63
robotic rectal surgery, 59
Index
315
Hybrid technique vs. totally robotic technique,
59, 60
Hypercarbia, 287
Hypogastric plexus, 184–186, 189
Hypothermia, 264
I
Ieal anal pouch anastomosis (IPAA), 154
robotic-assisted approach, 163–164
total proctocolectomy, 156–163
Ileocolic vessels, 31, 163
Ileocolics, 163
Immunofluorescence (IF)
history, 106
in surgery, 106
Incisional hernia rates, 201
Indocyanine green (ICG), 106, 107
Inferior hypogastric plexus, 184
Inferior mesenteric artery (IMA), 52, 63,
64, 187
Inferior mesenteric vein (IMV), 63
Inflammatory bowel disease
da Vinci robot, 153
laparoscopic surgery, 153
postoperative complications, 153
Initial learning curve, 13
International Continence Society (ICS), 141
International Index of Erectile Function
(IIEF), 215
International Prostate Symptom Score
(IPSS), 215
Interquartile range (IQR), 281
Intracorporeal anastomosis, 28, 41, 202
Intraoperative complications, 140, 289–290
Intraoperative hypothermia, 51
Intuitive Surgical, Inc., 297–299
advantages, 259
colectomy, 7, 23
colorectal surgery, 12
instruments, 175, 176
mechanical and neuroendocrine stress, 260
vs. open surgery, 209–211
pneumoperitoneum, 260
right colectomy, 37, 39
robotic assisted colorectal surgeries, 11
vs. robotic surgery, 211–212
robotic system, 259
studies, 109–110
Left hemicolectomy, 278–279
Length of stay (LOS), 195
Lithotomy, 25
Local anesthetics, 266
M
Magnetic resonance imaging (MRI), 248
MAUDE database, 288
Mesocolon, 160
Mesorectal fascia, 188
Michigan Surgical Quality Collaborative, 219
Mickey Mouse surgery, 5
Mid-clavicular line (MCL), 67, 133
Minimally invasive surgery, 177
COLOR II trial, 8
COST and CLASICC, 7, 8
CRMs, 8
laparoscopic colectomy, 7
laparoscopic group, 8
neoplasms, 7
rectal surgery, 8–9
Minimally invasive surgery (MIS), 105, 251
MIS colorectal IF studies, 108–109
Myofascial pain syndromes, 247
K
Koelioskopie, 259
L
Laparoendoscopic single-incision surgery
(LESS)
benefits, 272
colon resection, 271
laparoscopic surgical approach, 271
meta-analysis, 271
robotic platform, 271
SIRC, 272
Laparoscopy, 5–6
N
National Health and Nutrition Examination
Survey III (NHANES III), 117
Neoplasms, 7
Nerve preservation, robotic rectal surgery
conventional outcomes, 183
electrocoagulation, 189
hypogastric plexus, 184
minimally invasive surgery, 186
parasympathetic stimulation, 186
paravesical tissues, 184
QoL, 184
sexual and urinary dysfunctions, 184
TME, 183
316
Index
New robot system, 75
NIR imaging systems, 107
Novice robotic surgeon, 178
O
Obese patients
abnormal cardiorespiratory, 115
anatomy identification, 123, 124
bean bag, 121
bony pelvis, 119
da Vinci robot, 119
intra-abdominal access, 120
laparoscopic colectomy, 115
laparoscopic visualization, 121
port placement, 122, 123
positioning, 120
preoperative assessment, 116–118
risk factor, 118
robotic docking, 120
robotic surgery, 116
trocar position, 123
trocar selection, 122, 123
umbilicus, 122
WHI, 115
Obesity, 39
Omentum, 32
Operating room lighting, 172
Pneumo-occluder balloon, 143
Pneumoperitoneum, 2, 287
Port placements, 134
Positioning robotic TAMIS
anesthesia, 96
arm setup, 96, 97
bladder drainage, 96
candy canes, 96
ergonomic tumor dissection, 96
lateral placement arm, 96, 98
parallel docking, 96, 97
port and arm setup, 96, 98
port placement, 99, 100
ports and trocars, 99
robotic-assisted surgery, 96
transanal and conventional laparoscopic
approach, 99
Post operative management
obese patients, 125
Posterior mesh fixation, 137–138
Postoperative nausea, 267
Preoperative chemoradiation (PCRT), 95
Pulmonary system, 118, 125
Q
Quadport, Olympus, Center Valley, 272
Quality of life (QoL), 184
P
Pain, 266
Pelvic floor disorders
da Vinci Surgical Systems, 130
minimally invasive techniques, 129
multidisciplinary approach, 129
transabdominal procedures, 129
visualization, 130
Pelvic organ prolapse
complications, 149
concomitant rectopexy, 147
osteomyelitis, 147
pelvic floor muscle, 147
pelvic/abdominal abscess formation, 147
preoperative evaluation and
management, 148
surgical management, 147
symptoms, 147
technical considerations, 148
Perfusion Assessment in Laparoscopic
Left-Sided/Anterior Resection
(PILLAR) II study, 111, 112
Peritoneoscopy, 2
R
Rectal prolapse
anterolateral walls, 130
da Vinci Xi System, 134–136
patient positioning, 132–134, 136
port placement, 132–134, 136
preoperative evaluation, 130–132
recommended list, 135
robot-assisted laparoscopic surgery, 130
technical considerations, 132
thickness, 131
Rectal resection
retrospective and comparative studies,
203–206
robotic approach, 202–203
robotic vs. open approach, 206–207
Rectal traction, 124
Rectopexy, 138–140
Reoperation, 289
Right hemicolectomy, 277–278
Robot-assisted laparoscopic surgery, 282
Robot docking, 274–277
Robotic assisted colectomy, 12
Index
317
Robotic colectomy, 14
retrospective and comparative studies,
200–202
single institution studies, 198–200
Robotic colonoscopy, 304–308
Robotic colorectal surgery, 12, 39, 196–200
BMI values, 286
chemoradiation, 286
circumferential margins
rectum, 199
clinical realization, 295
complications
colon, 200
rectum, 199
conversion rates, 285
conversions, 213–214
colon, 196
rectum, 196
cost, 218–219
delayed response, 296
disadvantage, 220
dissection and hemostasis, 196
fellowship training issues, 219
haptic feedback, 296
hospital LOS
rectum, 197
inflammatory conditions, 286
intracorporeal anastomosis, 220
intracorporeal anastomosis and incisional
hernias, 216
laparoscopic surgery, 195, 296
learning curve, 214–215
mastery phase, 286
meta-analyses and reviews, 196, 207–209
minimally invasive approach, 195, 219, 297
minimally invasive single incision
surgery, 217
near-infrared technology, 296
oncologic outcomes, 212
operating time
rectum, 197
operating time/LOS
colon, 198
pathologic processes, 286
postoperative courses, 285
preoperative chemoradiation, 213
ROLARR, 196
sexual and urinary dysfunction, 215–216
telementoring surgeons, 219
transanal approach, rectal neoplasia,
217–218
visceral adiposity, 286
vision, 295
vision system cart, 296
Robotic low anterior resection, rectal cancer
colonic and pelvic phases, 59
hybrid technique, 59–64
patient cart alignment and docking, 62, 63
Robotic malfunction, 288
Robotic privileging, 14
Robotic prostatectomy, 59
Robotic right colectomy, 42
Robotic right hemicolectomy
indications and setting, 24
intracorporeal anastomosis, 24
port placement, 26
robotic camera, 31
Si port placement, 26–27
Robotic sewn anastomosis, 32
Robotic Single-Site™, 43
Robotic stapling, 290
Robotic studies, 110–111
Robotic surgery, 20
cardiopulmonary complications, 263
complications, 260
end-organ perfusion, 260
intracranial pressure, 260
intraocular pressure, 260
intraoperative concerns, 262–265
monitoring and vascular access, 261–262
operative time, 282
patient selection, 261
Robotic Surgical Simulator (RoSS), 19
Robotic systems, 171
Robotic technology, 13
Robotic total colectomy
colonic inertia and Hirschsprung’s
disease, 80
®
da Vinci
system, 79
distal transverse colon, splenic flexure, and
proximal colon, 89
division of the middle colic pedicle, 89
docking, 86–87
esophageal and pancreatic surgery, 79
extraction, anastomosis, and leak
test, 90, 91
final docking, 90
isolation and division, ileocolic artery, 89
laparoscopic inspection, exposure and
docking, 88, 89
mobilization of right colon and hepatic
flexure, 89
multiple dockings/port hopping, 79
multiple quadrants, 79
operating room setup and preparation,
80–82
operative steps, 87–88
OR setup and patient preparation, 81–83
318
Index
Robotic total colectomy (cont.)
polyposis syndromes, 80
port placement, 84–86
Si platform, 80
sigmoidectomy, 80
surgeon’s learning curve, 80
trocar placements, 83–85
Robotic Training Development and Research,
18–20
Robotic transanal minimally invasive surgery
(R-TAMIS), 93
Robotic transanal total mesorectal excision
(R-TME), 93
Robotic versus Laparoscopic Resection for
Rectal Cancer (ROLARR), 212
Robotic vs. open colectomy, 206
Robotic-assisted abdominoperineal resection
(APR)
closure, 55–56
complications, 56
follow-up, 56–57
genitourinary dysfunction, 57
indications and contraindications, 49–50
left lateral dissection, levator muscle, 54
minimally invasive approaches, 49
neoadjuvant chemoradiation therapy, 57
patient positioning, 51
perineal resection, 54–55
port setup, 51–52
postoperative care, 56
preoperative workup, 50
right lateral dissection, levator muscle, 54
sigmoid colon and ligation of vessels,
52–54
ureters, 57
Robotic-assisted completion
proctectomy, 164
Robotic-assisted laparoscopic surgery
(RALS)
benefits, 230
break even analysis, 232
clinical outcome data, 237
colorectal surgery, 229
cost challenge, 230–231
definitions, cost model, 236
financial outcome data, 238
increasing case volume, 235
instituting quality control metrics, 235
Intuitive Surgical’s Da Vinci robotic
system, 230
vs. laparoscopic colorectal costs,
230, 231
vs. laparoscopic surgery, 237–238
market niche, 233
marketplace competition, 235–236
minimally invasive techniques, 229
optimal model, 231–232
patient demographics, 237
profitability, 236
standardized equipment pack, 234
standardized vs. nonstandardized
equipment table, 234
streamlining instrumentation, 233–235
targeting open surgery, 232–233
Robotic-assisted single incision colectomy,
166–167
Robotic-assisted stricturoplasty, 167
Robotic-assisted transanal microscopic
surgery, 94, 95
chemoradiation therapy, 95
distal/medium rectum, 94
evolution, 94
indications
R-TAMIS, 94
R-TAMIS-TME, 95
preoperative study, 95–96
robotic surgery, 103
R-TAMIS and R-TME, 93, 94
single-port laparoscopic approach, 94
TAE, 93
TAMIS port, 94
TEM technique, 93
urethrorectal fissures, 102
Robotics
anterior mesh fixation, 136–137
posterior mesh fixation, 137–138
rectal prolapse, 130–140
rectopexy, 138–140
ROLARR (NCT01736072), 285
S
Sacrocolpopexy, 144–148
Sequela, 263–264
Si and Xi systems, 26
Sigmoid, 139
Sigmoidectomy, 282
Single docking method
hybrid technique, 64
left lateral setup, splenic flexure setup and
pelvic setup, 67, 68
lymphovascular dissection, 64
operative outcome, 68–71
port placement, 64–67
port usage and instrument arm setup per
procedure step, 67–68
Index
319
splenic flexure mobilization, 64
time-consuming process, 64
Single/dual docking method, 59
Single-incision laparoscopic surgery, 217
Single-incision robotic colon resection
(SIRC), 43–44
closure, 279–280
crossed-arm, 272
da Vinci single-site instruments, 273
institutional experience, 281
LESS colectomy, 272
multiport laparoscopic colectomy, 281
obesity, 282
positioning, 273–274
postoperative care, 280
preoperative patient evaluation, 273
procedure-specific complications, 280–281
right and left hemicolectomy, 282
single-site fascial access, 272
transumbilical incision, 281
umbilical access, 273–274
wound care, 279–280
Single Port Orifice Robotic Technology
(SPORT™) Surgical System, 236
Society of Gynecologic Oncologists, 170
SOFAR S.p.A, 301–303
Soft colonoscopy robotic platform, 305
Spinoumbilical line (SUL), 67, 133
Stanford Research International (SRI), 304
Superficial surgical site infections (SSI), 281
SurgiBot™, 300
Surgical environment, 265
Surgical injury, 265
Surgical site infection (SSI), 125
sympathetic nerve stimulation, 186
sympathetic system, 186
T
TAMIS
operative steps, 100
TAMIS-TME (transanal stage)
operative steps, 101–102
Telelap ALF-X bedside robotic carts, 302
Telepresence Surgery System, 259
Telesurgery, 303, 304
Thrombosis prophylaxis, 50
Titan Medical Inc., 300–301
Total mesorectal excision (TME), 8, 60, 118,
159, 183, 190, 202, 204
Transabdominal intersphincteric dissection,
205
Transanal endoscopic microsurgery (TEM), 93
Transanal excision (TAE), 93
Transanal minimally invasive surgery
(TAMIS), 217, 218
Transanal/transvaginal techniques, 204
TransEnterix, 299–300
Transvaginal ultrasound (TVUS), 251
Tricarbocyanine dye, 107
Trocar placement, 176, 274–277
U
UK Medical Research Council (MRC), 8
Ulcerative colitis (UC)
characterized, 154
colon and rectum, 154
da Vinci robot, 156
diagnosis, 154
fallopian tubes, 155
fecundity, 155
immunomodulators, 154
IPAA, 155
minimally invasive techniques, 155
mucosectomy, 155
proctocolectomy, 155
sexual dysfunction, 156
sphincter damage, 155
sympathetic and parasympathetic nerves,
156
technical challenges, 156
treatment, 154
Umbilical access, 273–274
United Kingdom Medical Research Council
Conventional versus LaparoscopicAssisted Surgery in Colorectal
Cancer (UK MRC
CLASICC), 209
Uterine/vaginal vault prolapse
da Vinci Si System, 142–144
da Vinci Xi System, 144
open/conventional laparoscopy, 141
patient positioning, 142–144
port placement, 142–144
preoperative evaluation, 141–142
robot-assisted sacrocolpopexies, 141
technical considerations, 142
transabdominal sacrocolpopexy, 140
V
Vasa nervorum, 189
Veress needle, 51
320
Index
Vertical rectus abdominis myocutaneous
(VRAM), 57
Virtual reality (VR)-based simulators, 19
Visual system, 177
Vomiting, 267
VR simulation, 20
VR simulators, 19
VR training, 19
W
World War II, 1
X
Xi port placement, 28–35
Xi system, 28
Y
Y-shaped mesh, 146
Z
Z-shaped skin incision, 278
Z-shaped transumbilical skin incision, 274