Journal Review in Minimally Invasive Surgery: Robotic Emergency General Surgery

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 10 July 2023

⏱️ 37 minutes

🔗️ Recording | iTunes | RSS

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Summary

Have you transitioned a portion of your practice to the robot, but would be hesitant to book an urgent/call case on the robot? Have you wondered if the robot might be useful in your emergency or acute care surgery practice? Join University of Washington MIS Surgeons, Drs. Andrew Wright, Nicole White, and Nick Cetrulo, and Resident Drs. Ben Vierra and Paul Herman as they discuss the growing use of the robot for acute cases and provide tips on appropriate case selection.

Hosts:
1. Andrew Wright, UW Medical Center – Montlake and Northwest, @andrewswright
2. Nick Cetrulo, UW Medical Center - Northwest, @Trules25
3. Nicole White, UW Medical Center - Northwest
4. Paul Herman, UW General Surgery Resident PGY-3, @paul_herm
5. Ben Vierra, UW General Surgery Resident PGY-2

Learning objectives:
- Describe the importance of the MIS approach in EGS
- Review 3 articles on robotic EGS outcomes
1) Robotic surgery in emergency setting: 2021 WSES position paper
2) Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients
3) Urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable periop outcomes to laparoscopic surgery
- Discuss factors influencing appropriate case selection for urgent/emergent robotic cases
- Discuss value as it pertains to robotic EGS

References
1. Havens JM, Peetz AB, Do WS, Cooper Z, Kelly E, Askari R, Reznor G, Salim A. The excess morbidity and mortality of emergency general surgery. J Trauma Acute Care Surg. 2015 Feb;78(2):306-11. doi: 10.1097/TA.0000000000000517. PMID: 25757115.
2. Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH, Salim A, Havens JM. Use of National Burden to Define Operative Emergency General Surgery. JAMA Surg. 2016 Jun 15;151(6):e160480. doi: 10.1001/jamasurg.2016.0480. Epub 2016 Jun 15. PMID: 27120712.
3. Arnold M, Elhage S, Schiffern L, Lauren Paton B, Ross SW, Matthews BD, Reinke CE. Use of minimally invasive surgery in emergency general surgery procedures. Surg Endosc. 2020 May;34(5):2258-2265. doi: 10.1007/s00464-019-07016-1. Epub 2019 Aug 6. PMID: 31388806.
4. Sheetz KH, Claflin J, Dimick JB. Trends in the Adoption of Robotic Surgery for Common Surgical Procedures. JAMA Netw Open. 2020 Jan 3;3(1):e1918911. doi: 10.1001/jamanetworkopen.2019.18911. PMID: 31922557; PMCID: PMC6991252.
5. de'Angelis N, Khan J, Marchegiani F, Bianchi G, Aisoni F, Alberti D, Ansaloni L, Biffl W, Chiara O, Ceccarelli G, Coccolini F, Cicuttin E, D'Hondt M, Di Saverio S, Diana M, De Simone B, Espin-Basany E, Fichtner-Feigl S, Kashuk J, Kouwenhoven E, Leppaniemi A, Beghdadi N, Memeo R, Milone M, Moore E, Peitzmann A, Pessaux P, Pikoulis M, Pisano M, Ris F, Sartelli M, Spinoglio G, Sugrue M, Tan E, Gavriilidis P, Weber D, Kluger Y, Catena F. Robotic surgery in emergency setting: 2021 WSES position paper. World J Emerg Surg. 2022 Jan 20;17(1):4. doi: 10.1186/s13017-022-00410-6. PMID: 35057836; PMCID: PMC8781145.
6. Robinson TD, Sheehan JC, Patel PB, Marthy AG, Zaman JA, Singh TP. Emergent robotic versus laparoscopic surgery for perforated gastrojejunal ulcers: a retrospective cohort study of 44 patients. Surg Endosc. 2022 Feb;36(2):1573-1577. doi: 10.1007/s00464-021-08447-5. Epub 2021 Mar 24. PMID: 33760973.
7. Anderson M, Lynn P, Aydinli HH, Schwartzberg D, Bernstein M, Grucela A. Early experience with urgent robotic subtotal colectomy for severe acute ulcerative colitis has comparable perioperative outcomes to laparoscopic surgery. J Robot Surg. 2020 Apr;14(2):249-253. doi: 10.1007/s11701-019-00968-5. Epub 2019 May 10. PMID: 31076952.
8. Gangemi A, Danilkowicz R, Bianco F, Masrur M, Giulianotti PC. Risk Factors for Open Conversion in Minimally Invasive Cholecystectomy. JSLS. 2017 Oct-Dec;21(4):e2017.00062. doi: 10.4293/JSLS.2017.00062. PMID: 29238153; PMCID: PMC5714218.
9. Bhama AR, Wafa AM, Ferraro J, Collins SD, Mullard AJ, Vandewarker JF, Krapohl G, Byrn JC, Cleary RK. Comparison of Risk Factors for Unplanned Conversion from Laparoscopic and Robotic to Open Colorectal Surgery Using the Michigan Surgical Quality Collaborative (MSQC) Database. J Gastrointest Surg. 2016 Jun;20(6):1223-30. doi: 10.1007/s11605-016-3090-6. Epub 2016 Feb 3. PMID: 26847352.
10. https://www.east.org/about-east/news-and-events/news/details/320/east-robotic-surgery-for-the-acute-care-surgeon-webinar-series

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Transcript

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0:00.0	Hi all, this is Paul Hermann. I am a general surgery resident at the University of Washington,
0:26.2	and I am excited to be continuing the work started over the past couple of years by the
0:29.3	University of Washington, minimally invasive surgery team led by resident Dr. Mike Wakeamp and
0:34.7	our MIS faculty, Dr. Andrew Wright, Nicole White, and Nick Citrulo. Dr. Wakeamp has handed off
0:40.6	the torch to myself and UW Co-Residents, Dr. Jamie Schnuck, and Ben Vieira. We are excited to
0:46.0	continue to discuss critical cutting edge MIS topics with our experienced MIS faculty educators.
0:52.5	As we start a new season as a BTK subspecialty team, I will reintroduce our distinguished faculty.
0:58.9	Dr. Wright is the Center for Video and Discopic Surgery and Dodd Professor, the Fellowship Director
1:03.5	for the Advanced Minimally Invasive Surgery Program at the University of Washington, as well as
1:07.6	the Director of our Hurnia Center. Hey there, so I view predominantly Forgot and Hurnia
1:13.0	Surgery in about 30 to 40% of my practice's robotics. Thanks Dr. Wright. Dr. White is Assistant
1:19.0	Division Chief at UWMC Northwest Campus, Section Chief of General Surgery at UWMC Northwest Campus,
1:25.9	Medical Director of UW-Surgical Services and the Hurnia Center,
1:29.6	and Physician Chair of the UWMC Northwest Robotics Committee.
1:33.3	Hi everyone, I enjoy doing robotics surgery the most, probably about 70% of my practice,
1:39.4	in addition I do Hurnia and forget as well. Thanks Dr. Wright. Dr. Citrulo is an Associate
1:44.8	Program Director and the Director of Ab Site and Board Review for our General Surgery Residency
1:48.7	Program. Hi everyone, I practice mostly General Surgery and Hurnia Surgery,
1:55.4	and I'm kind of in between Dr. Wright's and Whites where I do about 50% robotic and 50% lapiscopic
2:03.2	or open surgery. I'd like to start by thanking each of you for lending your time and expertise
2:07.4	to the behind-the-knife listeners. During prior episodes, our team is discussed evaluating the
2:11.7	robotic platform in General Surgery with the Rollar and Rival Trials, which evaluated robotic
	...

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