Robotic surgery in emergency setting: 2021 WSES position paper.
Authors
Khan, Jim
Marchegiani, Francesco
Bianchi, Giorgio
Aisoni, Filippo
Alberti, Daniele
Ansaloni, Luca
Biffl, Walter
Chiara, Osvaldo
Ceccarelli, Graziano
Coccolini, Federico
Cicuttin, Enrico
D'Hondt, Mathieu
Di Saverio, Salomone
Diana, Michele
De Simone, Belinda
Espin-Basany, Eloy
Fichtner-Feigl, Stefan
Kashuk, Jeffry
Kouwenhoven, Ewout
Leppaniemi, Ari
Beghdadi, Nassiba
Memeo, Riccardo
Milone, Marco
Moore, Ernest
Peitzmann, Andrew
Pessaux, Patrick
Pikoulis, Manos
Pisano, Michele
Ris, Frederic
Sartelli, Massimo
Spinoglio, Giuseppe
Sugrue, Michael
Tan, Edward
Gavriilidis, Paschalis
Weber, Dieter
Kluger, Yoram
Catena, Fausto
Publication Date
2022-01-20Journal Title
World J Emerg Surg
ISSN
1749-7922
Publisher
Springer Science and Business Media LLC
Volume
17
Issue
1
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
de'Angelis, N., Khan, J., Marchegiani, F., Bianchi, G., Aisoni, F., Alberti, D., Ansaloni, L., et al. (2022). Robotic surgery in emergency setting: 2021 WSES position paper.. World J Emerg Surg, 17 (1) https://doi.org/10.1186/s13017-022-00410-6
Abstract
BACKGROUND: Robotics represents the most technologically advanced approach in minimally invasive surgery (MIS). Its application in general surgery has increased progressively, with some early experience reported in emergency settings. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a systematic review of the literature to develop consensus statements about the potential use of robotics in emergency general surgery. METHODS: This position paper was conducted according to the WSES methodology. A steering committee was constituted to draft the position paper according to the literature review. An international expert panel then critically revised the manuscript. Each statement was voted through a web survey to reach a consensus. RESULTS: Ten studies (3 case reports, 3 case series, and 4 retrospective comparative cohort studies) have been published regarding the applications of robotics for emergency general surgery procedures. Due to the paucity and overall low quality of evidence, 6 statements are proposed as expert opinions. In general, the experts claim for a strict patient selection while approaching emergent general surgery procedures with robotics, eventually considering it for hemodynamically stable patients only. An emergency setting should not be seen as an absolute contraindication for robotic surgery if an adequate training of the operating surgical team is available. In such conditions, robotic surgery can be considered safe, feasible, and associated with surgical outcomes related to an MIS approach. However, there are some concerns regarding the adoption of robotic surgery for emergency surgeries associated with the following: (i) the availability and accessibility of the robotic platform for emergency units and during night shifts, (ii) expected longer operative times, and (iii) increased costs. Further research is necessary to investigate the role of robotic surgery in emergency settings and to explore the possibility of performing telementoring and telesurgery, which are particularly valuable in emergency situations. CONCLUSIONS: Many hospitals are currently equipped with a robotic surgical platform which needs to be implemented efficiently. The role of robotic surgery for emergency procedures remains under investigation. However, its use is expanding with a careful assessment of costs and timeliness of operations. The proposed statements should be seen as a preliminary guide for the surgical community stressing the need for reevaluation and update processes as evidence expands in the relevant literature.
Keywords
Review, Emergency surgery, Robotic surgery, General surgery, Minimally invasive surgery
Identifiers
s13017-022-00410-6, 410
External DOI: https://doi.org/10.1186/s13017-022-00410-6
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333219
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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