A general review is here presented on the development, composition, existing problems and prospects of telerobotic laparoscopic surgery systems, based on the related literatures and informations in recent years.
Laparoscopy ; methods ; Robotics ; methods

Hepatectomy ; methods ; Humans ; Laparoscopy

With the development of minimally invasive techniques, laparoscopic pancreaticoduodenectomy has been gaining increasing recognition in recent years, but it is still associated with a relatively high morbidity and mortality compared with surgeries for gastrointestinal carcinoma, and its practice has highly complex procedure and longer learning curve. This is a result of the complex nature of the organ, the difficult access as a result of the retroperitoneal position and the number of technically challenging anastomoses required. We try to find the solution for the surgical difficulties encountered with laparoscopic pancreaticoduodenectomy.
Humans ; Laparoscopy ; methods ; Pancreaticoduodenectomy ; methods

Humans ; Laparoscopy ; methods ; Urology ; methods

Utilization of the colostomy site for laparoscopic reversal of Hartmann's procedure was recently introduced, and several studies have shown the feasibility of the procedure, which allows the colostomy site to serve as an access port for the operation. We demonstrate a method utilizing an accessory 5 mm trocar to assist in the operation while employing a colostomy-deepened glove port.
Colostomy* ; Laparoscopy ; Methods ; Surgical Instruments

OBJECTIVES: Surgical robot system has broken the limitation of traditional surgery and shown excellent performance in surgery, and has been widely used in minimally invasive treatment in most areas of surgery. This study aims to verify the basic performance of the domestic surgical robot system and the safety and effectiveness of the integrated bipolar electrocoagulation and ultrasonic knife. METHODS: The basic performance of the domestic surgical robot system was evaluated by completing the square knot and surgical knot, vertical and horizontal perforation and right ring perforation and suture, as well as picking up beans. Compared with laparoscopy, the safety and effectiveness of the domestic surgical robot after integrated interconnection bipolar electrocoagulation and ultrasonic scalpel were evaluated by detecting the vascular closure performance and the degree of histopathological damage in animals. RESULTS: Compared with freehand knotting, domestic robot knotting speed and circumference were slightly worse, but better than laparoscopic knotting. There was no statistical significance in the tension difference of the surgical knots among the 3 methods (P>0.05), but the tension of the square knots made by the freehand and the domestic surgical robot was greater than that of the laparoscopy (P<0.05). The space required for both the left and right forceps heads of knots was smaller than that of laparoscopy (P<0.001), which successfully completed the 4 quadrant suture tasks, and the time of picking up beans was significantly less than that of laparoscopy (P<0.05). There was no significant difference in the temperature of the liver tissue after the bipolar electrocoagulation between the interconnected domestic surgical robot and the laparoscopy (P>0.05), and the acute thermal injury was observed under the light microscope. The temperature of the liver tissue treated by the domestic robotic ultrasound knife was higher than that of the laparoscopic ultrasound knife (P<0.05). CONCLUSIONS Domestic surgical robots are obviously superior to laparoscopy in suturing, knotting, and moving objects, and domestic surgical robots' interconnect bipolar electrocoagulation and ultrasonic knife have achieved success in animal experiments, and hemostasis is considered to be safe and effective.
Animals ; Robotics ; Laparoscopy/methods* ; Ultrasonography

Laparoscopic proctocolectomy is a safe and feasible but complicated procedure, which is widely used clinically. Fully understanding of surgical plane and vascular anatomy is important for operation. The anastomosis methods, the type of ileal reservoir pouch and whether or not performing protective ileostomy should be considered preoperatively. Many details should be paid attention to.
Colorectal Surgery ; methods ; Humans ; Laparoscopy ; methods

OBJECTIVETo compare the safety and efficacy of the medial approach(MA) and the lateral approach (LA) in the treatment of colorectal disease.

METHODSStudies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models.

RESULTSFive cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72, P=0.001), shorter operative time (WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41; OR:0.78, 95%CI:0.52-1.17, P=0.23).

CONCLUSIONSCompared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.

Humans ; Laparoscopy ; methods ; trends ; Pancreaticoduodenectomy ; methods

Humans ; Laparoscopy ; methods ; trends ; Urology ; methods