No abstract available.
Cesarean Section* ; Female ; Pregnancy

Robotic surgical systems were created partly to solve several constraints of laparoscopic surgery and to offer technical advantages. With a substantial body of evidence demonstrating its efficacy in rectal cancer treatment, robotic surgery will soon become another conventional treatment. However, further investigations and randomized trials focusing on primary endpoints are necessary to establish some advantages of robot-assisted colon surgery.Current Concepts: Da Vinci Single-Site and SP platforms (Intuitive Surgical Inc.) were developed to overcome the shortcomings of single-port laparoscopic surgery. Despite the currently insufficient evidence, it seems that the SP platform addresses several limitations of single-port transabdominal or transanal surgery. Robotic transanal minimally invasive surgery and total mesorectal excision were developed to overcome conventional platforms’ limitations, using wristed instrumentation to enhance dexterity and ergonomics. Studies on the effectiveness and viability of this novel approach are ongoing. The near-infrared fluorescence technique, real-time stereotactic navigation technology, and other surgical data platforms based on artificial intelligence incorporated into the robotic system will play an important role in improving outcomes.Discussion and Conclusion: Robotic systems for advanced colorectal cancer offer technical advantages for complex and precise surgeries. If robotic surgery costs are reduced by expanding its indications and enhancing competition among different robotic platforms, it will provide clinical benefits to more patients and reduce social healthcare costs.

Although obstructive colon cancer can often be treated with first-stage resection with primary anastomosis, the results of the oncological outcome of using stenting as a bridge of surgery in the literature are still controversial. Stent insertion for obstructed cancer provides an opportunity for bowel preparation and makes preoperative work-up and clinical staging possible. However, although stenting is becoming a more frequent treatment modality, studies with a significant number of patients acting as a bridge between surgery are still lacking. In this issue of Journal of Minimally Invasive Surgery, the study by Kim et al.highlights the efficacy of stent insertion as the initial treatment and analyzed the prognostic factors in symptomatic obstructive colon cancer. The study demonstrated that emergent surgery, vascular invasion, and omitting adjuvant chemotherapy were independent poor prognostic factors in long-term oncologic outcomes suggested that stent insertion should be considered an initial treatment for symptomatic obstructive colon cancer.

Although obstructive colon cancer can often be treated with first-stage resection with primary anastomosis, the results of the oncological outcome of using stenting as a bridge of surgery in the literature are still controversial. Stent insertion for obstructed cancer provides an opportunity for bowel preparation and makes preoperative work-up and clinical staging possible. However, although stenting is becoming a more frequent treatment modality, studies with a significant number of patients acting as a bridge between surgery are still lacking. In this issue of Journal of Minimally Invasive Surgery, the study by Kim et al.highlights the efficacy of stent insertion as the initial treatment and analyzed the prognostic factors in symptomatic obstructive colon cancer. The study demonstrated that emergent surgery, vascular invasion, and omitting adjuvant chemotherapy were independent poor prognostic factors in long-term oncologic outcomes suggested that stent insertion should be considered an initial treatment for symptomatic obstructive colon cancer.

Purpose: Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer. Methods: This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0. Results: On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016). Conclusion CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Purpose: Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer. Methods: This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0. Results: On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016). Conclusion CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Purpose: Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer. Methods: This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0. Results: On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016). Conclusion CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Purpose: Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer. Methods: This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0. Results: On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016). Conclusion CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.

Purpose: Continuous wound infiltration (CWI) has been introduced as a component of multimodal analgesia to counteract the adverse effects of the most frequently used opioids. Advantages of reduced-port laparoscopic surgery (RPLS) include cosmetic benefits and decreased postoperative pain. We aimed to investigate the effect of CWI in patients using intravenous (IV) patient-controlled analgesia (PCA) for pain management after RPLS for colorectal cancer. Methods: This retrospective study included 25 patients who received both CWI (0.5% ropivacaine infused over 72 hours) and IV PCA (fentanyl citrate) and 52 patients who received IV PCA alone. The primary endpoint was pain scores on postoperative days (PODs) 0, 1, and 2. Univariate and multivariate analyses were conducted to determine the factors affecting the pain score on POD 0. Results: On POD 0, the mean numeric rating scale score was significantly lower in the CWI group than in the control group (3.2±0.8 vs. 3.7±0.9, P=0.042). However, the scores were comparable between the groups during the rest of the period. Within 24 hours of surgery, the CWI group consumed fewer opioids (0.7±0.9 vs. 1.3±1.1, P=0.018) and more nonsteroidal anti-inflammatory drugs (2.0±1.4 vs. 1.3±1.4, P=0.046) than the control group. Time to removal of IV PCA was significantly longer in the CWI group than in the control group (4.4±1.6 days vs. 3.4±1.0 days, P=0.016). Conclusion CWI with ropivacaine and IV PCA was more effective than IV PCA alone in controlling postoperative pain within 24 hours of surgery, and opioid use could be reduced further.