Περίληψη:
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.
Συγγραφείς:
de'Angelis, Nicola
Khan, Jim
Marchegiani, Francesco
Bianchi,
Giorgio
Aisoni, Filippo
Alberti, Daniele
Ansaloni, Luca and
Biffl, Walter
Chiara, Osvaldo
Ceccarelli, Graziano and
Coccolini, Federico
Cicuttin, Enrico
D'Hondt, Mathieu
Di
Saverio, Salomone
Diana, Michele
De Simone, Belinda and
Espin-Basany, Eloy
Fichtner-Feigl, Stefan
Kashuk, Jeffry and
Kouwenhoven, Ewout
Leppaniemi, Ari
Beghdadi, Nassiba
Memeo,
Riccardo
Milone, Marco
Moore, Ernest
Peitzmann, Andrew and
Pessaux, Patrick
Pikoulis, Manos
Pisano, Michele
Ris,
Frederic
Sartelli, Massimo
Spinoglio, Giuseppe
Sugrue,
Michael
Tan, Edward
Gavriilidis, Paschalis
Weber, Dieter and
Kluger, Yoram
Catena, Fausto
