Robotic surgery in emergency setting : 2021 WSES position paper
de'Angelis, Nicola (University of Paris Est)
Khan, Jim (University of Portsmouth. Department of Colorectal Surgery)
Marchegiani, Francesco (University of Padua. Department of Surgical Oncological and Gastroenterological Sciences)
Bianchi, Giorgio (Henri Mondor University Hospital. CARE Department)
Aisoni, Filippo (Henri Mondor University Hospital. CARE Department)
Alberti, Daniele (Spedali Civili Children's Hospital of Brescia. Department of Pediatric Surgery)
Ansaloni, Luca (San Matteo University Hospital. General Surgery)
Biffl, Walter (Scripps Memorial Hospital La Jolla. Division of Trauma and Acute Care Surgery)
Chiara, Osvaldo (University of Milano. General Surgery and Trauma Team)
Ceccarelli, Graziano (San Giovanni Battista Hospital)
Coccolini, Federico (University Hospital of Pisa (Pisa, Itàlia))
Cicuttin, Enrico (University Hospital of Pisa (Pisa, Itàlia))
D'Hondt, Mathieu (Groeninge Hospital. Department of Digestive and Hepatobiliary/Pancreatic Surgery)
Di Saverio, Salomone (Cambridge University Hospitals NHS Foundation Trust (Regne Unit))
Diana, Michele (Research Institute Against Digestive Cancer)
De Simone, Belinda (Poissy and Saint-Germain-en-Laye Hospitals. Department of General and Metabolic Surgery)
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Fichtner-Feigl, Stefan (Medical Center University of Freiburg. Department of General and Visceral Surgery)
Kashuk, Jeffry (Tel Aviv University. Department of Surgery)
Kouwenhoven, Ewout (Hospital Group Twente ZGT. Department of Surgery)
Leppaniemi, Ari (University of Helsinki. Department of Gastrointestinal Surgery)
Beghdadi, Nassiba (University of Paris Est)
Memeo, Riccardo (General Regional Hospital "F. Miulli". Unit of Hepato-Pancreato-Biliary Surgery)
Milone, Marco ("Federico II" University of Naples. Department of Clinical Medicine and Surgery)
Moore, Ernest (University of Colorado. Ernest E Moore Shock Trauma Center at Denver Health)
Peitzmann, Andrew (University of Pittsburgh School of Medicine)
Pessaux, Patrick (Institute of Viral and Liver Disease (Strasbourg, France))
Pikoulis, Manos (National and Kapodistrian University of Athens. 3Rd Department of Surgery)
Pisano, Michele (ASST Papa Giovanni Hospital Bergamo. Department of Emergency)
Ris, Frederic (Geneva University Hospitals (Suïssa))
Sartelli, Massimo (Macerata Hospital)
Spinoglio, Giuseppe (IRCAD Faculty Member Robotic and Colorectal Surgery)
Sugrue, Michael (Letterkenny University Hospital. Department of Surgery)
Tan, Edward (Radboud University Medical Center. Department of Surgery)
Gavriilidis, Paschalis (University Hospitals Coventry. Department of HBP Surgery)
Weber, Dieter (Royal Perth Hospital (Perth, Austràlia))
Kluger, Yoram (Rambam Healthcare Campus (Haifa, Israel). Department of General Surgery)
Catena, Fausto (Bufalini Hospital)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	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. 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. 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. 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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Subject:	Emergency surgery ; Robotic surgery ; General surgery ; Minimally invasive surgery
Published in:	World Journal of Emergency Surgery : WJES, Vol. 17 Núm. 4 (january 2022) , ISSN 1749-7922

DOI: 10.1186/s13017-022-00410-6
PMID: 35057836

12 p, 1.6 MB

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