Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics
Andras, Iulia (Municipal Hospital, Cluj-Napoca, Romania)
Territo, Angelo (Institut d'Investigació Biomèdica Sant Pau)
Telecan, Teodora (Municipal Hospital, Cluj-Napoca, Romania)
Medan, Paul (Municipal Hospital, Cluj-Napoca, Romania)
Perciuleac, Ion (Municipal Hospital, Cluj-Napoca, Romania)
Berindean, Alexandru (Municipal Hospital, Cluj-Napoca, Romania)
Stanca, Dan V. (Municipal Hospital, Cluj-Napoca, Romania)
Buzoianu, Maximilian (Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania)
Coman, Ioan (Municipal Hospital, Cluj-Napoca, Romania)
Crisan, Nicolae (Municipal Hospital, Cluj-Napoca, Romania)
Universitat Autònoma de Barcelona

Fecha:	2021
Resumen:	(1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30. 76%/23. 8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15. 5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases.
Derechos:	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.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	3D laparoscopy ; Dual combined approach ; Radical cystectomy ; Radical nephroureterectomy ; Robotic surgery
Publicado en:	Journal of clinical medicine, Vol. 10 (april 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10091812
PMID: 33919290

18 p, 3.2 MB

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