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Robot-assisted liver surgery in a general surgery unit with a 'Referral Centre Hub&Spoke Learning Program'. Early outcomes after our first 70 consecutive patients
- Source :
- Minerva Chirurgica. 73
- Publication Year :
- 2018
- Publisher :
- Edizioni Minerva Medica, 2018.
-
Abstract
- The aim of this study was to evaluate safety, feasibility and short-term outcomes of our first 70 consecutive patients treated by robotic-assisted liver resection after a reversal proctoring between a high HPB volume centre and our well-trained center in minimally invasive General Surgery. Six surgeons were involved in this HubSpoke learning program.From September 2012 to December 2016, 70 patients underwent robotic-assisted liver resections (RALR). We treated 18 patients affected by colorectal and gastric cancer with synchronous liver lesions suspected for metastases in a one-stage robotic-assisted procedure. For the first 20 procedures we had a tutor in the operatory room, who was present also in the next most difficult procedures.The 30- and 90-day mortality rate was zero with an overall morbidity rate of 10.1%. Associated surgical procedures were performed in about 65,7% of patients. The observed conversion rate was 10%. The results of the first 20 cases were similar to the next 50 showing a shortned learning curve.Minimally invasive robot-assisted liver resection is a safe technique; it allows overcoming many limits of conventional laparoscopy. This innovative, time-enduring HubSpoke may allow patients to undergo a proper standard of care also for complex surgical procedures, without the need of reaching referral centres.
- Subjects :
- Adult
Male
Liver surgery
medicine.medical_specialty
Time Factors
Standard of care
Referral
Conventional laparoscopy
Operation Duration
030230 surgery
Unit (housing)
Resection
03 medical and health sciences
Laparoscopy
Liver neoplasms
Minimally invasive surgical procedures
Surgery
0302 clinical medicine
Robotic Surgical Procedures
Hepatectomy
Humans
Liver Resection
Conversion To Open Surgery
Medicine
Referral and Consultation
Aged
Retrospective Studies
Aged, 80 and over
Hepatology
business.industry
General surgery
Gastroenterology
Middle Aged
Surgical procedures
Treatment Outcome
030220 oncology & carcinogenesis
Referral centre
Feasibility Studies
Female
030211 gastroenterology & hepatology
business
Subjects
Details
- ISSN :
- 18271626 and 00264733
- Volume :
- 73
- Database :
- OpenAIRE
- Journal :
- Minerva Chirurgica
- Accession number :
- edsair.doi.dedup.....37a38586b09beeee3ae7b07161025a95