Emergency Colorectal Surgery Checklist and Technical Considerations
A surgical checklist is a step-by-step control procedure carried on for checking through the most delicate phases of the perioperative period, in order to increase surgical patient’s safety and avoid preventable complications. The checklist implementation within operating rooms have proved to be effective in reducing morbidity and mortality rates significantly, without being costly and lengthy. These results have been confirmed also in emergency surgery, which represents in itself a cause of higher risks for patients. Thus, the checklist use has rapidly spread out all over the world. The mechanism responsible for the improvement of surgical outcomes is not completely clear, partly due to am…
Does conversion during minimally invasive rectal surgery for cancer have an impact on short-term and oncologic outcomes? Results of a retrospective cohort study.
International audience; Background: Although minimally invasive rectal surgery (MIRS) for cancer provides better recovery for similar oncologic outcomes over open approach, conversion is still required in 10% and its impact on short-term and long-term outcomes remains unclear. The aim of our study was to evaluate the impact of conversion on postoperative and oncologic outcomes in patients undergoing MIRS for cancer. Methods: From June 2011 to March 2020, we reviewed 257 minimally invasive rectal resections for cancer recorded in a prospectively maintained database, with 192 robotic and 65 laparoscopic approaches. Patients who required conversion to open (Conversion group) were compared to t…
Incidence and predictors of portal and splenic vein thrombosis after pure laparoscopic splenectomy.
Background. Optimal modalities for diagnosis, treatment, and surveillance of portal or splenic vein thrombosis have not yet been defined. The present retrospective study aimed to investigate the role of computed tomography performed systematically before and after laparoscopic splenectomy to assess the incidence of portal or splenic vein thrombosis, predictors, and outcomes. Methods. Computed tomography scans were obtained from 170 patients undergoing elective laparoscopic splenectomy between 2005 and 2015. Pre- and postoperative splenic vein diameter was measured at the splenoportal junction and at a distance of 2, 4, 6 cm from it. Univariate and multivariate analyses were used to identify…
2017 WSES guidelines for the management of iatrogenic colonoscopy perforation
Abstract Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45–60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator’s level of experienc…
Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees
Background To prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surgeons of the 25 most viewed laparoscopic appendectomy videos listed on YouTube. Additionally, we assessed the video conformity to the published guidelines on how to report laparoscopic surgery videos (LAP-VEGaS). Methods Based on the number of visualization, the 25 most viewed videos on laparoscopic appendectomy uploaded on YouTube between 2010 and 2018 were selected. Videos were evaluated on the surgical technical performance (GOALS score), critical view of safety (CVS), and…
Clinical Cases on Colorectal Cancer Emergency
You have to manage in the emergency room a 75-year-old man with a medical history of pulmonary embolism 4 months ago and currently treated with warfarin. He has no history of abdominal surgery. He consults for diffuse abdominal pain, cessation of flatus and stools for 4 days, and fever of 38.7 °C and chills for 24 h. He vomited once 24 h ago. He also experienced asthenia and recent weight loss of 7 kg over the past 6 months not attributable to diet or exercise. He complains of progressively aggravating alternation of diarrhea and constipation for 3 months. He finally remembers that he noticed several times in the last months the presence of red blood in the stools, about which he did not wo…
Laparoscopic versus robotic right colectomy with extra-corporeal or intra-corporeal anastomosis: a systematic review and meta-analysis.
Purpose: The aim of the present systematic review and meta-analysis is to compare laparoscopic right colectomy (LRC) versus robotic right colectomy (RRC) using homogeneous subgroup analyses for extra-corporeal anastomosis (EA) and intra-corporeal anastomosis (IA). Methods: MEDLINE, Scopus, and Web of Science databases were searched up to April 2020 for prospective or retrospective studies comparing LRC versus RRC on at least one short- or long-term outcome. The primary outcome was the length of hospital stay (LOS). The secondary outcomes included operative and pathological results, survival, and total costs. LRC and RRC were compared using three homogeneous subgroups: without distinction by…
Additional file 1: of Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees
Table S1. Conformity to the 37 items of the LAP-VEGaS guidelines. (DOCX 172 kb)
Milestones in robotic colorectal surgery development: an historical overview
The present article is a historical review intended to trace the most important phases in the development of robotic surgical technology, with a special focus on colorectal surgery. The initial section considers the origin and some etymological aspects of the word “robot”. Then, a historical overview traces the development of robotic technology in industry and its implementation within the operating theatres. Finally, the first publications concerning robot-assisted colon and rectal surgery are reported together with a brief state of the art about this issue.