What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer?
Background Many studies have shown that robotic gastrectomy requires a longer operation time than laparoscopic gastrectomy. However, no study has analyzed the exact reason for this difference in detail. We therefore investigated the reasons why more time is needed in robotic gastrectomy. Methods Ten...
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| Veröffentlicht in: | Surgical endoscopy 2019-01, Vol.33 (1), p.192-198 |
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| creator | Liu, Heli Kinoshita, Takahiro Tonouchi, Akiko Kaito, Akio Tokunaga, Masanori |
| description | Background
Many studies have shown that robotic gastrectomy requires a longer operation time than laparoscopic gastrectomy. However, no study has analyzed the exact reason for this difference in detail. We therefore investigated the reasons why more time is needed in robotic gastrectomy.
Methods
Ten consecutive cases of robotic distal gastrectomy (RDG) performed in our institution were selected to measure the operation time in detail. Ten cases of laparoscopic distal gastrectomy (LDG) performed during the same period were chosen for comparison. The operation videos and electronic medical records of these 20 patients were retrospectively reviewed. The overall operation time, operation time in each step, and time required for instrument changes were measured. The number of intraoperative instrument changes and camera cleanings were also counted.
Results
The overall operation time (including effective time and junk time) was 56.8 min longer for RDG than LDG (273.7 vs. 216.9 min, respectively;
p
= 0.000). The effective time was only 15.3 min longer for RDG than LDG (145.9 vs. 130.6 min, respectively;
p
= 0.094). The time needed for the six technical steps was also not significantly different between the two groups. However, the junk time (instrument setup and docking or positioning of surgical arms) was 41.5 min longer for RDG than LDG (127.8 vs. 86.2 min, respectively;
p
= 0.001). The number of instrument changes was not different between RDG and LDG (
p
= 0.277), but the time required for each was longer for RDG than LDG (
p
= 0.000). The number of camera cleanings was lower for RDG than LDG (10.7 vs. 15.5 times, respectively;
p
= 0.005).
Conclusions
To reduce the operation time in RDG, a smarter and simpler system for setup should be developed to reduce the junk time. Additionally, a system for swifter instrument changes and more sophisticated energy devices are warranted to reduce the effective time. |
| doi_str_mv | 10.1007/s00464-018-6294-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2059552508</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2058844699</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-2e9e81fc059a052ae54a366f615141e88529974c4cafb73083c5ac34986b85ce3</originalsourceid><addsrcrecordid>eNp1kU9r3DAQxUVoSDbbfIBeiqCXXJzory2dSlnSJhDIpaVHMauMdx1sy5W0kIV8-Mhs2kIgJw3M7z3NzCPkE2eXnLHmKjGmalUxbqpaWFU9HZEFV1JUQnDzgSyYlawSjVWn5CylR1Zwy_UJORXWKsnqZkGef28hU4hI8xZpREhhTLQNkQLtw7jBSMOEEXIXRpq7AWk30hjWIXeebiDliD6HYV_kMM69HiaIIfkwvQFmz1Qq8FvqYfQYv34kxy30Cc9f3yX59f365-qmurv_cbv6dld5JU2uBFo0vPVMW2BaAGoFsq7bmmuuOBqjyz6N8spDu24kM9Jr8FJZU6-N9iiX5OLgO8XwZ4cpu6FLHvseRgy75ERx1lroolySL2_Qx7CLY5lupoxRqra2UPxA-bJqiti6KXYDxL3jzM3RuEM0rkTj5mjcU9F8fnXerQd8-Kf4m0UBxAFIpTVf_v_X77u-AM8xmro</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2058844699</pqid></control><display><type>article</type><title>What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer?</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Liu, Heli ; Kinoshita, Takahiro ; Tonouchi, Akiko ; Kaito, Akio ; Tokunaga, Masanori</creator><creatorcontrib>Liu, Heli ; Kinoshita, Takahiro ; Tonouchi, Akiko ; Kaito, Akio ; Tokunaga, Masanori</creatorcontrib><description>Background
Many studies have shown that robotic gastrectomy requires a longer operation time than laparoscopic gastrectomy. However, no study has analyzed the exact reason for this difference in detail. We therefore investigated the reasons why more time is needed in robotic gastrectomy.
Methods
Ten consecutive cases of robotic distal gastrectomy (RDG) performed in our institution were selected to measure the operation time in detail. Ten cases of laparoscopic distal gastrectomy (LDG) performed during the same period were chosen for comparison. The operation videos and electronic medical records of these 20 patients were retrospectively reviewed. The overall operation time, operation time in each step, and time required for instrument changes were measured. The number of intraoperative instrument changes and camera cleanings were also counted.
Results
The overall operation time (including effective time and junk time) was 56.8 min longer for RDG than LDG (273.7 vs. 216.9 min, respectively;
p
= 0.000). The effective time was only 15.3 min longer for RDG than LDG (145.9 vs. 130.6 min, respectively;
p
= 0.094). The time needed for the six technical steps was also not significantly different between the two groups. However, the junk time (instrument setup and docking or positioning of surgical arms) was 41.5 min longer for RDG than LDG (127.8 vs. 86.2 min, respectively;
p
= 0.001). The number of instrument changes was not different between RDG and LDG (
p
= 0.277), but the time required for each was longer for RDG than LDG (
p
= 0.000). The number of camera cleanings was lower for RDG than LDG (10.7 vs. 15.5 times, respectively;
p
= 0.005).
Conclusions
To reduce the operation time in RDG, a smarter and simpler system for setup should be developed to reduce the junk time. Additionally, a system for swifter instrument changes and more sophisticated energy devices are warranted to reduce the effective time.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6294-x</identifier><identifier>PMID: 29943067</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Female ; Gastrectomy - methods ; Gastric cancer ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Operative Time ; Proctology ; Retrospective Studies ; Robotic Surgical Procedures - methods ; Robotics ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - surgery ; Surgery ; Treatment Outcome</subject><ispartof>Surgical endoscopy, 2019-01, Vol.33 (1), p.192-198</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-2e9e81fc059a052ae54a366f615141e88529974c4cafb73083c5ac34986b85ce3</citedby><cites>FETCH-LOGICAL-c438t-2e9e81fc059a052ae54a366f615141e88529974c4cafb73083c5ac34986b85ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6294-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6294-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29943067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Heli</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Tonouchi, Akiko</creatorcontrib><creatorcontrib>Kaito, Akio</creatorcontrib><creatorcontrib>Tokunaga, Masanori</creatorcontrib><title>What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer?</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Many studies have shown that robotic gastrectomy requires a longer operation time than laparoscopic gastrectomy. However, no study has analyzed the exact reason for this difference in detail. We therefore investigated the reasons why more time is needed in robotic gastrectomy.
Methods
Ten consecutive cases of robotic distal gastrectomy (RDG) performed in our institution were selected to measure the operation time in detail. Ten cases of laparoscopic distal gastrectomy (LDG) performed during the same period were chosen for comparison. The operation videos and electronic medical records of these 20 patients were retrospectively reviewed. The overall operation time, operation time in each step, and time required for instrument changes were measured. The number of intraoperative instrument changes and camera cleanings were also counted.
Results
The overall operation time (including effective time and junk time) was 56.8 min longer for RDG than LDG (273.7 vs. 216.9 min, respectively;
p
= 0.000). The effective time was only 15.3 min longer for RDG than LDG (145.9 vs. 130.6 min, respectively;
p
= 0.094). The time needed for the six technical steps was also not significantly different between the two groups. However, the junk time (instrument setup and docking or positioning of surgical arms) was 41.5 min longer for RDG than LDG (127.8 vs. 86.2 min, respectively;
p
= 0.001). The number of instrument changes was not different between RDG and LDG (
p
= 0.277), but the time required for each was longer for RDG than LDG (
p
= 0.000). The number of camera cleanings was lower for RDG than LDG (10.7 vs. 15.5 times, respectively;
p
= 0.005).
Conclusions
To reduce the operation time in RDG, a smarter and simpler system for setup should be developed to reduce the junk time. Additionally, a system for swifter instrument changes and more sophisticated energy devices are warranted to reduce the effective time.</description><subject>Abdominal Surgery</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Operative Time</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Stomach Neoplasms - diagnosis</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU9r3DAQxUVoSDbbfIBeiqCXXJzory2dSlnSJhDIpaVHMauMdx1sy5W0kIV8-Mhs2kIgJw3M7z3NzCPkE2eXnLHmKjGmalUxbqpaWFU9HZEFV1JUQnDzgSyYlawSjVWn5CylR1Zwy_UJORXWKsnqZkGef28hU4hI8xZpREhhTLQNkQLtw7jBSMOEEXIXRpq7AWk30hjWIXeebiDliD6HYV_kMM69HiaIIfkwvQFmz1Qq8FvqYfQYv34kxy30Cc9f3yX59f365-qmurv_cbv6dld5JU2uBFo0vPVMW2BaAGoFsq7bmmuuOBqjyz6N8spDu24kM9Jr8FJZU6-N9iiX5OLgO8XwZ4cpu6FLHvseRgy75ERx1lroolySL2_Qx7CLY5lupoxRqra2UPxA-bJqiti6KXYDxL3jzM3RuEM0rkTj5mjcU9F8fnXerQd8-Kf4m0UBxAFIpTVf_v_X77u-AM8xmro</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Liu, Heli</creator><creator>Kinoshita, Takahiro</creator><creator>Tonouchi, Akiko</creator><creator>Kaito, Akio</creator><creator>Tokunaga, Masanori</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190101</creationdate><title>What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer?</title><author>Liu, Heli ; Kinoshita, Takahiro ; Tonouchi, Akiko ; Kaito, Akio ; Tokunaga, Masanori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-2e9e81fc059a052ae54a366f615141e88529974c4cafb73083c5ac34986b85ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Operative Time</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Stomach Neoplasms - diagnosis</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Heli</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Tonouchi, Akiko</creatorcontrib><creatorcontrib>Kaito, Akio</creatorcontrib><creatorcontrib>Tokunaga, Masanori</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Heli</au><au>Kinoshita, Takahiro</au><au>Tonouchi, Akiko</au><au>Kaito, Akio</au><au>Tokunaga, Masanori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer?</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>33</volume><issue>1</issue><spage>192</spage><epage>198</epage><pages>192-198</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Many studies have shown that robotic gastrectomy requires a longer operation time than laparoscopic gastrectomy. However, no study has analyzed the exact reason for this difference in detail. We therefore investigated the reasons why more time is needed in robotic gastrectomy.
Methods
Ten consecutive cases of robotic distal gastrectomy (RDG) performed in our institution were selected to measure the operation time in detail. Ten cases of laparoscopic distal gastrectomy (LDG) performed during the same period were chosen for comparison. The operation videos and electronic medical records of these 20 patients were retrospectively reviewed. The overall operation time, operation time in each step, and time required for instrument changes were measured. The number of intraoperative instrument changes and camera cleanings were also counted.
Results
The overall operation time (including effective time and junk time) was 56.8 min longer for RDG than LDG (273.7 vs. 216.9 min, respectively;
p
= 0.000). The effective time was only 15.3 min longer for RDG than LDG (145.9 vs. 130.6 min, respectively;
p
= 0.094). The time needed for the six technical steps was also not significantly different between the two groups. However, the junk time (instrument setup and docking or positioning of surgical arms) was 41.5 min longer for RDG than LDG (127.8 vs. 86.2 min, respectively;
p
= 0.001). The number of instrument changes was not different between RDG and LDG (
p
= 0.277), but the time required for each was longer for RDG than LDG (
p
= 0.000). The number of camera cleanings was lower for RDG than LDG (10.7 vs. 15.5 times, respectively;
p
= 0.005).
Conclusions
To reduce the operation time in RDG, a smarter and simpler system for setup should be developed to reduce the junk time. Additionally, a system for swifter instrument changes and more sophisticated energy devices are warranted to reduce the effective time.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29943067</pmid><doi>10.1007/s00464-018-6294-x</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Surgical endoscopy, 2019-01, Vol.33 (1), p.192-198 |
| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdominal Surgery Female Gastrectomy - methods Gastric cancer Gastroenterology Gynecology Hepatology Humans Laparoscopy Laparoscopy - methods Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Operative Time Proctology Retrospective Studies Robotic Surgical Procedures - methods Robotics Stomach Neoplasms - diagnosis Stomach Neoplasms - surgery Surgery Treatment Outcome |
| title | What are the reasons for a longer operation time in robotic gastrectomy than in laparoscopic gastrectomy for stomach cancer? |
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