Redefining robotic surgical education: teleproctoring feasibility and trainee perception.

Teleproctoring offers a remote alternative to traditional surgical mentoring, addressing logistical barriers in robotic surgery education. We conducted a prospective trial to assess the feasibility and trainee perception of teleproctoring using the Proximie platform. Eighteen surgeons with limited robotic experience performed a standardized enterotomy closure on synthetic bowel models using the da Vinci Si system, while receiving real-time remote guidance from an expert located 2570 km away.

Design and implementation of a composite performance score to drive cost efficiency in robotic-assisted surgery: the Orlando Score.

This study describes and evaluates the implementation of a composite performance score, an integrated metric designed to enhance performance in robotic surgery by focusing on three domains: operational efficiency, cost control, and clinical outcomes. Quarterly feedback meetings to discuss the evaluations based on the score and individualized reports fostered active surgeon engagement in cost-reduction strategies. The project compared two cohorts: an intervention group where surgeons adopted the score and a control group where it was not implemented.

Robot-assisted inguinal hernia repair and prostatectomy: safety and outcomes from a retrospective cohort study.

Prostate cancer and inguinal hernia frequently coexist in elderly men, with 20-33% of patients undergoing radical prostatectomy also presenting with an inguinal hernia. Combining robot-assisted radical prostatectomy (RARP) with transabdominal preperitoneal (rTAPP) hernia repair offers both clinical and logistical benefits, although concerns regarding mesh-related complications remain. This retrospective cohort study analyzed 40 patients who underwent combined RARP and rTAPP hernia repair between August 2021 and September 2024.

Is YouTube a reliable tool for approaching robotic assisted transabdominal preperitoneal surgery? A critical review of the available resources.

Introduction: The robotic transabdominal preperitoneal approach (rTAPP) is a relatively recent technique for the treatment of inguinal hernia. To achieve optimal results, the 10 golden rules described must be followed. Surgeons in training often review videos to familiarize themselves with new techniques, YouTube being one of the most used platforms.

Analysis of the Impact of the Learning Curve on the Safety Outcome of the Totally Robotic-Assisted Biliopancreatic Diversion with Duodenal Switch: a Single-Institution Observational Study.

Introduction: Totally robotic-assisted biliopancreatic diversion with duodenal switch (BPD/DS) learning curve has been described to be longer at approximately 50 cases, at which point operative time and complications rate decrease and tend to stabilize. This study aimed to form an analysis of the impact of the learning curve on the safety outcomes of the totally robotic-assisted BPD/DS.

Methods: A retrospective review of patients who underwent primary totally robotic-assisted BPD/DS by one of our certified bariatric and metabolic surgeon member of our institution was performed.

Improving efficiency and reducing costs in robotic surgery: a Lean Six Sigma approach to optimize turnover time.

Operating room (OR) turnover time (TOT) is the time it takes to prepare an OR for the next surgery after the previous one has been completed. Reducing OR TOT can improve the efficiency of the OR, reduce costs, and improve surgeons' and patients' satisfaction. The objective of this study is to evaluate the effectiveness of an operating room (OR) turnover time (TOT) reduction initiative using the Lean Six Sigma methodology (DMAIC) in the bariatric and thoracic service lines.

Introducing the E100: will the improvement make a significant difference? Financial analysis based on sleeve gastrectomy.

Robotic-assisted surgery has been shown to offer significant benefits for both patients and surgeons. However, the high cost of the equipment remains a major barrier to its widespread adoption in the medical field. To ensure cost-effectiveness of these procedures, it is important to implement strategies that can help reduce the costs involved.

Robot-assisted duodenal switch with DaVinci Xi: surgical technique and analysis of a single-institution experience of 661 cases.

Metabolic and bariatric surgery is an effective treatment for the management of obesity and related comorbidities. Although the duodenal switch has demonstrated superior results in terms of resolution of obesity-related comorbidities and weight loss, it is one of the less performed procedures. The use of robotic surgical platforms offers many advantages in obese patients and is particularly useful in technically demanding procedures such as duodenal switch.

Minimally Invasive Management of Post-treatment Rectovesical Fistulae.

The aim of this study is to report our experience in minimally invasive management of rectovesical fistulae (RVFs). Between 2004 and 2021, 24 patients who underwent minimally invasive RVF repair by a single surgeon at 3 international institutions were retrospectively reviewed. Baseline demographic characteristics and perioperative and postoperative variables were collected.

Minimally Invasive Management of Rectourethral Fistulae.

Objective: To report our experience and outcomes in minimally invasive management of rectourethral fistula (RUF).

Methods: From 2004 to 2021, 15 patients who underwent minimally invasive RUF repair by a single surgeon at 2 international institutions were retrospectively reviewed. Baseline demographic characteristics, perioperative, and postoperative data were collected.

Development of a robot-assisted thoracic surgery (RATS) program. Lessons learned after 2500 cases.

Robotic surgery provides significant advantages in terms of an optimal three-dimensional and magnified view of the surgical field, superior maneuverability of surgical instruments, removal of surgeon's tremor and excellent ergonomics. Nonetheless, the adoption of this technology in thoracic surgery has been slower than in other specialties such as urology, gynecology or digestive surgery. In this article we describe our institution's experience in robotic-assisted thoracic surgery (RATS) in the span from 2012 to 2020.

Robotic surgery: financial impact of surgical trays optimization in bariatric and thoracic surgery.

The incorporation of new technologies in the surgical field, such as the robotic da Vinci System, has made it possible to offer a series of advantages to the patient and the surgeon, with important benefits for both. However, cost continues to be a limiting factor to the adoption of this technology. The development of strategies to maximize the measures that can lead to reduced expenses is a key factor to improve cost-benefit ratio.

FFClust: Fast fiber clustering for large tractography datasets for a detailed study of brain connectivity.

Automated methods that can identify white matter bundles from large tractography datasets have several applications in neuroscience research. In these applications, clustering algorithms have shown to play an important role in the analysis and visualization of white matter structure, generating useful data which can be the basis for further studies. This work proposes FFClust, an efficient fiber clustering method for large tractography datasets containing millions of fibers.

Multi-informant universal screening: Evaluation of rater, item, and construct variance using a trifactor model.

Universal screening is a proactive method for identifying student risk, yet remains under-utilized in school systems. Instead, many schools rely on teacher reports and referrals without accounting for different informant perspectives. In the current study, multi-informant universal screening in evaluated using a trifactor model.

Robot-assisted surgery and incisional hernia: a comparative study of ergonomics in a training model.

Over the years, incisional hernia repair has evolved. Currently, primary closure of the defect before placing the mesh is a critical step in incisional hernia repair and minimally invasive surgery incorporation has an important role due to great advantages. Despite its benefits, laparoscopic closure with suture intracorporeal knotting is physically demanding and technically complex.

Laparoscopic subtotal cholecystectomy: a surgical alternative to reduce complications in complex cases.

Introduction: Laparoscopic cholecystectomy is a common procedure in general surgery, and in complex cases it is important for the surgeon to know all the alternatives with low associated morbidity. Laparoscopic subtotal cholecystectomy should be considered as an option when a critical view of safety cannot be obtained, because it has a low complication rate and gives the advantages of minimally invasive surgery.

Methods: Retrospective study of laparoscopic subtotal cholecystectomies in an eight years period.

Robot-assisted video endoscopic inguinal lymphadenectomy for melanoma.

Inguinal lymphadenectomy is the indicated procedure in the regional lymph node management for patients with lower limb melanoma and positive nodes. This procedure is commonly associated with surgical site complications. Video endoscopic inguinal lymphadenectomy is a minimally invasive alternative with oncological principles and lower wound-related morbidity.

Robot-assisted laparoscopic gastrectomy for Menetrier's disease.

Menetrier's disease, also known as hypoproteinemic hypertrophic gastropathy, is a rare condition characterized by the presence of gastric hypertrophy with foveolar infiltration that replaces the normal glandular architecture. We present a case of a 65-year-old female patient who had epigastric pain after meals which progressed to oral intolerance and weight loss. Upper endoscopy was performed showing prominent folds in the gastric mucosa and stenosis at the antrum-pylorus.

Laparoscopic surgery skills evaluation: analysis based on accelerometers.

Background And Objective: Technical skills assessment is considered an important part of surgical training. Subjective assessment is not appropriate for training feedback, and there is now increased demand for objective assessment of surgical performance. Economy of movement has been proposed as an excellent alternative for this purpose.

Clinical and pathological features of colorectal cancer in patients at a community hospital in Puerto Rico.

Objective: Colorectal cancer (CRC) is among the most common cancers in Puerto Rico. Few studies have correlated clinical and pathological variables with the overall survival of CRC patients in Puerto Rico. We report the clinical and pathological characteristics of patients who underwent surgical resection at a community hospital in Puerto Rico.

Robotic-assisted Heller myotomy versus laparoscopic Heller myotomy for the treatment of esophageal achalasia: a case-control study.

Minimally invasive surgery has become the gold standard for the treatment of achalasia. The incorporation of robotic technology can improve many limitations of laparoscopic surgery, through, for example, the availability of three-dimensional vision, increasing the degrees of movement, avoiding the fulcrum effect and optimizing ergonomics. The aim of this study was to compare robotic-assisted laparoscopic Heller myotomy (RAHM) with laparoscopic Heller myotomy (LHM) in terms of efficacy and safety.

Laparoscopic common bile duct exploration four-task training model: construct validity.

Background: Training models in laparoscopic surgery allow the surgical team to practice procedures in a safe environment. We have proposed the use of a 4-task, low-cost inert model to practice critical steps of laparoscopic common bile duct exploration.

Methods: The performance of 3 groups with different levels of expertise in laparoscopic surgery, novices (A), intermediates (B), and experts (C), was evaluated using a low-cost inert model in the following tasks: (1) intraoperative cholangiography catheter insertion, (2) transcystic exploration, (3) T-tube placement, and (4) choledochoscope management.

Robot-assisted laparoscopic common bile duct exploration: case report and proposed training model.

We present a case of a 32-year-old female patient with the diagnosis of gallstone disease and choledocholithiasis. Prior to in vivo surgery, we practiced the critical steps of the procedure using a proposed inert training model. We performed a robot-assisted laparoscopic common bile duct exploration, obtaining one stone.

Laparoscopic common bile duct exploration in patients with gallstones and choledocholithiasis.

Objectives: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP).

Methods: This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included.