Evidence map›Paper›PMID 30656579›Full record

ArticleTechniques in coloproctology2019

Robotic-assisted stereotactic real-time navigation: initial clinical experience and feasibility for rectal cancer surgery.

S Atallah, E Parra-Davila, A G F Melani, L G Romagnolo, S W Larach, J Marescaux

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In one paragraph

Article in Techniques in coloproctology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

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  14. Robotic transanal total mesorectal excision: Is the future now?World journal of gastrointestinal surgery · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

S AtallahDepartment of Colorectal Surgery, EndoSurgical Center of Florida, Florida Hospital, 100 N. Dean Road, Orlando, FL, 32825, USA. atallah@post.harvard.edu.
E Parra-DavilaDepartment of Surgery, Good Samaritan Hospital, West Palm Beach, FL, 33401, USA.
A G F MelaniDepartment of Surgery, IRCAD, Latin America, Rio de Jeneiro, Brazil.
L G RomagnoloDepartment of Surgery, IRCAD, Latin America, Barretos, Brazil.
S W LarachDepartment of Colorectal Surgery, EndoSurgical Center of Florida, Florida Hospital, 100 N. Dean Road, Orlando, FL, 32825, USA.
J MarescauxDepartment of Surgery, IRCAD, France, Strasbourg, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReal-time stereotactic navigation for transanal total mesorectal excision has been demonstrated to be feasible in small pilot series using laparoscopic techniques. The possibility of real-time stereotactic navigation coupled with robotics has not been previously explored in a clinical setting.

methodsAfter pre-clinical assessment, and configuration of a robotic-assisted navigational system, two patients with locally advanced rectal cancer were selected for enrollment into a pilot study designed to assess the feasibility of navigation coupled with the robotic da Vinci Xi platform via TilePro interface. In one case, fluorescence-guided surgery was also used as an adjunct for structure localization, with local administration of indocyanine green into the ureters and at the tumor site.

resultsEach operation was successfully completed with a robotic-assisted approach; image-guided navigation provided computed accuracy of ± 4.5 to 4.6 mm. The principle limitation encountered was navigation signal dropout due to temporary loss of direct line-of-sight with the navigational system's infrared camera. Subjectively, the aid of navigation assisted the operating surgeon in identifying critical anatomical planes. The combination of fluorescence with image-guided surgery further augmented the surgeon's perception of the operative field.

conclusionsThe combination of stereotactic navigation and robotic surgery is feasible, although some limitations and technical challenges were observed. For complex surgery, the addition of navigation to robotics can improve surgical precision. This will likely represent the next step in the evolution of robotics and in the development of digital surgery.

Indexed as

Stereotaxic TechniquesAdultAgedFeasibility StudiesFemaleHumansLaparoscopyMaleMedical IllustrationNeuronavigationPilot ProjectsRectal NeoplasmsRobotic Surgical ProceduresSurgery, Computer-AssistedAugmented realityDa Vinci navigationDigital surgeryFluorescence-guided surgeryImage-guided surgeryRectal cancerRobotic colorectalStereotactic navigationTaTME

Identifiers

PMID30656579

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.