ArticleJournal of robotic surgery2023
Using LAP PROTECTOR™ to prevent subcutaneous emphysema after robotic gastrectomy.
Article in Journal of robotic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Incidence, risk factors, and clinical impact of subcutaneous emphysema following laparoscopic totally extraperitoneal inguinal herniorrhaphy: a retrospective cohort study.BMC anesthesiology · 2026Article
- Incidence of severe subcutaneous emphysema after robotic versus conventional laparoscopic surgery: A retrospective single-center study.Fujita medical journal · 2025Article
- Impact of the new robotic platform hinotori™ in preventing subcutaneous emphysema after colorectal cancer surgery.Surgical endoscopy · 2025Article
- Subcutaneous emphysema associated with laparoscopic or robotic abdominal surgery: a retrospective single-center study.Surgical endoscopy · 2024Article
- Risk factors and clinical significance of subcutaneous emphysema after robot-assisted laparoscopic rectal surgery: a single-center experience.Journal of robotic surgery · 2024Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Subcutaneous emphysema (SE), a complication of robotic gastrectomy (RG), occurs when the gas used to establish pneumoperitoneum escapes and enters the soft tissue. SE typically does not result in major clinical problems, but massive SE can have life-threatening consequences. Hence, developing adequate preventive methods against postoperative SE is essential. We aimed to determine whether an existing protective device, the LAP PROTECTOR™ (LP), can be used to reduce the incidence of SE after RG. We analyzed the data of 194 patients who underwent RG at our hospital between August 2016 and December 2022. Since September 2021 (the 102nd patient), we have used the LP (FF0504; Hakko Medical, Hongo, Tokyo, Japan) at the trocar site, as this was expected to reduce the incidence of SE. The primary endpoint of this study was the efficacy of the LP in reducing the incidence of clinically relevant SE (defined as SE extending into the cervical area) a day after RG. Univariate analysis revealed that sex, body mass index (BMI), and LP usage differed significantly between patients with and without postoperative SE. Logistic regression analysis revealed that male sex (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.15-0.72, P < 0.001), high BMI (OR: 0.13, 95% CI: 1.23-4.45, P = 0.009), and LP usage (OR: 0.11, 95% CI: 0.04-0.3, P < 0.001) were preventive factors independently associated with a lower incidence of clinically relevant SE. Placing an LP at the trocar site may be a safe and effective method of preventing SE after RG.
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