Robotic-assisted surgery in gynecologic oncology.
Identifieur interne : 000E77 ( Main/Merge ); précédent : 000E76; suivant : 000E78Robotic-assisted surgery in gynecologic oncology.
Auteurs : Abdulrahman K. Sinno [États-Unis] ; Amanda N. Fader [États-Unis]Source :
- Fertility and sterility [ 1556-5653 ] ; 2014.
English descriptors
- KwdEn :
- Clinical Competence, Cost-Benefit Analysis, Education, Medical, Graduate, Female, Genital Neoplasms, Female (economics), Genital Neoplasms, Female (pathology), Genital Neoplasms, Female (surgery), Gynecologic Surgical Procedures (economics), Gynecologic Surgical Procedures (education), Gynecologic Surgical Procedures (methods), Health Care Costs, Humans, Laparoscopy (economics), Laparoscopy (education), Learning Curve, Medical Oncology (economics), Medical Oncology (education), Medical Oncology (methods), Robotics (economics), Robotics (education), Surgery, Computer-Assisted (economics), Surgery, Computer-Assisted (education), Treatment Outcome.
- MESH :
- economics : Genital Neoplasms, Female, Gynecologic Surgical Procedures, Laparoscopy, Medical Oncology, Robotics, Surgery, Computer-Assisted.
- education : Gynecologic Surgical Procedures, Laparoscopy, Medical Oncology, Robotics, Surgery, Computer-Assisted.
- methods : Gynecologic Surgical Procedures, Medical Oncology.
- pathology : Genital Neoplasms, Female.
- surgery : Genital Neoplasms, Female.
- Clinical Competence, Cost-Benefit Analysis, Education, Medical, Graduate, Female, Health Care Costs, Humans, Learning Curve, Treatment Outcome.
Abstract
The quest for improved patient outcomes has been a driving force for adoption of novel surgical innovations across surgical subspecialties. Gynecologic oncology is one such surgical discipline in which minimally invasive surgery has had a robust and evolving role in defining standards of care. Robotic-assisted surgery has developed during the past two decades as a more technologically advanced form of minimally invasive surgery in an effort to mitigate the limitations of conventional laparoscopy and improved patient outcomes. Robotically assisted technology offers potential advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve surgeon dexterity, and tremor canceling software that improves surgical precision. These technological advances may allow the gynecologic oncology surgeon to perform increasingly radical oncologic surgeries in complex patients. However, the platform is not without limitations, including high cost, lack of haptic feedback, and the requirement for additional training to achieve competence. This review describes the role of robotic-assisted surgery in the management of endometrial, cervical, and ovarian cancer, with an emphasis on comparison with laparotomy and conventional laparoscopy. The literature on novel robotic innovations, special patient populations, cost effectiveness, and fellowship training is also appraised critically in this regard.
DOI: 10.1016/j.fertnstert.2014.08.020
PubMed: 25274485
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pubmed:25274485Le document en format XML
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Fader</name><affiliation wicri:level="2"><nlm:affiliation>The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland. 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Sinno</name><affiliation wicri:level="2"><nlm:affiliation>The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Fader, Amanda N" sort="Fader, Amanda N" uniqKey="Fader A" first="Amanda N" last="Fader">Amanda N. Fader</name><affiliation wicri:level="2"><nlm:affiliation>The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore, Maryland. Electronic address: afader1@jhmi.edu.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins Medicine, Baltimore</wicri:cityArea></affiliation></author></analytic><series><title level="j">Fertility and sterility</title><idno type="eISSN">1556-5653</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical Competence</term><term>Cost-Benefit Analysis</term><term>Education, Medical, Graduate</term><term>Female</term><term>Genital Neoplasms, Female (economics)</term><term>Genital Neoplasms, Female (pathology)</term><term>Genital Neoplasms, Female (surgery)</term><term>Gynecologic Surgical Procedures (economics)</term><term>Gynecologic Surgical Procedures (education)</term><term>Gynecologic Surgical Procedures (methods)</term><term>Health Care Costs</term><term>Humans</term><term>Laparoscopy (economics)</term><term>Laparoscopy (education)</term><term>Learning Curve</term><term>Medical Oncology (economics)</term><term>Medical Oncology (education)</term><term>Medical Oncology (methods)</term><term>Robotics (economics)</term><term>Robotics (education)</term><term>Surgery, Computer-Assisted (economics)</term><term>Surgery, Computer-Assisted (education)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Genital Neoplasms, Female</term><term>Gynecologic Surgical Procedures</term><term>Laparoscopy</term><term>Medical Oncology</term><term>Robotics</term><term>Surgery, Computer-Assisted</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Gynecologic Surgical Procedures</term><term>Laparoscopy</term><term>Medical Oncology</term><term>Robotics</term><term>Surgery, Computer-Assisted</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Gynecologic Surgical Procedures</term><term>Medical Oncology</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Genital Neoplasms, Female</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Genital Neoplasms, Female</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Clinical Competence</term><term>Cost-Benefit Analysis</term><term>Education, Medical, Graduate</term><term>Female</term><term>Health Care Costs</term><term>Humans</term><term>Learning Curve</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The quest for improved patient outcomes has been a driving force for adoption of novel surgical innovations across surgical subspecialties. Gynecologic oncology is one such surgical discipline in which minimally invasive surgery has had a robust and evolving role in defining standards of care. Robotic-assisted surgery has developed during the past two decades as a more technologically advanced form of minimally invasive surgery in an effort to mitigate the limitations of conventional laparoscopy and improved patient outcomes. Robotically assisted technology offers potential advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve surgeon dexterity, and tremor canceling software that improves surgical precision. These technological advances may allow the gynecologic oncology surgeon to perform increasingly radical oncologic surgeries in complex patients. However, the platform is not without limitations, including high cost, lack of haptic feedback, and the requirement for additional training to achieve competence. This review describes the role of robotic-assisted surgery in the management of endometrial, cervical, and ovarian cancer, with an emphasis on comparison with laparotomy and conventional laparoscopy. The literature on novel robotic innovations, special patient populations, cost effectiveness, and fellowship training is also appraised critically in this regard.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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