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Conversions related to adhesions in abdominal surgery. Robotic versus laparoscopic approach: A multicentre experience
Author(s) -
Milone Marco,
de'Angelis Nicola,
Beghdadi Nassiba,
Brunetti Francesco,
Manigrasso Michele,
De Simone Giuseppe,
Servillo Giuseppe,
Vertaldi Sara,
De Palma Giovanni Domenico
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2186
Subject(s) - medicine , adhesion , abdominal surgery , surgery , laparoscopy , clinical endpoint , laparoscopic surgery , robotic surgery , open surgery , randomized controlled trial , chemistry , organic chemistry
Background An advantage of robotic surgery over laparoscopy is the lower rate of unplanned conversion. One of the implicated reasons for conversion is adhesions from previous abdominal surgeries (PASs). Methods A comparative analysis of 98 patients with history of open PAS treated by laparoscopic or robotic surgery was performed. Primary endpoint was the rate of conversion to open surgery related to adhesiolysis. Secondary endpoints were short‐term outcomes and complications. Results Conversion rate specifically related to adhesiolysis was significantly lower in robotic group (13 for laparoscopic group vs. 2 for robotic group; p = 0.046). Conversions occurred during adhesiolysis were significantly related to severity of adhesions expressed by peritoneal adhesion index (PAI) score ( p < 0.001), number of abdominal areas involved by adhesions ( p < 0.001) and severity of PAI into the target area of surgical intervention ( p = 0.021). Conclusions Benefits of robotic surgery are more noticeable in performing procedures with increasing technical difficulties.