Robotic-assisted cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
Adenocarcinoma, Mucinous
/ therapy
Appendicitis
/ therapy
Combined Modality Therapy
Cytoreduction Surgical Procedures
/ methods
Feasibility Studies
Female
Humans
Hyperthermia, Induced
/ methods
Middle Aged
Neoplasm, Residual
Peritoneal Neoplasms
/ therapy
Robotic Surgical Procedures
/ methods
Treatment Outcome
Cytoreductive surgery
HIPEC
Robotic assisted
Journal
Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
14
02
2018
accepted:
23
04
2018
pubmed:
8
5
2018
medline:
20
6
2019
entrez:
7
5
2018
Statut:
ppublish
Résumé
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an appropriate treatment for select patients with peritoneal carcinomatosis. While most commonly performed through an open incision, the laparoscopic approach has been reported and offers short-term benefits. A robotic-assisted approach for carcinomatosis of gastrointestinal origin, however, has not yet been described. We report our approach to robotic-assisted CRS-HIPEC for a patient with a perforated appendiceal mucocele. Our dynamic video highlights the advantages of this approach. Our patient was a 57-year-old woman with minimal residual disseminated peritoneal adenomucinosis (DPAM), having a peritoneal carcinomatosis index (PCI) score of 1. She had a previous surgical history of a Roux-en-Y gastric bypass. A robotic-assisted approach was utilized using the Intuitive daVinci Xi robotic surgical system through 4 ports. No laparoscopic assistant port was required. The operative time was 426 min, and the estimated blood loss was 50 cc. The greater omentum, falciform ligament, bilateral ovaries, and two small areas of tumor implant were resected. The post-operative length of stay was 4 days, and the patient had regained bowel function by post-operative day 2. Our video demonstrates the feasibility of a robotic-assisted CRS-HIPEC in a patient with minimal, residual DPAM. Similar to a laparoscopic approach, the short-term outcomes are improved as compared to an open approach. An MIS approach to CRS-HIPEC, now with the first-reported robotic-assisted approach, is a viable option for select patients with peritoneal tumors.
Sections du résumé
BACKGROUND
BACKGROUND
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is an appropriate treatment for select patients with peritoneal carcinomatosis. While most commonly performed through an open incision, the laparoscopic approach has been reported and offers short-term benefits. A robotic-assisted approach for carcinomatosis of gastrointestinal origin, however, has not yet been described.
METHODS
METHODS
We report our approach to robotic-assisted CRS-HIPEC for a patient with a perforated appendiceal mucocele. Our dynamic video highlights the advantages of this approach.
RESULTS
RESULTS
Our patient was a 57-year-old woman with minimal residual disseminated peritoneal adenomucinosis (DPAM), having a peritoneal carcinomatosis index (PCI) score of 1. She had a previous surgical history of a Roux-en-Y gastric bypass. A robotic-assisted approach was utilized using the Intuitive daVinci Xi robotic surgical system through 4 ports. No laparoscopic assistant port was required. The operative time was 426 min, and the estimated blood loss was 50 cc. The greater omentum, falciform ligament, bilateral ovaries, and two small areas of tumor implant were resected. The post-operative length of stay was 4 days, and the patient had regained bowel function by post-operative day 2.
CONCLUSIONS
CONCLUSIONS
Our video demonstrates the feasibility of a robotic-assisted CRS-HIPEC in a patient with minimal, residual DPAM. Similar to a laparoscopic approach, the short-term outcomes are improved as compared to an open approach. An MIS approach to CRS-HIPEC, now with the first-reported robotic-assisted approach, is a viable option for select patients with peritoneal tumors.
Identifiants
pubmed: 29730733
doi: 10.1007/s11701-018-0820-7
pii: 10.1007/s11701-018-0820-7
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
175-179Références
Esquivel J, Sticca R, Sugarbaker P, Levine E, Yan TD, Alexander R, Baratti D, Bartlett D, Barone R, Barrios P et al (2007) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Society of Surgical Oncology. Ann Surg Oncol 14(1):128–133
doi: 10.1245/s10434-006-9185-7
pubmed: 17072675
Glehen O, Gilly FN, Boutitie F, Bereder JM, Quenet F, Sideris L, Mansvelt B, Lorimier G, Msika S, Elias D (2010) Toward curative treatment of peritoneal carcinomatosis from nonovarian origin by cytoreductive surgery combined with perioperative intraperitoneal chemotherapy: a multi-institutional study of 1,290 patients. Cancer 116(24):5608–5618
doi: 10.1002/cncr.25356
pubmed: 20737573
Verwaal VJ, Bruin S, Boot H, van Slooten G, van Tinteren H (2008) 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 15(9):2426–2432
doi: 10.1245/s10434-008-9966-2
pubmed: 18521686
National Comprehensive Cancer Network. Colon Cancer (2017) (Version 2.2017). http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf . Accessed 5 January 2018
Sugarbaker PH, Van der Speeten K (2016) Surgical technology and pharmacology of hyperthermic perioperative chemotherapy. J Gastrointest Oncol 7(1):29–44
pubmed: 26941982
pmcid: 4754302
Lotti M, Capponi MG, Piazzalunga D, Poiasina E, Pisano M, Manfredi R, Ansaloni L (2016) Laparoscopic HIPEC: a bridge between open and closed-techniques. J Minim Access Surg 12(1):86–89
doi: 10.4103/0972-9941.158965
pubmed: 26917929
pmcid: 4746985
Facchiano E, Risio D, Kianmanesh R, Msika S (2012) Laparoscopic hyperthermic intraperitoneal chemotherapy: indications, aims, and results: a systematic review of the literature. Ann Surg Oncol 19(9):2946–2950
doi: 10.1245/s10434-012-2360-0
pubmed: 22526907
Fagotti A, Costantini B, Gallotta V, Cianci S, Ronsini C, Petrillo M, Pacciani M, Scambia G, Fanfani F (2015) Minimally invasive secondary cytoreduction plus HIPEC versus open surgery plus HIPEC in isolated relapse from ovarian cancer: a retrospective cohort study on perioperative outcomes. J Minim Invasive Gynecol 22(3):428–432
doi: 10.1016/j.jmig.2014.11.008
pubmed: 25461683
Esquivel J, Averbach A, Chua TC (2011) Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with limited peritoneal surface malignancies: feasibility, morbidity and outcome in an early experience. Ann Surg 253(4):764–768
doi: 10.1097/SLA.0b013e31820784df
pubmed: 21475017
Gabriel E, Singla S, Kim M, Fisher D, Powers C, Visioni A, Attwood K, Skitzki J (2017) Water lavage as an adjunct to cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Am J Surg 214(3):462–467
doi: 10.1016/j.amjsurg.2017.05.016
pubmed: 28622839
pmcid: 5833924
Levine EA, Votanopoulos KI, Shen P, Russell G, Fenstermaker J, Mansfield P, Bartlett D, Stewart JH (2018) A multicenter randomized trial to evaluate hematologic toxicities after hyperthermic intraperitoneal chemotherapy with oxaliplatin or mitomycin in patients with appendiceal tumors. J Am Coll Surg 226(4):434–443
doi: 10.1016/j.jamcollsurg.2017.12.027
pubmed: 29331663
pmcid: 5890298
Abu Gazala M, Wexner SD (2017) Re-appraisal and consideration of minimally invasive surgery in colorectal cancer. Gastroenterol Rep (Oxf) 5(1):1–10
doi: 10.1093/gastro/gox001
Kang SB1, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, Lim SB, Lee TG, Kim DY, Kim JS et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol 11(7):637–645
doi: 10.1016/S1470-2045(10)70131-5
pubmed: 20610322
Tarr ME, Brancato SJ, Cunkelman JA, Polcari A Nutter B, Kenton K (2015) Comparison of postural ergonomics between laparoscopic and robotic sacrocolpopexy: a pilot study. J Minim Invasive Gynecol 2(2):234–238
doi: 10.1016/j.jmig.2014.10.004
Lunca S, Bouras G, Stanescu AC (2005) Gastrointestinal robot-assisted surgery. A current perspective. Rom J Gastroenterol 14(4):385–391
pubmed: 16400356
Harr JN, Luka S, Kankaria A, Juo YY, Agarwal S, Obias V (2017) Robotic-assisted colorectal surgery in obese patients: a case-matched series. Surg Endosc 31(7):2813–2819
doi: 10.1007/s00464-016-5291-1
pubmed: 27796599
Lotti M, Giulii Capponi M, Campanati L, Poiasina E, Ansaloni L, Poletti E, Frigerio L (2016) The onset of intra-abdominal adhesions during closed-abdomen hyperthermic intraperitoneal chemotherapy. J Laparoendosc Adv Surg Tech A 26(12):997–1002
doi: 10.1089/lap.2016.0396
pubmed: 27705085
Tuvin D, Berger Y, Aycart SN, Shtilbans T, Hiotis S, Labow DM, Sarpel U (2016) Prophylactic hyperthermic intraperitoneal chemotherapy in patients with epithelial appendiceal neoplasms. Int J Hyperth 32(3):311–315
doi: 10.3109/02656736.2016.1152514
Fish R, Selvasekar C, Crichton P, Wilson M, Fulford P, Renehan A, O’Dwyer S (2014) Risk-reducing laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for low-grade appendiceal mucinous neoplasm: early outcomes and technique. Surg Endosc 28(1):341–345
doi: 10.1007/s00464-013-3189-8
pubmed: 24061624
Vasudevan V, Reusche R, Wallace H, Kaza S (2016 Dec) Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries. Surg Endosc 30(12):5490–5493
doi: 10.1007/s00464-016-4910-1
pubmed: 27126626