2nd International Summit on
Robotic Surgery & Surgical System
Scientific Program
Keynote Session:
Title: Which procedure should we prefer robotic surgical system to laparoscopy?
Biography:
Asst.Prof. Dr, Istanbul Medipol University, Department of Urogynecology, Istanbul, Turkey
Abstract:
Objective: The robotic surgical system is mainly superior to laparoscopy with its ability to move in seven axes and the opportunity to mimic the surgeon's hand movements. At the same time provides the surgeon with a high-definition, three-dimensional view of the operative field. However, despite these advantages, it have not completely replace laparoscopy. However, in some procedures, we prefer the robotic system especially to laparoscopy. Here, we aimed to evaluate the cases in which we prefer the robot to the laparoscopy.
Methodology: An electronic-based search was performed on our university database for benign gynecologic operations performed with Da Vınci XI Robotic system and laparoscopy in the last 10 years was searched. The indications were also Compared.
Findings: We found 1152 benign minimal invasive procedures performed for benıgn conditions at this period. 220(19.09%) of them operated with Da Vınci XI Robotic system and the rest was performed with laparascopy. When we search the indications of surgeries from the patient file archives, we see that the robotic system was most frequently preferred in  deep infiltrating endometriosis120(54.5%), myomectomy48(21.8%), (11.2%), hysterectomy 50(22.7%) and tuboplasty2(0.9%) procedures respectively. On the other hand laparascopy was most frequently preferred for hysterectomy ,myomectomy , ovarian cystectomy respectively.
Conclusion & Significance: Since the higher cost of robotic surgery, it does not seem possible to replace the laparoscopy completely. However, endometriosis, which requires dissection in deeper abdominal planes, in tuboplasty and myomectomy procedures as easier suturation capability with hıgh definition, three-dimensional view,  robotic system is preferred primarily.
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Title: Challenges in Reprocessing Reusable Robotic Instruments: getting a handle on time, technology and training
Biography:
Casey Czarnowski’s surgical instrument processing experience spans 13 years at Sanford and Essentia hospitals in Fargo, ND, and Stanford Health Care in Palo Alto CA. In addition, Casey has brought his experience to the classroom at Skyline and MedTek Colleges in San Bruno and Hayward, CA, and serves on the Board of Directors of the California Central Service Association. In the sterile processing department, Casey has held the positions of Clinics Coordinator, Endoscope Reprocessing Specialist, Supervisor, Preceptor, and Educator. Casey currently works on the Interventional Platform Education team for the Stanford Health Care enterprise. Casey’s role on the team is to support the doctors, nurses, and technicians of the Platform with education and training in the discipline of surgical instrument reprocessing. Casey feels fortunate to cover Stanford’s two in-patient facilities, and six ambulatory sites in his daily work.
Abstract:
Since pioneering efforts in the mid-1980s, robotic procedures worldwide have become widespread around the world.1 Millions of patients have benefitted from minimally invasive procedures in Gynecology, Urology, Neurology, Orthopedics, ENT, and many more. More than a dozen companies produce robots for both general and specialized applications. Between procedures, the reusable components of the robot are cleaned, decontaminated and sterilized in the Sterile Processing Department of the hospital. In general, robotic instruments are difficult to clean, require specialized equipment to decontaminate. However, successfully cleaning and sterilizing these instruments is of vital importance to our patients. It is important for everyone involved in robotic surgery to have knowledge of this important facet of patient care. Crucial to this effort are proper reprocessing equipment, adequate time for reprocessing, and excellent training of technical staff.
Title: Cosmetic robotic single dock suprapubic eTEP via arcuate line access (eTEP-Pal) with ventral hernia repair and plication of diastasis recti
Biography:
Dr. Mario Leyba have extensive robotic experience with ventral hernia repairs in a variety of methods. Dr. Leyba has done over 2500 robotic procedures. They have a busy practice in New Mexico with procedures ranging from intracorporeal colon resections to foregut surgery. They specialize in Abdominal wall reconstructions such as robotic eTEP, Tapp, and TAR.
Abstract:
Statement of the Problem: A commonly encountered problem in the post-partum female is the diastasis recti with a concomitant abdominal wall hernia with underlying abdominal wall dysfunction. There has been some controversy in the surgical world as to the optimal mode of repair. The controversy stems from the cosmetic approach versus the abdominal wall dysfunction approach and usually includes repair of the diastasis recti and the abdominal hernia. The cosmetic approach usually involves an abdominoplasty with skin resection and anterior closure of the diastasis recti and usually a non-mesh repair of the hernia. If the hernia is large this can pose a problem and often they are fixed prior to the abdominoplasty and usually referred to a general surgeon. With the advent of robotic surgery, several different approaches for repair have surfaced to accommodate both small and large hernias at the same time as the diastasis recti repair. My partner and I have developed a reproducible technique for a cosmetic like repair via 3 small incisions in the suprapubic region (panty line) with access to the arcuate line (Robotic eTEP-PaL or eTEP -Pubic Arcuate Line) and then the subsequent retro rectus space development with ability to suture close and repair the small and moderately large hernia defects, with the associated plication of the diastasis recti and placement of a retro rectus mesh for support. In addition, larger hernias have the ability to expand to either a unilateral or bilateral transversus abdominus release (TAR) from the same single dock approach. This is our experience on our first 50 cases. Several novel approaches to access the retro rectus space have been utilized, developed and expanded from concepts of the known Phillips technique. Our experience demonstrates this is feasible, reproducible and a cosmetically pleasing technique, with great implications in this and other patient populations.
Title: A Cannabis Compass for the Cancer Journey
Biography:
Works at Northside Hospital Cancer Institute Atlanta, Georgia, USA
Abstract:
Overview and Objectives:This presentation was developed in response to the many questions posed to me by navigator colleagues, patients and physicians about the veracity of medicinal cannabis as an adjuvant to cancer treatment. It became obvious to me that there is a crucial need for accurate, evidence-based factual information to empower navigators to disseminate to their patients as well as patients being empowered with credible data, with which to base their treatment choices upon as well as avoiding poor choices which could be detrimental to their care, their experience along their journey as well as their pocketbook.
The essential question is how can Cannabis provide quality of life for a cancer patient with an emphasis on restoring joy and re-actualization to a sense of self?
The value of Cannabis used for symptom management, including pain, anorexia, depression and sexual issues will be explored with expert experience and case studies overview. Oncology Nurse Navigation has demonstrated benefits for patients at risk for or diagnosed with cancer. Benefits include shorter time to diagnosis and treatment, increased patient and caregiver knowledge, better adherence to care, and improved quality of life. Now these navigators have an additional tool; Cannabis.
At the completion of this presentation the attendee will be
1. Provided with a comprehensive historical view of cannabis as a medicinal adjuvant to the medicinal modalities provided.
2. Provided with evidence-based information and implementation in various medical conditions
3. Provided with actual case studies of real-life patients who have uniquely benefited from medicinal cannabis
4.Provided with documented references and information with which to guide their patients to make informed decisions about their use of medicinal cannabis.
1. The author will present an historical as well as a present-day perspective of medicinal cannabis in this country and establish real-time scenarios related to various forms and cultivars of cannabis.
2.This information will be completely evidence-based to enable the attendee to partner with and guide their patients to make educated decisions related to the use of CBD and THC along with an understanding of terpenes and cannabimimetic’s and their physiologic components
Results:
This presentation is structured to provide a practical, multifaceted resource, enabling those of us who will guide our patients to factually answer the many questions patients and other medical professionals are seeking valid answers to.
Conclusion:
Navigation is a multifaceted and ongoing process that must include education, emotional and psychosocial reinforcement, all geared toward empowering patients to become partners in their care and re-partner with themselves as individuals who can experience joy in their lives.
With the plethora of information and references to real life experiences this presentation will offer navigators an invaluable addition to their “tool-kit” as part of the unique and intimate marriage of navigator and patient (as well as those who care for them) as together they traverse the cancer journey from initial diagnosis throughout the continuum of care.
The restoration of joy in life is the ultimate gift we can offer those who put their trust in us as their guides.
The Overlooked systems (HPA Axis, Vagus Nerve which interfaces with the Parasympathetic controls of the heart, lungs & digestive tract, Krebs cycle + more) which cannot function in concert of one another without the ECS being supplemented beyond cannabis alone. Presenting a multi-tiered wholistic lifestyle approach.
Title: Green Technology and Digitization of Alternative Medicine for Healthcare Robotic Surgery
Biography:
Works at University of Wales Trinity Saint David, UK
Abstract:
The dramatology of Covid-19 Pandemic is evitable and requires investment by various government, business and industrial sector in digital healthcare, hospitalisation, robotic surgery and virology research. The implications of green technology in digital healthcare and robotic surgery cannot be ignored rather the effective use of systematic control mechanisms may reduce the efficacy of Covid-19 pandemic and local based variance in the society and community grass roots. The alternative medicine provides options from traditional medicine and 'gapology' of digital healthcare due to availability of herbs, food, agricultural and environmental services. The super market based clinics as global model for recovery leading to change in behaviour either work related or social context.Green Technology provides best practice indicators, positive platform for health and wellbeing, best behaviour syndrome in the acquisition of quality food products at the supermarket during Covid-19, considering other people as well as generating caring attributes to humanity and key workers in healthcare as systematic priorities globally. Coro-demic is seen as penetrating and over flowing the healthcare parameter that displays the global economy recovery indicators through sustainability, virtual business and employability.
