Advancement in Technology and its Benefits in Gastrointestinal Stromal Tumours Resections
EAES Academy. Chaudhury M. 07/05/22; 366562; P305
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Abstract
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Aim: In 2017, two of our Upper Gastrointestinal (GI) surgeons in our centre performed the first robotic Gastrointestinal Stromal Tumours (GIST) excision in the United Kingdom successfully. The patient was discharged 5 days later after an uneventful recovery. Our site has been involved in removing GISTs for over 10 years. With the surgical advancements, our techniques have upgraded from open to laparoscopic to robotic.
GISTs can arise in inconvenient locations (cardia, pylorus) and in different sizes. With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology. This is all completed with the comfort and protection of the surgeon’s musculoskeletal system. This study was to see the changes in Length of Stay (LoS) with the advancement of technology.
Methods: Data of the cases were collected retrospectively from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Cases where notes were unavailable were removed from data collection. Length of Stay (LoS) was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: From 2011- 2021, we have completed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic. The median age of the patients were 59 years (ranging 48-82 years). The median length of stay for Open was 9 days (5-19 days), for laparoscopic it was 7 days (5-12 days) and for robotic 5 days (2-9 days). Our data suggested significant results comparing LoS between the 3 groups. Tumour negative margins were noted in all cases reviewed. Complementary table attached to show p-values.
Conclusion: Our current data trends show that as technology advances, there is a significant reduction in the total LoS in both ITU and the complete hospital admission. In addition, our robotic surgery data suggests increased success in removal of GIST tumours from challenging anatomical locations. This effectively reduces the requirement of formal major resection and reconstruction and ops for a wedge resection which subsequently reduces the need for HDU admission and improves functional outcome.
GISTs can arise in inconvenient locations (cardia, pylorus) and in different sizes. With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology. This is all completed with the comfort and protection of the surgeon’s musculoskeletal system. This study was to see the changes in Length of Stay (LoS) with the advancement of technology.
Methods: Data of the cases were collected retrospectively from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Cases where notes were unavailable were removed from data collection. Length of Stay (LoS) was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: From 2011- 2021, we have completed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic. The median age of the patients were 59 years (ranging 48-82 years). The median length of stay for Open was 9 days (5-19 days), for laparoscopic it was 7 days (5-12 days) and for robotic 5 days (2-9 days). Our data suggested significant results comparing LoS between the 3 groups. Tumour negative margins were noted in all cases reviewed. Complementary table attached to show p-values.
Conclusion: Our current data trends show that as technology advances, there is a significant reduction in the total LoS in both ITU and the complete hospital admission. In addition, our robotic surgery data suggests increased success in removal of GIST tumours from challenging anatomical locations. This effectively reduces the requirement of formal major resection and reconstruction and ops for a wedge resection which subsequently reduces the need for HDU admission and improves functional outcome.
Aim: In 2017, two of our Upper Gastrointestinal (GI) surgeons in our centre performed the first robotic Gastrointestinal Stromal Tumours (GIST) excision in the United Kingdom successfully. The patient was discharged 5 days later after an uneventful recovery. Our site has been involved in removing GISTs for over 10 years. With the surgical advancements, our techniques have upgraded from open to laparoscopic to robotic.
GISTs can arise in inconvenient locations (cardia, pylorus) and in different sizes. With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology. This is all completed with the comfort and protection of the surgeon’s musculoskeletal system. This study was to see the changes in Length of Stay (LoS) with the advancement of technology.
Methods: Data of the cases were collected retrospectively from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Cases where notes were unavailable were removed from data collection. Length of Stay (LoS) was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: From 2011- 2021, we have completed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic. The median age of the patients were 59 years (ranging 48-82 years). The median length of stay for Open was 9 days (5-19 days), for laparoscopic it was 7 days (5-12 days) and for robotic 5 days (2-9 days). Our data suggested significant results comparing LoS between the 3 groups. Tumour negative margins were noted in all cases reviewed. Complementary table attached to show p-values.
Conclusion: Our current data trends show that as technology advances, there is a significant reduction in the total LoS in both ITU and the complete hospital admission. In addition, our robotic surgery data suggests increased success in removal of GIST tumours from challenging anatomical locations. This effectively reduces the requirement of formal major resection and reconstruction and ops for a wedge resection which subsequently reduces the need for HDU admission and improves functional outcome.
GISTs can arise in inconvenient locations (cardia, pylorus) and in different sizes. With the development of robotic surgery, the DaVinci robot has allowed the surgeon to perform precise wedge resection with high definition 3D visualisation and instruments with endowrist technology. This is all completed with the comfort and protection of the surgeon’s musculoskeletal system. This study was to see the changes in Length of Stay (LoS) with the advancement of technology.
Methods: Data of the cases were collected retrospectively from 2011-2021. The database comprised of open, laparoscopic and robotic cases amongst 5 surgeons. Cases where notes were unavailable were removed from data collection. Length of Stay (LoS) was statistically assessed using Mann-Whitney U test on SPSS v22.
Results: From 2011- 2021, we have completed 88 GIST resection cases. 19 (22%) cases were open, 61(69%) cases were laparoscopic and 8 (9%) cases were robotic. The median age of the patients were 59 years (ranging 48-82 years). The median length of stay for Open was 9 days (5-19 days), for laparoscopic it was 7 days (5-12 days) and for robotic 5 days (2-9 days). Our data suggested significant results comparing LoS between the 3 groups. Tumour negative margins were noted in all cases reviewed. Complementary table attached to show p-values.
Conclusion: Our current data trends show that as technology advances, there is a significant reduction in the total LoS in both ITU and the complete hospital admission. In addition, our robotic surgery data suggests increased success in removal of GIST tumours from challenging anatomical locations. This effectively reduces the requirement of formal major resection and reconstruction and ops for a wedge resection which subsequently reduces the need for HDU admission and improves functional outcome.
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