Our Summary

This research paper is about a study that compared the performance of remote surgery (telesurgery) and local surgery. In this case, the operation in question was a robotic cholecystectomy, which is the removal of the gallbladder. The study used a system called Saroa™ for the surgeries, and they were performed in two different hospitals in Japan, which were 250 km apart.

Eight experienced surgeons performed these surgeries on artificial organ models. The surgeons were divided into two groups and they either started with local surgery or telesurgery. The performance of the surgeons was measured based on the time they took to finish the task, the distance covered by the surgical instruments, and their skill levels.

The results showed that telesurgery can be performed just as safely as local surgery. There was no significant difference in the time taken to complete the surgery, or in the skill levels as assessed by standard tests. However, the path covered by the tools used in telesurgery was longer, particularly for the left-hand tool. This suggests that the surgeons had to make more adjustments during telesurgery, and this could be an area for improvement in the future.

FAQs

  1. What is the main difference observed between telesurgery and local surgery in this study?
  2. How did the study measure the performance of the surgeons during the cholecystectomy procedures?
  3. What improvements can be made in the future for telesurgery based on the results of this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about cholecystectomy is to follow post-operative instructions carefully, including taking prescribed medications, avoiding heavy lifting or strenuous activities, and gradually reintroducing solid foods into the diet. It is important to listen to your body and report any unusual symptoms or complications to your healthcare provider promptly.

Suitable For

In general, patients who are recommended for cholecystectomy are those who have symptomatic gallstones, which can cause symptoms such as severe abdominal pain, nausea, vomiting, and fever. Other factors that may indicate the need for cholecystectomy include complications such as inflammation of the gallbladder (cholecystitis), gallbladder polyps, gallbladder cancer, or pancreatitis caused by gallstones.

Patients who have recurrent episodes of gallstone-related symptoms, have large or multiple gallstones, or have complications such as jaundice or pancreatitis are also typically recommended for cholecystectomy. Additionally, patients who are at high risk for developing complications from gallstones, such as those with diabetes, obesity, or a history of gallstone-related complications, may be recommended for cholecystectomy as a preventive measure.

Overall, the decision to recommend cholecystectomy is based on the individual patient’s symptoms, medical history, and risk factors, and should be made in consultation with a healthcare provider.

Timeline

Before cholecystectomy:

  • Patient experiences symptoms of gallbladder disease such as abdominal pain, nausea, vomiting, and bloating.
  • Patient undergoes diagnostic tests such as ultrasound, CT scan, or MRI to confirm the presence of gallstones.
  • Patient is advised by their healthcare provider to undergo cholecystectomy if symptoms persist or if complications arise.

After cholecystectomy:

  • Patient undergoes pre-operative tests and evaluations to ensure they are fit for surgery.
  • Cholecystectomy is performed either through traditional open surgery or minimally invasive laparoscopic surgery.
  • Patient is discharged from the hospital within a few days after surgery.
  • Patient may experience temporary discomfort, bloating, or diarrhea as they recover.
  • Patient is advised to follow a special diet for a few weeks to allow their body to adjust to the absence of the gallbladder.
  • Patient may gradually resume normal activities and return to work within a week or two.
  • Long-term complications are rare, and most patients do not experience any adverse effects after cholecystectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with cholecystectomy?
  2. What are the benefits of robotic cholecystectomy compared to traditional laparoscopic surgery?
  3. How experienced is the surgeon in performing robotic cholecystectomy procedures?
  4. What is the success rate of robotic cholecystectomy in terms of complete removal of the gallbladder and minimal post-operative complications?
  5. Are there any specific pre-operative preparations or restrictions I should be aware of before undergoing a robotic cholecystectomy?
  6. What is the recovery process like after a robotic cholecystectomy and how long is the typical hospital stay?
  7. Are there any long-term effects or considerations I should be aware of after undergoing a cholecystectomy?
  8. How will my quality of life be impacted after having my gallbladder removed?
  9. Are there any alternative treatment options to cholecystectomy that I should consider?
  10. What follow-up care or monitoring will be necessary after the surgery?

Reference

Authors: Ebihara Y, Hirano S, Takano H, Kanno T, Kawashima K, Morohashi H, Oki E, Hakamada K, Urushidani S, Mori M. Journal: J Robot Surg. 2023 Jun;17(3):1105-1111. doi: 10.1007/s11701-023-01522-0. Epub 2023 Jan 5. PMID: 36602754