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The new robotic TELELAP ALF-X in gynecological surgery: single-center experience

Surgical Endoscopy volume 30, pages 215–221 (2016)Cite this article

Abstract

Background

To evaluate the safety and feasibility of the new robotic TELELAP ALF-X platform in a heterogeneous series of gynecological procedures.

Methods

Between September 2013 and May 2014, 146 patients were enrolled in this Phase II study trial. Patients with presumed benign or borderline adnexal disease, and benign and early stage malignant uterine disease were prospectively included.

Results

Median age was 52 years (range 19–79 years), and median BMI was 23.7 (range 17.3–34.0 kg/m2). Sixty-two patients (32.5 %) underwent mono/bilateral salpingo-oophorectomy or cyst removal (Group A), four patients (2.7 %) myomectomy (Group B), 46 patients (31.5 %) total hysterectomy (Group C), and 34 (23.3 %) endometrial cancer staging (Group D). Median docking time was 7 min (range 3–36). Median OT was 35 min (range 17–145) in the Group A, 40 min (range 10–50) in the Group B, 133 min (range 58–320) in the Group C, and 160 min (range 69–290) in the Group D. Reduction in OT over the study period for hysterectomy (p < 0.001) and adnexal surgery (p < 0.002) was observed. We registered two laparoscopic conversion (3.2 %) in the Group A and two (4.3 %) in the Group C. In the Group D, we showed one (2.9 %) laparoscopic and two (5.8 %) laparotomic conversions. One patient (2.17 %) in the Group C was readmitted in the early postoperative period for severe vaginal bleeding.

Conclusions

We report the first series of a novel robotic approach for the treatment of various gynecological conditions. When performed by experienced minimally invasive surgeons, TELELAP ALF-X is feasible and safe. Further studies are mandatory to define the benefits, advantages, and costs of this new robotic approach with respect to others minimally invasive approaches.

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References

  1. Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, van Voorst S, Mol BW, Kluivers KB (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev (3):CD003677

  2. Fanfani F, Fagotti A, Ercoli A, Bifulco G, Longo R, Mancuso S, Scambia G (2004) A prospective randomized study of laparoscopy and minilaparotomy in the management of benign adnexal masses. Hum Reprod 19:2367–2371

    PubMed  Article  Google Scholar 

  3. Langerbrekke A, Istre O, Hallqvist AC, Hartgill TW, Onsrud M (2002) Comparison of laparoscopy and laparotomy in patients with endometrial cancer. J Am Assoc Gynecol Laparosc 9:152–157

    Article  Google Scholar 

  4. Fader AN, Seamon LG, Escobar PF, Frasure HE, Havrilesky LA, Zanotti KM, Secord AA, Boggess JF, Cohn DE, Fowler JM, Skafianos G, Rossi E, Gehrig PA (2012) Minimally invasive surgery versus laparotomy in women with high grade endometrial cancer: a multi-site study performed at high volume cancer centers. Gynecol Oncol 126:180–185

    PubMed  Article  Google Scholar 

  5. Mori KM, Neubauer NL (2013) Minimally invasive surgery in gynecologic oncology. ISRN Obstet Gynecol 2013:312982

    PubMed  PubMed Central  Article  Google Scholar 

  6. Fanfani F, Fagotti A, Rossitto C, Gagliardi ML, Ercoli A, Gallotta V, Gueli Alletti S, Monterossi G, Turco LC, Scambia G (2012) Laparoscopic, minilaparoscopic and single-port hysterectomy: perioperative outcomes. Surg Endosc 26:3592–3596

    PubMed  Article  Google Scholar 

  7. Ghezzi F, Cromi A, Siesto G, Uccella S, Boni L (2011) Minilaparoscopic versus conventional laparoscopic hysterectomy: results of randomized trial. J Minim Invasive Gynecol 18:455–456

    PubMed  Article  Google Scholar 

  8. Fanfani F, Fagotti A, Gagliardi ML, Monterossi G, Rossitto C, Costantini B, Gueli Alletti S, Vizzielli G, Ercoli A, Scambia G (2013) Minilaparoscopic versus single-port total hysterectomy: a randomized trial. J Minim Invasive Gynecol 20:192–197

    PubMed  Article  Google Scholar 

  9. Scheib SA, Fader AN (2015) Gynecologic robotic laparoendoscopic single-site surgery: prospective analysis of feasibility, safety, and technique. Am J Obstet Gynecol 212(2):179

    PubMed  Article  Google Scholar 

  10. Rosero EB, Kho KA, Joshi GP, Giesecke M, Schaffer JI (2013) Comparison of robotic and laparoscopic hysterectomy for benign gynecologic disease. Obstet Gynecol 122:778–786

    PubMed  PubMed Central  Article  Google Scholar 

  11. Gidaro S, Altobelli E, Falavolti C, Bove AM, Ruiz EM, Stark M, Ravasio G, Lazzaretti SS, Maurizio B (2014) Vesicourethral anastomosis using a novel telesurgical system with haptic sensation, the Telelap Alf-X: a pilot study. Surg Technol Int 24:35–40

    PubMed  Google Scholar 

  12. Lococo A, Larocca V, Marino F, De Filippis AF, Cesario A, Lococo F (2014) Experimental robotic pulmonary lobectomy with the TELELAP/ALFX system in the ovine model. Surg Innov. doi:10.1177/1553350614549633

    PubMed  Google Scholar 

  13. Stark M, Benhidjeb T, Gidaro S, Morales ER (2012) The future of telesurgery: a universal system with haptic sensation. J Turk Ger Gynecol Assoc 13:74–76

    PubMed  PubMed Central  Article  Google Scholar 

  14. Gidaro S, Buscarini M, Ruiz E, Stark M, Labruzzo A (2012) Telelap Alf-X: a novel telesurgical system for the 21st century. Surg Technol Int 22:20–25

    PubMed  Google Scholar 

  15. Fagotti A, Bottoni C, Vizzielli G, Rossitto C, Tortorella L, Monterossi G, Fanfani F, Scambia G (2012) Laparoendoscopic single-site surgery (LESS) for treatment of benign adnexal disease: single-center experience over 3-years. J Minim Invasive Gynecol 19:695–700

    PubMed  Article  Google Scholar 

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Disclosures

Francesco Fanfani, Giorgia Monterossi, Anna Fagotti, Cristiano Rossitto, Salvatore Gueli Alletti, Barbara Costantini, Valerio Gallotta, Luigi Selvaggi, Stefano Restaino, and Giovanni Scambia have no conflict of interest or financial ties to disclose. The TELELAP ALF-X was offered by the SOFAR s.p.a. for the study period.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, Department of Women and Child Health, Catholic University of the Sacred Heart, Rome, Italy

    Francesco Fanfani, Giorgia Monterossi, Cristiano Rossitto, Salvatore Gueli Alletti, Barbara Costantini, Valerio Gallotta, Luigi Selvaggi, Stefano Restaino & Giovanni Scambia

  2. Minimally Invasive Gynecology, St. Maria Hospital, University of Perugia, Terni, Italy

    Anna Fagotti

Authors
  1. Francesco Fanfani
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  2. Giorgia Monterossi
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  3. Anna Fagotti
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  4. Cristiano Rossitto
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  5. Salvatore Gueli Alletti
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  6. Barbara Costantini
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  7. Valerio Gallotta
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  8. Luigi Selvaggi
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  9. Stefano Restaino
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  10. Giovanni Scambia
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Corresponding author

Correspondence to Francesco Fanfani.

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Fanfani, F., Monterossi, G., Fagotti, A. et al. The new robotic TELELAP ALF-X in gynecological surgery: single-center experience. Surg Endosc 30, 215–221 (2016). https://doi.org/10.1007/s00464-015-4187-9

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  • DOI: https://doi.org/10.1007/s00464-015-4187-9

Keywords

  • TELELAP ALF-X
  • Robotic surgery
  • Minimally invasive surgery
  • Gynecology