A comparative study between robotic and human-assisted control of the optics in video-assisted thoracic sympathectomy / Estudo comparativo entre o controle robótico e humano da ótica na cirurgia videoassistida para simpatectomia torácica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

INTRODUCTION: With the advance of technology, some pieces of equipment have been incorporated into the surgical act, among which robots, that, in spite of their notoriety, are still considered controversial. METHOD: A randomized double blind clinical study to evaluate the safety and efficiency in video-assisted thoracic surgery for the treatment of palmar/axillary hyperhidrosis, comparing the "Hu" (human-assisted) group and the "Ro" (robot-assisted) group, in the manipulation of the optics. Thirty-eight cases were analyzed, 19 cases in each group, "Hu" and "Ro". All the procedures were conducted under general anesthesia, with the ablation of the sympathetic nerve at T3, T4 and G3 levels. The procedures were recorded, in that two independent observers assessed: the number of involuntary movements, contact with structures of the thoracic cavity, and the number of times in which the optics was removed to be cleaned. The following parameters were also assessed: 1. on safety - surgical events, thoracic pain and scar appearance; 2. on efficiency - total times, surgical and optics use, presence of palmar/axillary anhydrosis, hospital stay, vicarious hyperhidrosis and satisfaction with the result of the procedure. RESULTS: The results obtained by comparing the "Hu" and "Ro" groups on safety show there was no significant statistical difference in the following parameters: surgical events, involuntary movements, thoracic pain and scar appearance between the two groups. However, the number of contacts with structures in the thoracic cavity was less in the "Ro" group (p<0.001). On efficiency, there was no significant statistical difference between the two groups in the following parameters: number of times in which the optics was removed to be cleaned, presence of palmar/axillary anhydrosis, hospital stay, vicarious hyperhidrosis, and the level of satisfaction with the result of the procedure. However, the "Hu" group presented less total time of surgery and of optics use (p<0.001), when compared to the "Ro" group. CONCLUSIONS: We can conclude that the robot-assisted procedure in handling the optics in video-assisted thoracic sympathectomy for the treatment of hyperhidrosis is safe and efficient when compared to the human-assisted procedure.

ASSUNTO(S)

thoracoscopy hiperidrose robótica video-assisted thoracic surgery cirurgia torácica vídeo-assistida hyperhidrosis cirurgia torácica thoracic surgery simpatectomia robotics sympathectomy ramdomized controlled trials toracoscopia ensaios clínicos controlados aleatórios

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