TY - JOUR
T1 - The Role of AirSeal in Robotic Urologic Surgery
T2 - A Systematic Review
AU - Razdan, Shirin
AU - Ucpinar, Burak
AU - Okhawere, Kennedy E.
AU - Badani, Ketan K.
N1 - Publisher Copyright:
© Copyright 2023, Mary Ann Liebert, Inc., publishers 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Introduction: The adoption of a valveless trocar system in robotic surgery has allowed for stable pneumoperitoneum and constant smoke evacuation. The reported benefits of this system are improved visualization, lower abdominal pressures resulting in a decrease in cardiopulmonary complications, ileus, and postoperative pain. We endeavored to perform a systematic review of the available literature on the clinical and systems-based outcomes of AirSeal™ during robotic urologic surgery. Materials and Methods: We performed this review according to the preferred reporting items for systematic reviews and meta-Analyses (PRISMA) guidelines. Our population of interest was any patient undergoing robotic urologic surgery. Our outcomes of interest were (1) clinical effectiveness, (2) safety parameters, and (3) health system outcomes. Results: Of 83 records identified and screened at title/abstract level, 17 were examined for full-Text, of which 10 studies enrolling a total of 1765 patients (cohorts ranging in size from 11 to 642 patients) were ultimately used for review. AirSeal resulted in improved respiratory parameters, specifically lower inspiratory plateau pressure, lower minute volume, lower CO2 elimination rate, low end-Tidal CO2, and higher static compliance. Two studies described decreased complication rates with low pneumoperitoneum. There were mixed results regarding AirSeal effect on operative time. Conclusion: Valveless trocar technology using the AirSeal system is a valuable adjunct to current robotic urologic surgery. The established benefits include improved cardiopulmonary parameters, particularly within the steep trendelenburg position that is common in pelvic surgery. Further studies are necessary to elucidate the effects on safety and hospital system-wide outcomes.
AB - Introduction: The adoption of a valveless trocar system in robotic surgery has allowed for stable pneumoperitoneum and constant smoke evacuation. The reported benefits of this system are improved visualization, lower abdominal pressures resulting in a decrease in cardiopulmonary complications, ileus, and postoperative pain. We endeavored to perform a systematic review of the available literature on the clinical and systems-based outcomes of AirSeal™ during robotic urologic surgery. Materials and Methods: We performed this review according to the preferred reporting items for systematic reviews and meta-Analyses (PRISMA) guidelines. Our population of interest was any patient undergoing robotic urologic surgery. Our outcomes of interest were (1) clinical effectiveness, (2) safety parameters, and (3) health system outcomes. Results: Of 83 records identified and screened at title/abstract level, 17 were examined for full-Text, of which 10 studies enrolling a total of 1765 patients (cohorts ranging in size from 11 to 642 patients) were ultimately used for review. AirSeal resulted in improved respiratory parameters, specifically lower inspiratory plateau pressure, lower minute volume, lower CO2 elimination rate, low end-Tidal CO2, and higher static compliance. Two studies described decreased complication rates with low pneumoperitoneum. There were mixed results regarding AirSeal effect on operative time. Conclusion: Valveless trocar technology using the AirSeal system is a valuable adjunct to current robotic urologic surgery. The established benefits include improved cardiopulmonary parameters, particularly within the steep trendelenburg position that is common in pelvic surgery. Further studies are necessary to elucidate the effects on safety and hospital system-wide outcomes.
KW - outcomes
KW - robotic surgery
KW - systematic review
KW - valveless trocar system
UR - http://www.scopus.com/inward/record.url?scp=85145955191&partnerID=8YFLogxK
U2 - 10.1089/lap.2022.0153
DO - 10.1089/lap.2022.0153
M3 - Review article
C2 - 35671523
AN - SCOPUS:85145955191
SN - 1092-6429
VL - 33
SP - 21
EP - 31
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 1
ER -