The role of RObotic surgery in EMergency setting (ROEM): protocol for a multicentre, observational, prospective international study on the use of robotic platform in emergency surgery

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2024年6月4日

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Marco Milone,
Pietro Anoldo,
Nicola de’Angelis,
Federico Coccolini,
Jim Khan,
Yoram Kluger,
Massimo Sartelli,
Luca Ansaloni,
Luca Morelli,
Nicola Zanini,
Carlo Vallicelli,
Gabriele Vigutto,
Ernest E. Moore,
Walter Biffl,
Fausto Catena,
Michele Manigrasso,
Anna D’Amore,
Andrea Pakula,
Ibrahim Umar Garzali,
Francesk Mulita,
Gupta Amit,
Maciej Walędziak,
Jelle P Ruurda,
Antonio Caycedo-Marulanda,
Alicia Mangram,
Argyrios L Ioannidis,
Long R Jiao,
Carolina González,
Dhaivat Vaishnav,
Adeel Ahmed Shamim,
Ali F Mallat,
Stefano Rossi,
Giuseppe Ietto,
Pasquale Cianci,
Desire Pantalone,
Claudia Zaghi,
Igor Monsellato,
Gianluca Garulli,
Vito D’Andrea,
Marcello Gasparrini,
Micaela Piccoli,
Maria Fortuna Offi,
Riccardo Memeo,
Andrea Coratti,
Giuseppe Giuliani,
Giampaolo Formisano,
Paolo Pietro Bianchi,
Benedetto Ielpo,
Antonio Giuliani,
Louis Perkins,
Maximilian Scheiterle,
Pietro Coletta,
Irnerio Muttillo,
Jerzy Draus,
Jacopo Andreuccetti,
Georgios-Ioannis Verras,
Michał Wiłkojć,
Richard van Hillegersberg,
Alexis Sanchez,
Konstantinos Konstantinidis,
Fabio Ausania,
Biagio Picardi,
Ivana Conversano,
Gherardo Maltinti,
Giulia Costantini,
Mattia Portinari,
Maria Irene Bellini,
Federica Cosmi,
Sofia Esposito,
Rosalinda Filippo,
Fabio Vistoli,
Maricn Zawadzki,
Barbara J Broome,
Michael Konstantinidis,
Caterina Puccioni,
Enrico Restini,
Anna Maria Di Bella,
Gianmarco Palini,
Maria Ludovica Costanzo,
Matteo Gasparrini,
Alice Francescato,
Antonella Delvecchio,
Barbara Mullineris,
Pierfrancesco Lapolla,
Andrea Mingoli,
Gioia Brachini,
Simone Guadagni,
Francesco Matarazzo

摘要

Background

Robotic surgery has gained widespread acceptance in elective interventions, yet its role in emergency procedures remains underexplored. While the 2021 WSES position paper discussed limited studies on the application of robotics in emergency general surgery, it recommended strict patient selection, adequate training, and improved platform accessibility. This prospective study aims to define the role of robotic surgery in emergency settings, evaluating intraoperative and postoperative outcomes and assessing its feasibility and safety.

Methods

The ROEM study is an observational, prospective, multicentre, international analysis of clinically stable adult patients undergoing robotic surgery for emergency treatment of acute pathologies including diverticulitis, cholecystitis, and obstructed hernias. Data collection includes patient demographics and intervention details. Furthermore, data relating to the operating theatre team and the surgical instruments used will be collected in order to conduct a cost analysis. The study plans to enrol at least 500 patients from 50 participating centres, with each centre having a local lead and collaborators. All data will be collected and stored online through a secure server running the Research Electronic Data Capture (REDCap) web application. Ethical considerations and data governance will be paramount, requiring local ethical committee approvals from participating centres.

Discussion

Current literature and expert consensus suggest the feasibility of robotic surgery in emergencies with proper support. However, challenges include staff training, scheduling conflicts with elective surgeries, and increased costs. The ROEM study seeks to contribute valuable data on the safety, feasibility, and cost-effectiveness of robotic surgery in emergency settings, focusing on specific pathologies. Previous studies on cholecystitis, abdominal hernias, and diverticulitis provide insights into the benefits and challenges of robotic approaches. It is necessary to identify patient populations that benefit most from robotic emergency surgery to optimize outcomes and justify costs.