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E.O.E Newsletter | www.huanet.gr
Στην απονομή του Βραβείου “Κωνσταντίνος Δημόπουλος”, Αθήνα Οκτώβριος 2022, μαζί με Έλληνες συναδέλφους
που εκπαιδευτήκαν κοντά του. Από αριστερά προς τα δεξιά οι κ.κ. : Βασίλειος Μυγδάλης, Ανδρέας Καραγιάννης, Κωνσταντίνος Σιγάλας, Peter Wiklund, Σταύρος Βουρεκάς, Ευάγγελος Φραγκιάδης, Σταύρος Τυριτζής
T.S.: What are your thoughts on other robotic platforms? Can they compete with the DaVinci right now? Can you guess or imagine their future?
P.W.: I think there are going to be a lot of platforms that can compete with Intuitive. I have used myself other platforms for some patients and I think that some of them seem to be very good. I don’t know if they are exactly as good or not, but you can do prostatectomies and neobladders with the new platforms. So, yes, there are going to be a lot of platforms coming in the next few years.
T.S.: What are your thoughts on single port robotic surgery? Is the DaVinci SP really better that the conventional one?
P.W.: For me, absolutely not. I have done (not a large amount) but at least 40 or 50 surgeries with single port. Yes, you can do almost everything you can do with multiple ports. But, is there a big difference in favor of single port? Not really. Not at this point. Maybe in the future. But at this point, the single port still makes the surgery a little bit more complicated and we have not seen a huge difference in the results.
F.N.: Are there some points, where the robotic surgery has not been yet proved to be better than the other types of surgery? You mentioned before
that the port placement is sometimes a problem. Is there anything else?
P.W.: It has been very difficult to prove that robotic surgery is better than open surgery. I think the combined evidence show that there are small incremental benefits from doing robotic surgery, like blood loss, hospital stay, mobilization after surgery and the complications. There is a small shift, in which robotic surgery is shown to be better than open surgery. Are there any problems with robotic surgery? Yes, there are specific problems. Port placement is one of the problems. You have to be very careful, because if the ports are in the wrong position, it becomes very difficult. There are also specific contraindications, relative contraindications. If the patient has a lot of adhesions, for instance, it becomes more difficult. Another problem is when you have patients who can’t stay for long time in the Trendelenburg position. There are patients who are extremely obese, patients who can’t be ventilated and patients who will maybe get higher intracranial pressure. There are some issues with robotics, but it is very rare for these issues to become a major problem. Nowadays, I would say that I do maybe 5 open cases each year. In these cases, I say from the beginning of the surgery, that we should do this surgery open. Conversions happen almost never. But yes, a conversion may happen for a specific occasion.