RTAPP,RDGと連続で当たっている。 頑張るぞ〜

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Robotic TAPP (rTAPP) Repair of Left Inguinal Hernia with Imbrication of Transversalis Fascia Why imbricate: 🔵Direct defect/large hernia risk factors for postoperative seroma 🔵In open hernia repair, direct defect often closed ➡️Helps create a flat posterior wall and expedite mesh placement 🔵However it is not a routine practice during MIS Robotic Imbrication of Transversalis fascia: 🔴Possible advantages include: ➡️Reduce seroma risk formation ➡️Reduce risk of recurrence (mesh migration) 🔴Avoid deep bite ➡️Cord structures can be easily caught in sutures

Disponible à 12.000F #RtApp

Disponible à 8.000F #RtApp

Disponible à 4.000F 0194384722 WhatsApp #RtApp

𝗥𝗼𝗯𝗼𝘁𝗶𝗰 𝗧𝗿𝗮𝗻𝘀𝗮𝗯𝗱𝗼𝗺𝗶𝗻𝗮𝗹 𝗥𝗲𝘁𝗿𝗼𝗺𝘂𝘀𝗰𝘂𝗹𝗮𝗿 𝗨𝗺𝗯𝗶𝗹𝗶𝗰𝗮𝗹 𝗣𝗿𝗼𝘀𝘁𝗵𝗲𝘁𝗶𝗰 𝗥𝗲𝗽𝗮𝗶𝗿 (𝗿𝗧𝗔𝗥𝗨𝗣): 𝗕𝗼𝘁𝘁𝗼𝗺𝘀 𝗨𝗽 𝗔𝗽𝗽𝗿𝗼𝗮𝗰𝗵 Advantages of Approach: 🔴Overcomes limitations of lateral docking to achieve adequate cephalad dissection beyond defect 🔴Option to extend dissection into TAR plane ➡️Indicated in cases where approximation of defect becomes difficult 🔴Allows good mesh overlap 🔴rTAPP approach can be difficult ➡️Thin peritoneum laterally ➡️May not allow defect approximation in absence of posterior rectus sheath release for defect >4cm See our paper on outcomes during the learning curve and implementation of the @eurohernias guidelines for RAWS in the UK: frontierspartnerships.org/jo…

Disponible à 6.000F #RtApp

Robotic versus laparoscopic minimally invasive inguinal hernia repair: randomized clinical trial (the ROGER trial) ➡️doi.org/10.1093/bjs/znaf283 🤖 Robotic vs laparoscopic inguinal hernia repair — does robotics reduce pain? • 🧪 Single-centre, patient- and investigator-blinded RCT (n=182) comparing TEP vs robotic TAPP (rTAPP) • 🎯 Primary endpoint: pain while coughing 24h after surgery • 📊 Pain scores: TEP 5 (IQR 2–7) vs rTAPP 4 (IQR 2–7) → no significant difference (P=0.431) • ⚠️ Complication rates similar: 11% (TEP) vs 10% (rTAPP) • ⏱️ Operating time longer with robotics: 80 vs 64 minutes (P<0.001) • 🧠 Surgeon workload (NASA TLX) significantly lower with rTAPP 📌 Takeaway: Robotic repair did not reduce postoperative pain or complications but was associated with lower surgeon workload—at the cost of longer operating time. Work by Fiorenzo V Angehrn , Julian Süsstrunk , Romano Schneider , Kaspar Baltzer , Beat P Müller , Johannes Baur , Daniel C Steinemann #SoMe4Surgery #MedTwitter #SurgEd #Surgery @RCPSGTrainees @aecirujanos @SEIQuirurgica @iss_sic #MedicalTechniques @BJSAcademy @young_bjs @BjsOpen @evanscolorectal @robhinchliffe1 @bplwijn @MalinASund @nfmkok @TejedorPat @paulo_sutt @PVaughanShaw @JJEarnshaw @juliomayol @ksoreide @eurohernias #hernia

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Procedimientos con el Da Vinci 5 en el Hospital Universitario Rey Juan Carlos, rSugarbaker por eventracion paracolostomica y rTaPP por eventracion epigastrica. @CarlosFerrigni @BelenMansoA @AECP_FAECP @CirujanosMad @BalibreaJose @abexDaVinci