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334
Using LAP PROTECTOR™ to prevent subcutaneous emphysema after robotic gastrectomy.
Kengo Hayashi1, Noriyuki Inaki2, Yusuke Sakimura3
1Department of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Kuratsukihigashi, 2 Chome-1, Kanazawa, Ishikawa, 920-8530, Japan. scab.japan@gmail.com.
Journal of Robotic Surgery
|June 19, 2023
Summary
Subcutaneous emphysema (SE) after robotic gastrectomy (RG) can be serious. Using the LAP PROTECTOR™ (LP) device at trocar sites significantly reduced SE incidence in a study of 194 patients.
Area of Science:
- Surgical innovation
- Minimally invasive surgery
- Patient safety
Background:
- Subcutaneous emphysema (SE) is a potential complication of robotic gastrectomy (RG).
- While often minor, severe SE can lead to life-threatening outcomes.
- Preventive strategies for postoperative SE are crucial.
Purpose of the Study:
- To evaluate the efficacy of the LAP PROTECTOR™ (LP) device in reducing SE after RG.
- To identify factors associated with the incidence of clinically relevant SE.
Main Methods:
- Retrospective analysis of 194 patients undergoing RG between August 2016 and December 2022.
- Comparison of SE incidence in patients with and without LP usage (implemented from September 2021).
- Logistic regression analysis to identify independent preventive factors for SE.
Main Results:
- Male sex, higher BMI, and LP usage were independently associated with a lower incidence of clinically relevant SE.
- LP usage showed a significant reduction in SE incidence (OR: 0.11, P < 0.001).
- Clinically relevant SE was defined as SE extending into the cervical area.
Conclusions:
- The LAP PROTECTOR™ device appears to be a safe and effective method for preventing SE after robotic gastrectomy.
- Male sex and higher BMI are also identified as protective factors against SE.
