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1. Ergonomics in the operating room and surgical training: a survey on the Italian scenario

Author

Stefano Restaino, Marco D’Indinosante, Federica Perelli, Martina Arcieri, Vittorio Cherchi, Marco Petrillo, Anna Franca Cavaliere, Stefano Cianci, Giulia Pellecchia, Roberto Luca Meniconi, Alessandro Coppola, Vito Chiantera, Giovanni Scambia, Lorenza Driul, Giuseppe Vizzielli, SPIGC Working Group, Federico Berton, Luigi Conti, Giampaolo Formisano, Eleonora Guaitoli, Angelo Iossa, Michele Maruccia, Andrea Mazzari, Luigi Oragano, Alessandro Pasculli, Francesca Ratti, Matteo Serenari, Alberto Settembrini, Pasqualino Sirignano, Domenico Soriero, Carlo Vallicelli, Stefano Cianci (Sicilia), Giulia De Iaco (Puglia), Francesca Falcone (Campania), Sara Giaccari (Triveneto), Marco Giovenzana (Lombardia), Edoardo Pasqui (Toscana), Marco Petrillo (Sardegna), Luca Portigliotti (Piemonte), Giuseppe Sena (Calabria), Marco Sparavigna (Liguria), Giordana Bettini, Gianfranco Fanello, Paolo Mendogni, Lorenzo Monteleone, Davide Pertile Nicoletta Pia Ardò, Pasquina Tomaiuolo, Sara Negrello, Mattia Di Bartolomeo, Romeo Patini, Alberto Vito Marcuzzo, Alberto Campione, Giovanni Comacchio, Giacomo Murana, Martino Antonio, Mattia Manitto, Giuseppe Galzerano, Carlo Di Marco, Francesco Velluti, Gianmauro Berardi, Andrea Romboli, Jacopo Weindelmejer, Domenico Tamburrino, Alessandro Calarco, Luigi Losco, Eleonora Nacchiero, Rossella Elia, Federico Lo Torto, Giovanni Vicenti, Vincenzo Pappalardo, Dafne Pisani, Graziano Palmisano, Debora Brascia, Luigi Troisi, Federica Renzi, Fabio Melandro, Silvia Pecere, Carlo Gazia, Gregorio Di Franco, Gaetano Romano, Alberto Bolletta, Emanuele Botteri, Giovanna Di Meo, Carlo Ronsini, Sonia Chiappetta, Ilaria Sgaramella, Francesco Pennestri, Antonella Girardi, Donatella Mariniello, Marco Marcasciano, Michele Telegrafo, Simona Fragomeni, Francesca De Paoli, Giorgio Bogani, Salvatore Gueli Alletti, Luigi Pedone Anchora, Luigi Della Corte, Elisa Piovano, Martina Borghese, Cristina Taliento, Diego Raimondo, Antonio Raffone, Jvan Casarin, Emanuele Perrone, Guglielmo Stabile, and Vito Capozzi

Subjects
surgery, ergonomic, gyne and obstetrics, operatory room, survey, Public aspects of medicine, RA1-1270
Abstract

IntroductionSurgical-related injuries are frequent, in fact the reported percentage of musculoskeletal disorders in surgeons is between 47% and 87%. These conditions are caused by long periods of standing, incorrect postures, repeated movements, little rest between operations, the lack of integrated operator rooms, the correct number and arrangement of monitors and the use of non-ergonomic instruments. This survey aims to assess the Italian overview both highlighting how prevalent surgical-related injury is in our surgeons and whether there is an operating room ergonomics education program in Italian surgical specialty schools.MethodsAn anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of 3 different sections concerning the general characteristics of the participants, their surgical background and any training performed, and any injuries or ailments related to the surgical activity. The survey was carried out in the period 1th of December 2022 and the 6th of February 2023.ResultsAt the close of our survey, 300 responses were collected. Among the participants, the two most represented specialties were Gynecology and Obstetrics (42.3%) and General Surgery (39.7%) and surgeons were mainly employed in the Northern regions of Italy (54.8%). Analyzing the participants’ background, 61.7% of the respondents had laparoscopic training during their training and only 53.1% had a pelvic trainer during their residency. In accordance with 98.7% of the respondents, during surgery we have the feeling of being in an uncomfortable position that causes discomfort or muscle pain, and regarding the frequency of these discomforts, the majority of our study population experiences these problems monthly (46.2%), while in 29.6% it is experienced weekly, 12.1% annually and finally 12.1% daily. The surgical approach that is most correlated with these disorders is laparoscopy (62.7%) while the one that causes the least discomfort is robotic surgery (1.4%). These discomforts cause 43.9% of our population to take a break or do short exercises to reduce pain during surgery, and the body areas most affected are the back (61.6%), neck (40.6%) and shoulders (37.8%).ConclusionDespite this, our survey allows us to highlight some now-known gaps present in the surgical training program of our schools and the lack of protection toward our surgeons during their long career.

Published
2024
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2. Prior Robotic Console Expertise May Improve Basic Skills at the New Hugo RAS Simulator: Results from a Cohort Trial and Implications for Skill Transference Across Platforms

Author

Maria Chiara Sighinolfi, Stefano Terzoni, Elena Scanferla, Pietro Paolo Bianchi, Giampaolo Formisano, Gaetano Piccolo, Matteo Barabino, Andrea Pisani, Adelona Salaj, Giorgia Gaia, Anna Maria Marconi, Filippo Turri, Mattia Sangalli, Stefano Centanni, Matteo Stocco, Davide Chiumello, Simone Assumma, Luca Sarchi, Tommaso Calcagnile, Enrico Panio, Angelica Grasso, Paolo Dell'Orto, Nicolo Maria Mariani, Clemente Verrusio, Alessandro Baisi, Giorgio Bozzini, and Bernardo Rocco

Subjects
Robotic, Simulator, Hugo RAS, Basic robotic skill acquisition, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background: Robot-assisted surgery ensures minimal invasiveness; since the expiry of the Da Vinci patent, new robotic systems have entered the market. Recently, the Hugo RAS received CE approval for several surgical procedures. However, more is needed to know about skill acquisition at the new simulator. Objective: This study aims to analyse the factors impacting basic surgical skills at the Hugo RAS simulator. Design, setting, and participants: We present a cross-sectional study involving 71 participants of different backgrounds invited to a hands-on session with the Hugo RAS simulator voluntarily. All of them had no prior expertise with the system. Participants were recruited among medical/nurse students, residents, and laparoscopic and robotic surgeons. Intervention: All participants underwent a hands-on “pick and place” exercise at the Hugo RAS simulator; the metrics of a second-round pick and place exercise were recorded. Outcome measurements and statistical analysis: Metrics were analysed with regard to the following variables: demographics, videogame use, and prior surgical experience (no surgical expertise, experience with laparoscopy, and experience with robotic console). Results and limitations: All participants completed the test. Of them, 77.5% were naïve to surgery, 8.5% had prior laparoscopic expertise, and 14.1% had prior robotic console experience. The time to complete the pick and place exercise was significantly lower (p

Published
2023
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3. 7 - Multi platform robotic reconstructive surgery of the pelvic floor in patients with genital prolapse: Anatomical, functional and quality of life outcomes

Author

Margarita Afonina, Giorgia Gaia, Bernardo Maria Cesare Rocco, Giampaolo Formisano, Mattia Nicola Sangalli, Maria Chiara Sighinolfi, Stefano Terzoni, Serena Maruccia, Alessandro Morandi, Paolo Pietro Bianchi, and Anna Maria Marconi

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Published
2023
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4. 13 - Analysis of the configuration and the port-training criteria of the Versius robotic system (CMR) in patients undergoing robotic surgery for benign gynaecological pathology: Preliminary report

Author

Giorgia Gaia, Margarita Afonina, Maria Chiara Sighinolfi, Mauro Felline, Stefano Terzoni, Giampaolo Formisano, Alessandro Morandi, Veronica Iannuzzi, Paolo Pietro Bianchi, Bernardo Maria Cesare Rocco, and Anna Maria Marconi

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Published
2023
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6. Restructuring surgical training after COVID-19 pandemic: A nationwide survey on the Italian scenario on behalf of the Italian polyspecialistic young surgeons society (SPIGC)

Author

Gaetano Gallo, Eleonora Guaitoli, Fabio Barra, Arcangelo Picciariello, Alessandro Pasculli, Alessandro Coppola, Davide Pertile, Roberto Luca Meniconi, SPIGC Surgical Training Working Group, Federico Berton, Luigi Conti, Giampaolo Formisano, Angelo Iossa, Michele Maruccia, Andrea Mazzari, Luigi Oragano, Francesca Ratti, Matteo Serenari, Alberto Settembrini, Pasquale Sirignano, Domenico Soriero, Carlo Vallicelli, Giuseppe Vizzielli, Ruggero Dimonte, Stefano Cianci, Marco Giovenzana, Geraldo Palmieri, Edoardo Pasqui, Marco Petrillo, Luca Portigliotti, Daniele Sambucci, Giuseppe Sena, Marco Sparavigna, Giordana Bettini, Gianfranco Fanello, Paolo Mendogni, Lorenzo Monteleone, Nicoletta Pia Ardò, Pasquina Tomaiuolo, Giovanni Tomasicchio, Nicola Paradiso, Rigers Dibra, Giuseppe Trigiante, Agnese Dezi, Ludovico Carbone, Sara Negrello, Mattia Di Bartolomeo, Romeo Patini, Alberto Vito Marcuzzo, Alberto Campione, Giovanni Comacchio, Giacomo Murana, Martino Antonio, Mattia Manitto, Giuseppe Galzerano, Carlo Di Marco, Francesco Velluti, Gianmauro Berardi, Andrea Romboli, Federica Perelli, Jacopo Weindelmejer, Domenico Tamburrino, Alessandro Calarco, Luigi Losco, Eleonora Nacchiero, Rossella Elia, Federico Lo Torto, Giovanni Vicenti, Vincenzo Pappalardo, Dafne Pisani, Graziano Palmisano, Debora Brascia, Luigi Troisi, Federica Renzi, Fabio Melandro, Silvia Pecere, Carlo Gazia, Gregorio Di Franco, Gaetano Romano, Alberto Bolletta, Emanuele Botteri, Giovanna Di Meo, Sonia Chiappetta, Ilaria Sgaramella, Francesco Pennestri, Antonella Girardi, Donatella Mariniello, Marco Marcasciano, Michele Telegrafo, Simona Fracomeni, and Francesca De Paoli

Subjects
surgical training, COVID-19 pandemic, trainee, training programme, survey, Surgery, RD1-811
Abstract

IntroductionThe COVID-19 pandemic has led to the disruption of surgical training. Lack of communication, guidelines for managing clinical activity as well as concerns for safety in the workplace appeared to be relevant issues. This study aims to investigate how surgical training has been reorganized in Italy, almost 2 years after the outbreak of COVID-19 pandemic.Materials and methodsA 16-item-electronic anonymous questionnaire was designed through SurveyMonkey© web application. This survey was composed of different sections concerning demographic characteristics and impacts of the second COVID-19 pandemic wave on surgical and research/didactic activities. Changes applied in the training programme and activities carried out were also investigated. The survey was carried out in the period between June and October 2021.ResultsFour hundred and thirty responses were collected, and 399 were considered eligible to be included in the study analysis. Three hundred and thirty-five respondents continued working in Surgical Units, with a significant reduction (less than one surgical session per week) of surgical sessions in 49.6% of them. With concern to didactic and research activities, 140 residents maintained their usual activity, while 116 reported a reduction. A sub-group analysis on resident moved to COVID-19 departments showed a reduction of research activities in 35% of them. During the period considered in this survey, the surgical training program was not substantially modified for most of participants (74.6%).ConclusionOur survey demonstrated that surgical residency programs haven't improved 2 years after the beginning of the pandemic. Further improvements are needed to guarantee completeness of surgical training, even in emergency conditions.

Published
2023
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7. Consensus Statement of the Italian Polispecialistic Society of Young Surgeons (SPIGC): Diagnosis and Treatment of Acute Appendicitis

Author

Eleonora Guaitoli, Gaetano Gallo, Eleonora Cardone, Luigi Conti, Simone Famularo, Giampaolo Formisano, Federica Galli, Giuseppe Giuliani, Antonio Martino, Alessandro Pasculli, Romeo Patini, Domenico Soriero, Vincenzo Pappalardo, Gianmaria Casoni Pattacini, Marco Sparavigna, Roberto Meniconi, Andrea Mazzari, Fabio Barra, Elena Orsenigo, and Davide Pertile

Subjects
acute appendicitis, appendix, laparoscopic appendectomy, open appendectomy, complicated appendicitis, perforated appendicitis, Surgery, RD1-811
Abstract

Background Acute appendicitis (AA) is one of the most common causes of abdominal pain requiring surgical intervention. Approximately 20% of AA cases are characterized by complications such as gangrene, abscesses, perforation, or diffuse peritonitis, which increase patients’ morbidity and mortality. Diagnosis of AA can be difficult, and evaluation of clinical signs, laboratory index and imaging should be part of the management of patients with suspicion of AA. Methods This consensus statement was written in relation to the most recent evidence for diagnosis and treatment of AA, performing a literature review on the most largely adopted scientific sources. The members of the SPIGC (Italian Polispecialistic Society of Young Surgeons) worked jointly to draft it. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by the American College of Chest Physicians (CHEST) for the strength of the recommendations. Results Fever and migratory pain tend to be present in patients with suspicion of AA. Laboratory and radiological examinations are commonly employed in the clinical practice, but today also scoring systems based on clinical signs and laboratory data have slowly been adopted for diagnostic purpose. The clinical presentation of AA in children, pregnant and elderly patients can be unusual, leading to more difficult and delayed diagnosis. Surgery is the best option in case of complicated AA, whereas it is not mandatory in case of uncomplicated AA. Laparoscopic surgical treatment is feasible and recommended. Postoperative antibiotic treatment is recommended only in patients with complicated AA.

Published
2021
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9. Utility of near infrared fluorescent cholangiography in detecting biliary structures during challenging minimally invasive cholecystectomy

Author

Gaetano Piccolo, Matteo Barabino, Francesca Lecchi, Giampaolo Formisano, Adelona Salaj, Guglielmo Niccolo Piozzi, and Paolo Pietro Bianchi

Abstract

Background Surgeons can minimize the risk of bile duct injury (BDI) during challenging mini-invasive cholecystectomy through technical standardization by means of a precise anatomical landmark identification (Critical View of Safety) and advanced technology for biliary visualization. Among these systems, the adoption of magnified stereoscopic 3-dimensional view provided by robotic platforms and near infrared fluorescent cholangiography (NIRF-C) are the most promising. Methods In this prospective cohort study we evaluated all consecutive minimally invasive cholecystectomies (laparoscopic and robotic) performed with NIRF-C between May 2022 and January 2023 at General Surgery Unit, Department of Health Sciences, University of Milan, San Paolo Hospital (Milan, Italy). Inclusions criteria were: 1) acute cholecystitis (emergency group), 2) history of chronic cholecystitis or complicated cholelithiasis (deferred urgent group), 3) difficult cases (patients affected by cirrhosis, with scleroatrophic gallbladder or BMI > 35 kg/m2). For each group, the detection rate and visualization order of the main biliary structures were reported (cystic duct, CD; common hepatic duct, CHD; common bile duct, CBD; and CD-CHD junction). Results A total of 101 consecutive patients were enrolled, including 83 laparoscopic and 18 robotic cholecystectomies. All patients were stratified into three subgroups: a) emergency group (n = 33, 32.7%), b) deferred urgent group (n = 46, 45.5%), c) difficult group (n = 22, 21.8%). Visualization of at least one biliary structure was possible in 94.1% of cases (95/101). Interestingly, all four main structures were detected in 43.6% of cases (44/101). The CD was the structure identified most frequently, being recognized in 91/101 patients (90.1%), followed by CBD (83.2%), CHD (62.4%), and CD-CHD junction (52.5%). In the subset of patients that underwent emergency surgery for AC, the CD-CHD confluence was identified in only 45.5% of cases. However, early and precise identification of CBD (75.8%) and CD (87.9%) allowed safe isolation, clipping and transection of the cystic duct. In the deferred urgent group, the CBD and the CD were easily identified as first structure in a high percentage of cases (65.2% and 41.3% respectively), whereas the CD-CHD junction was the third structure to be identified in 67.4% of cases, the highest value among the three subgroups. In the difficult group, NIRF-C did not prove to be a useful tool for biliary visualization. The rates of failure of visualization were elevated: CBD (27.3%), CD (18.2%), CHD (54.5%) and CD-CHD (68.2%). Conclusions NIRF-C is a powerful real-time diagnostic tool to detect CBD and CD during minimally invasive cholecystectomy, especially when inflammation due to acute or chronic cholecystitis subverted the anatomy of the hepatoduodenal ligament.

Published
2023
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10. Impact of hands-on practice with HugoRAS and Versius System simulators on the attractiveness of robotic surgery among medical and nurse undergraduate students

Author

Maria Chiara Sighinolfi, Stefano Terzoni, Elena Scanferla, Pietro Paolo Bianchi, Giampaolo Formisano, Giorgia Gaia, Anna Maria Marconi, Davide Chiumello, Vipul Patel, Marcio Covas Moschovas, Filippo Turri, Paolo Dell’Orto, Serena Maruccia, Angelica Grasso, Mattia Sangalli, Stefano Centanni, Matteo Stocco, Simone Assumma, Luca Sarchi, Tommaso Calcagnile, Enrico Panio, Giorgio Bozzini, and Bernardo Rocco

Subjects
Health Informatics, Surgery
Published
2023
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11. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

Author

Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, Antonino, Agrusa, Daniele, Aguzzi, Mariantonietta, Alagia, Laura, Alberici, Marco Ettore Allaix, Luisa, Ambrosio, Alfonso, Amendola, Michele, Ammendola, Pietro Maria Amodio, Gabriele, Anania, Jacopo, Andreuccetti, Alfredo, Annichiarico, Pietro, Anoldo, Alessandro, Anselmo, Giovanni, Aprea, Giacomo, Arcuri, Alberto, Arezzo, Giulia, Armatura, Giulia, Bagaglini, Francesco, Bagolini, Beatrice, Bailetti, Gianluca, Baiocchi, Edoardo, Baldini, Elisa, Bannone, Mirko, Barone, Gianluca, Baronio, Raffaele, Basile, Bellucci, Marco, Andrea Benedetti Cacciaguerra, Ilaria, Benzoni, Francesco, Bianco, Giuseppe, Boccia, Cristina, Bombardini, Luigi, Boni, Dario, Bono, Luca Domenico Bonomo, Giulia, Bonventre, Andrea, Bottari, Claudio, Botti, Giacomo, Brentegani, Mattia, Buonomo, Umberto, Bracale, Cosimo, Callari, Luca, Calligaris, Pietro Giorgio Calò, Angelo, Cangiano, Lorenzo, Capezzuoli, Gabriella Teresa Capolupo, Marianna, Capuano, Filippo, Carannante, Eugenia, Cardamone, Teresa, Carfora, Chiara, Caricato, Pietro, Carnevali, Francesco Maria Carrano, Lorenzo, Casali, Gianmaria Casoni Pataccini, Gianluca, Cassese, Simone, Castiglioni, Flavia, Cavicchi, Ceccarelli, Graziano, Giovanni, Cestaro, Pasquale, Cianci, Claudio, Cimmino, Marco, Clementi, Coletta, Diego, Riccardo, Conventi, Corallino, Diletta, Maurizio, Costantini, Lorenzo, Crepaz, Diego, Cuccurullo, Curci, FABIO PIO, Giuseppe, Currò, Giorgio, Dalmonte, Giovanni, D'Alterio, Michele, D'Ambra, D'Ambrosio, Giancarlo, Anna, D'Amore, Michele De Capua, Simona, Deidda, Daniele, Delogu, Maurizio De Luca, Nicolò De Manzini, DE STEFANI, Elena, Giuseppe Di Buono, Marcello Di Martino, DI TOMASO, Anna, Ugo, Elmore, CORDOVA HERENCIA, INGRID ELVA, Giovanni, Emiliani, Sofia, Esposito, Fazio, Federico, Federico, Festa, Marcello, Filotico, Fiocca, Fausto, Irene, Fiume, Francesco, Fleres, Giulia, Fontana, Tommaso, Fontana, Edoardo, Forcignanò, Giampaolo, Formisano, Laura, Fortuna, Uberto Fumagalli Romario, Andrea, Galderisi, Raffaele, Galleano, Carlo, Gazia, Alessio, Giordano, Giorgio, Giraudo, Maria Carmela Giuffrida, Simona, Giura, Anna, Guida, Antonio Maria Iannello, Marco, Inama, Sara, Ingallinella, Iossa, Angelo, Livio, Iudici, Laracca, GIOVANNI GUGLIELMO, LARGHI LAUREIRO, Zoe, Saverio, Latteri, Luca, Leonardi, Pasquale, Lepiane, Edelweiss, Licitra, Paolo, Locurto, Sarah Lo Faso, Nicola, Luciani, Luzza, Luigi, Magaletti, Sara, Michele, Manigrasso, Alessandra, Marano, Francesco, Marchetti, Alessandra, Marello, Nicolò, Mariani, Jacopo Nicolò Marin, Gennaro, Martines, Laura, Mastrangelo, Antonio, Matarangolo, Marco, Materazzo, Mazzarella, Gennaro, Giorgio, Mazzarolo, Maria Paola Menna, Meoli, Francesca, Marco, Milone, Elisabetta, Moggia, Davide, Moioli, Sarah, Molfino, Vitantonio, Mongelli, Roberto, Montalti, Giulia, Montori, Luca, Morelli, Gianluigi, Moretto, Muttillo, EDOARDO MARIA, Irnerio, Muttillo, Francesca, Notte, Alessandro, M Paganini, Gianluca, Pagano, Palmieri, Livia, Giuseppe, Palomba, Valentina, Palumbo, Panetta, Cristina, Giulia, Paradiso, Beniamino, Pascotto, Passannanti, Daniele, Renato, Patrone, Francesca, Pecchini, Francesca, Pego, Fabio, Pelle, Perrotta, Nicola, Wanda, Petz, Biagio, Picardi, Picchetto, Andrea, Chiara, Piceni, Pietricola, Giulia, Enrico, Pinotti, Felice, Pirozzi, Paolo, Pizzini, Poillucci, Gaetano, Ilaria, Puccica, Lorenzo, Ramaci, Rapanotti, Eleonora, Daniela, Rega, Angelica, Reggiani, Giorgio, Romano, Gregorio, Romeo, Luigi, Romeo, Gianluca, Rompianesi, Stefano, Rossi, Edoardo, Saladino, Roberto, Santambrogio, Federica, Saraceno, Giuliano, Sarro, Diego, Sasia, Grazia, Savino, Rosa, Scaramuzzo, Antonio, Sciuto, Michela, Scollica, Giovanni, Scudo, Ardit, Seitaj, Carlo, Serra, Francesco, Serra, Pierpaolo, Sileri, Leandro, Siragusa, Carmen, Sorrentino, Giuseppe, Surfaro, Ernesto, Tartaglia, Beatrice, Torre, Andrea, Tufo, Matteo, Uccelli, Alessandro, Ussia, Vaccari, Samuele, Marina, Valente, Sara, Vertaldi, Alessandro, Vitali, Luca, Zaccherini, Luigi, Zorcolo, Noemi, Zorzetti, Balla, A., Sartori, A., Botteri, E., Podda, M., Ortenzi, M., Silecchia, G., Guerrieri, M., Agresta, F., Agrusa, A., Aguzzi, D., Alagia, M., Alberici, L., Allaix, M. E., Ambrosio, L., Amendola, A., Ammendola, M., Amodio, P. M., Anania, G., Andreuccetti, J., Annichiarico, A., Anoldo, P., Anselmo, A., Aprea, G., Arcuri, G., Arezzo, A., Armatura, G., Bagaglini, G., Bagolini, F., Bailetti, B., Baiocchi, G., Baldini, E., Bannone, E., Barone, M., Baronio, G., Basile, R., Bellucci, M., Cacciaguerra, A. B., Benzoni, I., Bianco, F., Boccia, G., Bombardini, C., Boni, L., Bono, D., Bonomo, L. D., Bonventre, G., Bottari, A., Botti, C., Brentegani, G., Buonomo, M., Bracale, U., Callari, C., Calligaris, L., Calo, P. G., Cangiano, A., Capezzuoli, L., Capolupo, G. T., Capuano, M., Carannante, F., Cardamone, E., Carfora, T., Caricato, C., Carnevali, P., Carrano, F. M., Casali, L., Pataccini, G. C., Cassese, G., Castiglioni, S., Cavicchi, F., Ceccarelli, G., Cestaro, G., Cianci, P., Cimmino, C., Clementi, M., Coletta, D., Conventi, R., Corallino, D., Costantini, M., Crepaz, L., Cuccurullo, D., Curci, F. P., Curro, G., Dalmonte, G., D'Alterio, G., D'Ambra, M., D'Ambrosio, G., D'Amore, A., De Capua, M., Deidda, S., Delogu, D., De Luca, M., De Manzini, N., De Stefani, E., Di Buono, G., Di Martino, M., Di Tomaso, A., Elmore, U., Herencia, I. E. C., Emiliani, G., Esposito, S., Fazio, F., Festa, F., Filotico, M., Fiocca, F., Fiume, I., Fleres, F., Fontana, G., Fontana, T., Forcignano, E., Formisano, G., Fortuna, L., Romario, U. F., Galderisi, A., Galleano, R., Gazia, C., Giordano, A., Giraudo, G., Giuffrida, M. C., Giura, S., Guida, A., Iannello, A. M., Inama, M., Ingallinella, S., Iossa, A., Iudici, L., Laracca, G. G., Laureiro, Z. L., Latteri, S., Leonardi, L., Lepiane, P., Licitra, E., Locurto, P., Faso, S. L., Luciani, N., Luzza, L., Magaletti, S., Manigrasso, M., Marano, A., Marchetti, F., Marello, A., Mariani, N., Marin, J. N., Martines, G., Mastrangelo, L., Matarangolo, A., Materazzo, M., Mazzarella, G., Mazzarolo, G., Menna, M. P., Meoli, F., Milone, M., Moggia, E., Moioli, D., Molfino, S., Mongelli, V., Montalti, R., Montori, G., Morelli, L., Moretto, G., Muttillo, E. M., Muttillo, I., Notte, F., Paganini, A. M., Pagano, G., Palmieri, L., Palomba, G., Palumbo, V., Panetta, C., Paradiso, G., Pascotto, B., Passannanti, D., Patrone, R., Pecchini, F., Pego, F., Pelle, F., Perrotta, N., Petz, W., Picardi, B., Picchetto, A., Piceni, C., Pietricola, G., Pinotti, E., Pirozzi, F., Pizzini, P., Poillucci, G., Puccica, I., Ramaci, L., Rapanotti, E., Rega, D., Reggiani, A., Romano, G., Romeo, G., Romeo, L., Rompianesi, G., Rossi, S., Saladino, E., Santambrogio, R., Saraceno, F., Sarro, G., Sasia, D., Savino, G., Scaramuzzo, R., Sciuto, A., Scollica, M., Scudo, G., Seitaj, A., Serra, C., Serra, F., Sileri, P., Siragusa, L., Sorrentino, C., Surfaro, G., Tartaglia, E., Torre, B., Tufo, A., Uccelli, M., Ussia, A., Vaccari, S., Valente, M., Vertaldi, S., Vitali, A., Zaccherini, L., Zorcolo, L., Zorzetti, N., Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, de Manzini, Nicolo, and ARMIS (Augmented Reality in Minimally Invasive Surgery) Collaborative, Group

Subjects
Virtual reality (VR), minimally invasive surgery (MIS), Augmented reality (AR), Minimally invasive surgery (MIS), Mixed reality (MR), Survey, Training, training, augmented reality (AR), mixed reality (MR), survey, virtual reality (VR), Settore MED/18 - Chirurgia Generale, Surgery
Abstract

Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training.

Published
2023

12. The COVID - AGICT study: COVID–19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes

Author

Giuseppe Giuliani, Francesco Guerra, Simona Messinese, Francesco Santelli, Lucia Salvischiani, Sofia Esposito, Luca Ferraro, Alessandro Esposito, Matteo De Pastena, Daniela Rega, Paolo Delrio, Carlotta La Raja, Antonino Spinelli, Simonetta Massaron, Paola De Nardi, Emanuele Federico Kauffmann, Ugo Boggi, Simona Deidda, Angelo Restivo, Alessandra Marano, Felice Borghi, Micaela Piccoli, Norma Depalma, Stefano D'Ugo, Marcello Spampinato, Federico Cozzani, Paolo Del Rio, Rosa Marcellinaro, Massimo Carlini, Raffaele De Rosa, Stefano Scabini, Fabio Maiello, Roberto Polastri, Giulia Turri, Corrado Pedrazzani, Monica Zese, Dario Parini, Andrea Casaril, Gianluigi Moretto, Antonio De Leo, Marco Catarci, Renza Trapani, Sandro Zonta, Patrizia Marsanic, Andrea Muratore, Gregorio Di Franco, Luca Morelli, Alessandro Coppola, Damiano Caputo, Jacopo Andreuccetti, Giusto Pignata, Laura Mastrangelo, Elio Jovine, Michele Mazzola, Giovanni Ferrari, Lorenzo Mariani, Graziano Ceccarelli, Rocco Giuseppe, Stefano Bolzon, Mariateresa Grasso, Silvio Testa, Paola Germani, Nicolò de Manzini, Serena Langella, Alessandro Ferrero, Diego Coletta, Paolo Pietro Bianchi, Carmelo Bengala, Andrea Coratti, Lorenzo De Franco, Roberto Benigni, Angela Tribuzi, Ubaldo Marra, Michele Di Marino, Chiara Cova, Beatrice Bianchi, Sara Nobile, Luigi Zorcolo, Giorgio Lisi, Fabrizio Allisiardi, Michele Grieco, Carolina Righetti, Marco Frisini, Alberto Brolese, Michele Grassia, Andrea Lucchi, Giulia Bagaglini, Giuseppe S. Sica, Michele Manara, Luca Turati, Lorenzo Macone, Roberta Carminati, Pierpaolo Mariani, Gianluca Rizzo, Claudio Coco, Francesca Pennetti Pennella, Fabio Rondelli, Lucia Romano, Antonio Giuliani, Raffaele Palaia, Andrea Belli, Vittorio Albino, Maddalena Leongito, Giulia David, Pasquale Misitano, Silvia Pasulo, Gian Luca Baiocchi, Roberta La Mendola, Mohamnad Abu Hilal, Ludovica Baldari, Elisa Cassinotti, Luigi Boni, Gabriella Teresa Capolupo, Marco Caricato, Enrico Pinotti, Mauro Montuori, Cristina Bombardini, Gabriele Anania, Rigers Dibra, Gennaro Martines, Leonardo Solaini, Giorgio Ercolani, Renato Oliva, Maria Vittoria Carati, Gian Luca Grazi, Giacomo Ghio, Francesco Marchegiani, Salvatore Pucciarelli, Filippo La Torre, Immacolata Iannone, Dimitri Krizzuk, Francesco Sammartino, Giorgia Catalano, Paolo Strignano, Renato Romagnoli, Domenico Piccione, Bruno Nardo, Rossella Reddavid, Maurizio Degiuli, Martino Gerosa, Dario Maggioni, Michele Zuolo, Marco Rigamonti, Omar Ghazouani, Raffaele Galleano, Andrea Percivale, Luca Tirloni, Luca Moraldi, Nicolò Fabbri, Carlo Vittorio Feo, Samuele Colombo, Salomone Di Saverio, Giuseppe Barbato, Francesco Coratti, Andrea Sagnotta, Stefano Mancini, Nicola Cillara, Antonello Deserra, Alessandro Cannavera, and Giampaolo Formisano

Subjects
Settore MED/18 - Chirurgia Generale, Oncology, gastrointestinal cancer, Advanced cancer, Gastroesophageal cancer, COVID-19, Colorectal cancer, Gastrointestinal cancers, Pancreatic cancer, Surgery
Published
2023
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13. Feasibility of robotic right colectomy with complete mesocolic excision and intracorporeal anastomosis: short-term outcomes of 161 consecutive patients

Author

Paolo Bianchi, Luca Ferraro, Giuseppe Giuliani, Giampaolo Formisano, and Adelona Salaj

Subjects
medicine.medical_specialty, Colorectal cancer, Operative Time, Anastomosis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Robotic Surgical Procedures, medicine, Humans, Complication rate, Robotic surgery, Colectomy, Retrospective Studies, Intracorporeal anastomosis, business.industry, Anastomosis, Surgical, medicine.disease, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Colonic Neoplasms, Right Colectomy, Feasibility Studies, Operative time, Laparoscopy, 030211 gastroenterology & hepatology, business
Abstract

Technical and oncological aspects are still debated when dealing with minimally-invasive right colectomy. Main controversial issues still remain about whether the anastomosis should be performed intra- or extracorporeally and if a complete mesocolic excision (CME) should be carried out. We report the feasibility of robotic right colectomy with CME and intracorporeal anastomosis (IA) for right sided colon cancer. Data from patients who underwent robotic right colectomy with IA and CME from January 2015 to April 2020 were prospectively collected and retrospectively analyzed. Intraoperative outcomes and complications (minor I-II and major III-IV according to Clavien-Dindo classification), conversion rate, 30-day postoperative outcomes and pathological outcomes were the variables assessed. A total of 161 patients undergoing robotic right colectomy for cancer met the inclusion criteria. Mean operative time was 185 min, no intraoperative complications were observed, and the conversion rate was 3.7% (6 patients requiring elective conversions). Overall, mean postoperative stay was 4.9 days and the overall 30-day complication rate was 16.1%. 20 patients (12.4%) had minor complications, while major postoperative complications occurred in six patients (3.7%). Anastomotic leak was recorded in one patient (0.6%) and the 30-day re-admission rate was 0.6%. Mean number of harvested lymph nodes was 21.9. Patients requiring conversion experienced two minor complications, with a mean length of stay of 7 days. Robotic right colectomy with CME and IA is feasible and it is associated with good intraoperative and short-term postoperative clinical outcomes.

Published
2021
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14. Robotic right colectomy with complete mesocolic excision: Senior versus junior surgeon, a case-matched retrospective analysis

Author

Luca Ferraro, Giampaolo Formisano, Adelona Salaj, Simona Giuratrabocchetta, Giuseppe Giuliani, Lucia Salvischiani, and Paolo Pietro Bianchi

Subjects
Surgeons, Treatment Outcome, Robotic Surgical Procedures, Colonic Neoplasms, Operative Time, Biophysics, Humans, Lymph Node Excision, Surgery, Laparoscopy, Colectomy, Computer Science Applications, Retrospective Studies
Abstract

Robotic surgery may facilitate complex procedures such as right colectomy with complete mesocolic excision (CME) and shorten the learning curve. This study aimed to compare senior and junior surgeons' results in performing robotic right colectomy (RRC) with CME and intracorporeal anastomosis for right colon cancer.Between January 2015 and April 2020, a total of 161 patients underwent RRC with CME. After propensity score matching, two groups of 31 patients for each surgeon were formed. Intraoperative, postoperative and pathological outcomes were the variables assessed.No statistically significant difference was recorded between the two groups. The senior surgeon experienced 16.1% minor complications (Clavien-Dindo I-II) and 3.2% major complications (Clavien-Dindo III-IV), while the novice surgeon reported 19.3% and 3.2% rates of minor and major adverse events, respectively.After a structured training protocol, a novice may obtain comparable results to an expert in performing RRC with CME.

Published
2022

15. ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Author

Marco, Milone, Ugo, Elmore, Michele, Manigrasso, Monica, Ortenzi, Emanuele, Botteri, Alberto, Arezzo, Silecchia, Gianfranco, Mario, Guerrieri, Giovanni Domenico De Palma, Ferdinando, Agresta, Francesco, Pizza, Dario, D???antonio, Francesco, Amalfitano, Francesco, Selvaggi, Guido, Sciaudone, Lucio, Selvaggi, Daniela, Prando, Fabio, Cavallo, Giovanni, Lezoche, Diego, Cuccurullo, Ernesto, Tartaglia, Carlo, Sagnelli, Andrea, Coratti, Angela, Tribuzi, Michele Di Marino, Gabriele, Anania, Cristina, Bombardini, Mauro Pietro Zago, Fulvio, Tagliabue, Morena, Burati, Salomone Di Saverio, Samuele, Colombo, Sara El Adla, Maurizio De Luca, Monica, Zese, Dario, Parini, Paolo, Prosperi, Giovanni, Alemanno, Jacopo, Martellucci, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Dario, Bono, Donatella, Scaglione, Roberto, Saracco, Mauro, Podda, Adolfo, Pisanu, Valentina, Murzi, Antonino, Agrusa, Salvatore, Buscemi, Irnerio Angelo Muttillo, Biagio, Picardi, Leonardo, Solaini, Davide, Cavaliere, Giorgio, Ercolani, Francesco, Corcione, Roberto, Peltrini, Umberto, Bracale, Andrea, Lucchi, Laura, Vittori, Michele, Grassia, Alberto, Porcu, Teresa, Perra, Claudio, Feo, Pierluigi, Angelini, Domenico, Izzo, Luigi, Ricciardelli, Mario, Trompetto, Gallo, Gaetano, Alberto Realis Luc, Andrea, Muratore, Marcello, Calabr??, Bruno, Cuzzola, Andrea, Barberis, Federico, Costanzo, Giulio, Angelini, Graziano, Ceccarelli, Fabio, Rondelli, Michele De Rosa, Elisa, Cassinotti, Luigi, Boni, Ludovica, Baldari, Paolo Pietro Bianchi, Giampaolo, Formisano, Giuseppe, Giuliani, Andrea Alessandro Pisani Ceretti, Nicol?? Maria Mariani, Marco, Giovenzana, Roberto, Farfaglia, Paolo, Marcian??, Valeria, Arizzi, Micaela, Piccoli, Francesca, Pecchini, Gianmaria Casoni Pattacini, Nereo, Vettoretto, Claudio, Guarnieri, Letizia, Laface, Emmanuele, Abate, Massimiliano, Casati, Carlo, Feo, Nicol??, Fabri, Antonio, Pesce, Piero, Maida, Giampaolo, Marte, Roberta, Abete, Lorenzo, Casali, Alessandro, Marchignoli, Matteo, Dall???aglio, Stefano, Scabini, Davide, Pertile, Alessandra, Aprile, Jacopo, Andreuccetti, Alberto Di Leo, Lorenzo, Crepaz, Francesco, Maione, Sara, Vertaldi, Alessia, Chini, Riccardo, Rosati, Francesco, Puccetti, Giulia, Maggi, Andrea, Cossu, Alberto, Sartori, Giacomo, Piatto, Nicola, Perrotta, Marta, Celiento, Marco, Scorzelli, Vincenzo, Pilone, Salvatore, Tramontano, Pietro, Calabrese, Raffaele, Sechi, Nicola, Cillara, Giaime, Putzu, Michele Guido Podda, Mauro, Montuori, Enrico, Pinotti, Giuseppe, Sica, Marzia, Franceschilli, Bruno, Sensi, Maurizio, Degiuli, Rossella, Reddavid, Lucia, Puca, Marco, Farsi, Alessio, Minuzzo, Elena, Gia, Gian Luca Baiocchi, Valerio, Ranieri, Andrea, Celotti, Francesco, Bianco, Sebastiano, Grassia, Alessandra, Novi, Muttillo, EDOARDO MARIA, Milone, Marco, Elmore, Ugo, Manigrasso, Michele, Ortenzi, Monica, Botteri, Emanuele, Arezzo, Alberto, Silecchia, Gianfranco, Guerrieri, Mario, De Palma, Giovanni Domenico, Agresta, Ferdinando, and Rosati, Riccardo

Subjects
colorectal, ERAS, enhanced recovery, minimally invasive, Length of Stay, Postoperative Complications, Enhanced Recovery, Humans, Surgery, Laparoscopy, Prospective Studies, Minimally invasive, Colorectal Neoplasms, Colorectal Surgery, Colorectal
Abstract

Background Several reports demonstrated a strong association between the level of adherence to the protocol and improved clinical outcomes after surgery. However, it is difficult to obtain full adherence to the protocol into clinical practice and has still not been identified the threshold beyond which improved functional results can be reached. Methods The ERCOLE (ERas and COLorectal Endoscopic surgery) study was as a cohort, prospective, multi-centre national study evaluating the association between adherence to ERAS items and clinical outcomes after minimally invasive colorectal surgery. The primary endpoint was to associate the percentage of ERAS adherence to functional recovery after minimally invasive colorectal cancer surgery. The secondary endpoints of the study was to validate safety of the ERAS programme evaluating complications’ occurrence according to Clavien-Dindo classification and to evaluate the compliance of the Italian surgeons to each ERAS item. Results 1138 patients were included. Adherence to the ERAS protocol was full only in 101 patients (8.9%), > 75% of the ERAS items in 736 (64.7%) and > 50% in 1127 (99%). Adherence to > 75% was associated with a better functional recovery with 90.2 ± 98.8 vs 95.9 ± 33.4 h (p = 0.003). At difference, full adherence to the ERAS components 91.7 ± 22.1 vs 92.2 ± 31.6 h (p = 0.8) was not associated with better recovery. Conclusions Our results were encouraging to affirm that adherence to the ERAS program up to 75% could be considered satisfactory to get the goal. Our study could be considered a call to simplify the ERAS protocol facilitating its penetrance into clinical practice.

Published
2022

16. Minimally Invasive Repair of Recurrent Inguinal Hernia: Multi-Institutional Retrospective Comparison of Robotic Versus Laparoscopic Surgery

Author

Antonio Vitiello, Adam Abu Abeid, Roberto Peltrini, Luca Ferraro, Giampaolo Formisano, Paolo Pietro Bianchi, Roberto del Giudice, Lucio Taglietti, Valerio Celentano, Giovanna Berardi, Umberto Bracale, Mario Musella, Vitiello, Antonio, Abu Abeid, Adam, Peltrini, Roberto, Ferraro, Luca, Formisano, Giampaolo, Bianchi, Paolo Pietro, Del Giudice, Roberto, Taglietti, Lucio, Celentano, Valerio, Berardi, Giovanna, Bracale, Umberto, and Musella, Mario

Subjects
recurrent inguinal hernia, robotic surgery, laparoscopy, Surgery, inguinal hernia repair
Abstract

Introduction: Inguinal hernia repair is one of the most commonly performed surgical procedures in general surgery. Despite surgical advances, recurrence and chronic pain are still major issues after this intervention. Aim of our study was to retrospectively assess and compare outcomes of robotic versus laparoscopic repair of recurrent inguinal hernia. Methods: All patients who underwent recurrent inguinal hernia repair between 2014 and 2021 in five different institutions were included in our study. Baseline data on age, gender, body mass index, comorbidities, smoking habit, and anticoagulant therapy were retrospectively collected from prospectively maintained databases. Operative time, length of stay, and early and late complications were compared between the robotic and the laparoscopic approach. Results: Forty-eight patients underwent recurrent inguinal hernia repair between January 2014 and December 2021. Twenty-three patients underwent a robotic procedure, whereas 25 were submitted to the laparoscopic intervention. Overall mean follow-up was 26.2 months. There was no significant difference in the baseline characteristics of the two groups. Acceptable and comparable rates of peri- and postoperative outcomes were recorded. However, postoperative visual analog scale score and incidence of chronic pain were lower after the robotic rather than after the laparoscopic approach. (2.9 versus 3.8 P = .002; 20% versus 0%; P = .02, respectively). Conclusions: Minimally invasive repair of recurrent inguinal hernia is safe and feasible; robotic surgery is associated with low rate of postoperative and chronic pain without a significant increase in operative time.

Published
2022

17. Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

Author

Pata, Francesco, Di Martino, Marcello, Podda, Mauro, Di Saverio, Salomone, Ielpo, Benedetto, Pellino, ACIE Appy Study Collaborative Abba Julio, Gianluca., Abdullah, Alshamrani, Abdullah, Alturkistani, Abdulrahman, Alghamdi, Abdulrahman, Almalki, Adam, Orengia, Adnan, Kuvvetli, Adolfo, Pisanu, Adrian, Smith, Adriana Michelle Treviño Figueroa, Aeris Jane Nacion, Ahmad, Alhazmi, Ahmad, Bouhuwaish, Ahmad, Khalid, Ahmed, Alsufyani, Ainhoa Valle Rubio, Akshay, Bavikatte, Kumar, Akshay, Al-Radjid, Jamiri, Alberto de San Ildefonso Pereira, Alberto, Porcu, Alberto, Sartori, Aldo, Rocca, Aleksandar, Sretenovic, Anselmo, Alessandro, Alessandro De Luca, Alexandros, Charalabopoulos, Alexios, Tzivanakis, Alfonso, Bandin, Alfonso, Nájar, Alice, Frontali, Alsulaimani, Faisal, Amaia Martínez Roldan, Amal, Hamid, Ana, André, Ana, Minaya-Bravo, Andre, Das, Andrea, Bondurri, Andrea, Costanzi, Lucchi, Andrea, Andrei, Mihailescu, Police, Andrea, Andres Mendoza Zuchini, Angela, Romano, Iossa, Angelo, Antonella, Chessa, Antonella, Tromba, Antonio, Castaldi, Antonio, Brillantino, Antonio, Ferronetti, Giuliani, Antonio, Antonio Ramos-De la Medina, Antonio, Tarasconi, Arcangelo, Picciariello, Argyrios, Ioannidis, Ari, Leppäniemi, Arshad, Rashid, Ashrarur Rahman Mitul, Asif, Mehraj, Asim, Laharwal, Atif, Iqbal, Athanasios, Liarakos, Athanasios, Marinis, Beatriz de Andrés-Asenjo, Belén, Matías-García, DE SIMONE, Belinda, Ben, Creavin, Ben, Stubbs, Brian, Goh, Branislav, Jovanovic, Bruno, Sensi, Carlo, Gazia, Carlos, Cerdán, Carlos Javier Gómez Díaz, Carlos Petrola Chacón, Carlos, Yánez, Carmelo Lo Faro, Caroline, Reinke, Casandra, Dominguez, Charudutt, Paranjape, Charlotte, Thomas, Chia Chi Fung, DE LUCIA, Chiara, Chiu Hiu Fung Jennifer, Christian, Ovalle-Chao, Claudio, Guerci, Cleo, Kenington, Corina, Gica, Cristina, Folliero, Cristopher, Varela, Daniel, Popowich, Daniele, Delogu, Daniele, Zigiotto, Danilo, Vinci, Dario, D'Antonio, David Alessio Merlini, David, Merlini, David, Moro-Valdezate, Deborah, Keller, Diana Cristiana Nicolaescu, Diego, Sasia, Edgar, Rodas, Dimitrios, Linardoutsos, Domenico, Russello, Pedro Alfonso Nájar-Castañeda, Habil Gregor Stavrou, Edoardo, Rosso, Edoardo, Saladino, Edoardo, Ricciardi, Eduardo, Smith-Singares, Efstratia, Baili, Eleftheria, Douka, Guaitoli, Eleonora, Elisa, Francone, Elisa Maria Vaterlini, Elisa Sefora Pierobon, Emilio, Morales, Emilio Peña Ros, Enrico, Benzoni, Enrico, Erdas, Enrico, Pinotti, Enrique, Colás-Ruiz, Ernesto, Laterza, Esteban, Foianini, Eugenia, Cardamone, Eugenio, Licardie, Fabio, Marino, Fahad, Alsofyani, Fahad, Qahtani, Farhan, Khan, Fatlum, Maraska, Fatmir, Saliu, Fausto, Madrid, Fausto, Rosa, Federico, Luvisetto, Felipe, Alconchel, Felipe, Pareja-Ciuro, Fernanda, Neves, Ferdinando, Agresta, Fernando, Cordera, Fernando, Pardo, Fernando, Mendoza-Moreno, Fernando, Munoz-Flores, Francesca Maria Silvestri, Francesca Paola Tropeano, Francesca, Pecchini, Francesca, Serio, Francesco, Colombo, Francesco Di Marzo, Francesco, Ferrara, Francesco, Lancellotti, Francesco, Litta, Francesco, Martini, Francesco, Roscio, Francisco, Blanco-Antona, Francisco Javier Quezada Barcenas, Francisco, Schlottmann, Gabriel, Herrera-Almario, Gabrielle van Ramshorst, Gallo, Gaetano, Gaetano, Luglio, Georgios, Kampouroglou, Georgios, Papadopoulos, Gerardo, Arredondo, Giacomo, Calini, Giampaolo, Formisano, Galiffa, Giampaolo, Gian Marco Palini, Gianluca, Colucci, Gianluca, Pagano, Gianluca, Vanni, Gianmaria Casoni Pattacini, Gianpiero, Gravante, Giorgio, Lisi, Giovanni, Bellanova, Giovanni De Nobili, Giovanni Sammy Necchi, Sinibaldi, Giovanni, Giulia, Bacchiocchi, Giulia, Bagaglini, Maggi, Giulia, Giuliano, Izzo, Giulio, Argenio, Giuseppe, Brisinda, Giuseppe, Esposito, Giuseppe, Frazzetta, Giuseppe Massimiliano De Luca, Nigri, Giuseppe, Giuseppe, Sica, MARTIN DE MERCADO, Gonzalo, Gustavo Armand Ugon, Gustavo, Martinez-Mier, Gustavo Miguel Machain Vega, Gustavo, Nari, Herald, Nikaj, Ignacio, Neri, Igor Alberdi San Roman, Iliya, Fidoshev, Iñaki, Martínez, Ionut, Negoi, Irene, Ortega, Irune Vicente Rodríguez, Isabel, Cornejo, Ismael, Mora-Guzmán, Issam, Al-Najami, Ivan, Romic, Izaskun, Balciscueta, James, Olivier, Jan, Lammel-Lindemann, Jana, Dziakova, Javier, Salinas, Jelena Pejanovic Jovanovic, Jeryl Anne Silvia Reyes, Joanne, Salas, Jose Antonio Diaz-Elizondo, Jose Gustavo Parreira, Juan, Bellido, Juan, Salamea, Juan Carlos Martín Del Olmo, Juliana María Ordoñez, Sofi, Junaid, Justin, Davies, Kapil, Sahnan, Kebebe, Bekele, Kelvin, Voon, Leandro, Siragusa, Lorenzo, Petagna, Ferrario, Luca, Luca, Giordano, Luca, Nespoli, Luca, Pio, Lucia, Moletta, Luciano, Curella, Lucio, Taglietti, Luigi, Bonavina, Luigi, Conti, Luis Eduardo Pérez-Sánchez, Luis Felipe Cabrera Vargas, Luis, Sánchez-Guillén, Luis, Tallon-Aguilar, Mansoor, Khan, Marcello Giuseppe Spampinato, Marcelo, Viola, Marcelo Viola Malet, Angrisani, Marco, Marco, Calussi, Marco, Catarci, Marco, Giordano, Marco, Materazzo, Marco, Milone, Marco, Pellicciaro, Marco Vito Marino, María Daniela Moreno Villamizar, Lolli, MARIA GIULIA, Bellini, MARIA IRENE, Maria, Lemma, Maria Michela Chiarello, Mario, Montes-Manrique, Mario, Rodriguez-Lopez, Mario, Serradilla-Martín, Mark, Peter, Marta, Paniagua-García-Señoráns, Martin, Rutegård, Martin, Salö, Massimiliano, Silveri, Massimiliano, Veroux, Matteo, Nardi, Matteo, Rottoli, Matti, Tolonen, Mauricio Pedraza Ciro, Mauricio, Zuluaga, Maurizio, Iacobone, Mauro, Montuori, Mazin, Ali, Melody García Domínguez, Menna Maria Paola, Micaela, Piccoli, Michela, Campanelli, Michele De Rosa, Manigrasso, Michele, Maruccia, Michele, Michele, Torre, Michele, Zuolo, Miguel, Pera, Mihiri, Weerasekera, Mikel, Prieto, Min Myat Thway, Mohamed, Shaat, Mohammad, Azfar, Mostafa, Shalaby, Muhammad Asif Raza, Muhammad Umar Younis, Muhammed, Elhadi, Mujahid, Ali, Musab, Althomali, Nadiah Al Amri, Nagendra, Dudi-Venkata, Nahar, Alselaim, Neil, Smart, Nelson, Trelles, Nicolò, Falco, Petrucciani, Niccolo', Nicola, Antonacci, Nicola, Cillara, Nicolae, Gica, Nicolò, Pecorelli, Nicolò, Tamini, Nikolaos, Machairas, Nura, Feituri, Nuria Ortega Torrecilla, Octavio Avila Mercado, Ohood, Alaamer, Oktay, Irkorucu, Omar, Alsherif, Oreste Claudio Buonomo, Orestes, Valles-Guerra, Orestis, Ioannidis, Oscar Isaac Hernández Palmas, Oscar Sanz Guadarrama, Osman, Bozbiyik, Pablo, Rodrigues, Pamela, Milito, Paolo, Panaccio, Panagiotis, Dorovinis, Paola, Prieto, Paolo, Baroffio, Patrizia, Marsanic, Pawel, Ajawin, Peng Soon Koh, Pietro, Anoldo, Piotr, Major, Qasem, Alharthi, Rashid, Lui, Riccardo, Caruso, Richard, Brady, Rishi, Rattan, Rishi, Singhal, Roberta, Angelico, Roberta Maria Isernia, Roberta, Tutino, Roberto, Peltrini, Rodrigo, Tejos, Roosevelt, Fajardo, Rossella, Elia, Salvador, Morales-Conde, Sami, Benli, Sara, Fuentes, Sara Gortázar de Las Casas, Sara Ortiz de Guzmán Aragón, Sara, Vertaldi, Selmy, Awad, Sergio, Gentilli, Sergio Alberto Weckmann Lujan, Serkan, Tayar, Shabab, Althobaiti, DI GIOVANNI, Silvia, Soliman, Ghedan, Sonia, Pérez-Bertólez, Sonja, Chiappetta, Spiros, Delis, Stefano, Scaringi, Süleyman, Çetinkünar, Stylianos, Kykalos, Syed Muhammad Ali, Sylvia, Krivan, Tak Lit Derek Fung, Tarik, Delko, Tatiana Nicolás López, Tercio De Campos, Teresa Calderón Duque, Teresa, Perra, Theodore, Liakakos, Theodoros, Daskalakis, Tijmen, Koëter, Tiku, Zalla, Tomás Elosua González, Tommaso, Campagnaro, Toure Alpha Oumar, Ugo, Grossi, Valentina, Sosa, Valentina, Testa, Valentina, Tomajer, Valeria, Andriola, Valeria, Tonini, Valerio, Celentano, Voglino, Valerio, Venkateswara Rao Katta, Víctor Hugo García Orozco, Victor, Turrado-Rodriguez, Victor, Visag-Castillo, Victoria, Graham, Viktor, Rachkov, Vincenzo, Papagni, Vincenzo, Vigorita, Virginia Jiménez Carneros, Bellato, Vittoria, Wolf, Bechstein, Yuksel, Altinel, and Zutoia, Balciscueta

Subjects
appendicitis, COVID19
Published
2022

18. Correction: ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Author

Milone, Marco, Elmore, Ugo, Manigrasso, Michele, Ortenzi, Monica, Botteri, Emanuele, Arezzo, Alberto, Silecchia, Gianfranco, Guerrieri, Mario, De Palma, Giovanni Domenico, Agresta, Ferdinando, Francesco, Pizza, Dario, D'Antonio, Francesco, Amalfitano, Francesco, Selvaggi, Sciaudone, Guido, Lucio, Selvaggi, Daniela, Prando, Fabio, Cavallo, Giovanni, Lezoche, Diego, Cuccurullo, Ernesto, Tartaglia, Carlo, Sagnelli, Andrea, Coratti, Angela, Tribuzi, Michele Di Marino, Gabriele, Anania, Cristina, Bombardini, Mauro Pietro Zago, Fulvio, Tagliabue, Morena, Burati, Salomone Di Saverio, Samuele, Colombo, Sara El Adla, Maurizio De Luca, Monica, Zese, Dario, Parini, Paolo, Prosperi, Giovanni, Alemanno, Jacopo, Martellucci, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Dario, Bono, Donatella, Scaglione, Roberto, Saracco, Mauro, Podda, Adolfo, Pisanu, Valentina, Murzi, Antonino, Agrusa, Salvatore, Buscemi, Irnerio Angelo Muttillo, Biagio, Picardi, Edoardo Maria Muttillo, Leonardo, Solaini, Davide, Cavaliere, Giorgio, Ercolani, Francesco, Corcione, Roberto, Peltrini, Umberto, Bracale, Andrea, Lucchi, Laura, Vittori, Michele, Grassia, Alberto, Porcu, Teresa, Perra, Claudio, Feo, Pierluigi, Angelini, Domenico, Izzo, Luigi, Ricciardelli, Mario, Trompetto, Gaetano, Gallo, Alberto Realis Luc, Andrea, Muratore, Marcello, Calabrò, Bruno, Cuzzola, Andrea, Barberis, Federico, Costanzo, Giulio, Angelini, Graziano, Ceccarelli, Fabio, Rondelli, Michele De Rosa, Elisa, Cassinotti, Luigi, Boni, Ludovica, Baldari, Paolo Pietro Bianchi, Giampaolo, Formisano, Giuseppe, Giuliani, Andrea Alessandro Pisani Ceretti, Nicolò Maria Mariani, Marco, Giovenzana, Roberto, Farfaglia, Paolo, Marcianò, Valeria, Arizzi, Micaela, Piccoli, Francesca, Pecchini, Gianmaria Casoni Pattacini, Nereo, Vettoretto, Claudio, Guarnieri, Letizia, Laface, Emmanuele, Abate, Massimiliano, Casati, Carlo, Feo, Nicolò, Fabri, Antonio, Pesce, Piero, Maida, Giampaolo, Marte, Roberta, Abete, Lorenzo, Casali, Alessandro, Marchignoli, Matteo, Dall'Aglio, Stefano, Scabini, Davide, Pertile, Alessandra, Aprile, Jacopo, Andreuccetti, Alberto Di Leo, Lorenzo, Crepaz, Francesco, Maione, Sara, Vertaldi, Alessia, Chini, Riccardo, Rosati, Francesco, Puccetti, Giulia, Maggi, Andrea, Cossu, Alberto, Sartori, Giacomo, Piatto, Nicola, Perrotta, Marta, Celiento, Marco, Scorzelli, Vincenzo, Pilone, Salvatore, Tramontano, Pietro, Calabrese, Raffaele, Sechi, Nicola, Cillara, Giaime, Putzu, Michele Guido Podda, Mauro, Montuori, Enrico, Pinotti, Giuseppe, Sica, Marzia, Franceschilli, Bruno, Sensi, Maurizio, Degiuli, Rossella, Reddavid, Lucia, Puca, Marco, Farsi, Alessio, Minuzzo, Elena, Gia, Gian Luca Baiocchi, Valerio, Ranieri, Andrea, Celotti, Francesco, Bianco, Sebastiano, Grassia, and Alessandra, Novi

Subjects
Surgery, Settore MED/18
Published
2022

21. Update on Robotic Total Mesorectal Excision for Rectal Cancer

Author

Luca Ferraro, Francesco Toti, Enrico Opocher, Adelona Salaj, Paolo Bianchi, Giampaolo Formisano, and Simona Giuratrabocchetta

Subjects
medicine.medical_specialty, Colorectal cancer, Population, Medicine (miscellaneous), Conventional laparoscopy, Review, law.invention, Indirect costs, Randomized controlled trial, law, robotic surgery, Medicine, Robotic surgery, education, rectal cancer, education.field_of_study, business.industry, total mesorectal excision, Open surgery, General surgery, medicine.disease, Total mesorectal excision, robotic low anterior resection, business
Abstract

The minimally invasive treatment of rectal cancer with Total Mesorectal Excision is a complex and challenging procedure due to technical and anatomical issues which could impair postoperative, oncological and functional outcomes, especially in a defined subgroup of patients. The results from recent randomized controlled trials comparing laparoscopic versus open surgery are still conflicting and trans-anal bottom-up approaches have recently been developed. Robotic surgery represents the latest consistent innovation in the field of minimally invasive surgery that may potentially overcome the technical limitations of conventional laparoscopy thanks to an enhanced dexterity, especially in deep narrow operative fields such as the pelvis. Results from population-based multicenter studies have shown the potential advantages of robotic surgery when compared to its laparoscopic counterpart in terms of reduced conversions, complication rates and length of stay. Costs, often advocated as one of the main drawbacks of robotic surgery, should be thoroughly evaluated including both the direct and indirect costs, with the latter having the potential of counterbalancing the excess of expenditure directly related to the purchase and maintenance of robotic equipment. Further prospectively maintained or randomized data are still required to better delineate the advantages of the robotic platform, especially in the subset of most complex and technically challenging patients from both an anatomical and oncological standpoint.

Published
2021

22. Update on Robotic Rectal Prolapse Treatment

Author

Paolo Bianchi, Giampaolo Formisano, Luca Ferraro, Enrico Opocher, Andrea Pisani Ceretti, Simona Giuratrabocchetta, and Adelona Salaj

Subjects
medicine.medical_specialty, Medicine (miscellaneous), Conventional laparoscopy, Review, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Quality of life, robotic surgery, medicine, Robotic surgery, Pelvis, pelvic organ prolapse treatment, business.industry, medicine.disease, robotic ventral rectopexy, Surgery, Rectal prolapse, medicine.anatomical_structure, Invasive surgery, Medicine, 030211 gastroenterology & hepatology, Complication, business, Hospital stay, rectal prolapse
Abstract

Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates.

Published
2021

23. Robotic elective colectomy for diverticular disease: short-term outcomes of 80 patients

Author

Paolo Bianchi, Lucia Salvischiani, Giuseppe Giuliani, Luca Ferraro, Giampaolo Formisano, Martina De Luca, and Adelona Salaj

Subjects
Leak, medicine.medical_specialty, Intraoperative Complication, medicine.medical_treatment, diverticular disease, Biophysics, Anastomosis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Robotic Surgical Procedures, robotic surgery, medicine, Humans, Robotic surgery, colorectal surgery, diverticulitis, Colectomy, Retrospective Studies, Diverticular Diseases, business.industry, Length of Stay, Diverticulitis, medicine.disease, Colorectal surgery, Computer Science Applications, Surgery, Settore MED/18 - Chirurgia Generale, Treatment Outcome, 030220 oncology & carcinogenesis, Diverticular disease, Laparoscopy, 030211 gastroenterology & hepatology, business
Abstract

BACKGROUND This study aimed to evaluate the impact of the robotic approach on the minimally invasive elective treatment of diverticular disease. METHODS Data from patients who underwent elective robotic colectomy for diverticular disease from January 2015 to February 2020 were prospectively collected and retrospectively analysed. Intraoperative and 30-day postoperative outcomes were the variables assessed. RESULTS A total of 80 patients (71% with prior complicated diverticulitis) met the inclusion criteria. Mean operative time was 241 min, one intraoperative complication (1.2%) was observed, the conversion rate was 2.5%. Mean hospital stay was 6.4 days and overall 30-day complication rate was 22.5%. Fourteen patients (17.5%) had minor complications, while major postoperative complications occurred in four patients (5%). Anastomotic leak rate was 3.9% and the 30-day readmission rate was 3.7%. CONCLUSIONS Robotic colectomy for diverticular disease has proven to be feasible and safe, with low intraoperative complications, conversion, and anastomotic leak rates.

Published
2021

24. Bottom-up suprapubic approach for robotic right colectomy: technical aspects and preliminary outcomes

Author

Adelona Salaj, Francesco Toti, Giampaolo Formisano, Enrico Opocher, Luca Ferraro, Giuseppe Giuliani, and Paolo Bianchi

Subjects
operative, medicine.medical_specialty, Anastomosis, Incisional hernia, Operative Time, Conventional laparoscopy, Suprapubic approach, surgical, Surgical procedures, Robotic Surgical Procedures, Extraction site, medicine, Humans, Colectomy, Retrospective Studies, Intracorporeal anastomosis, business.industry, medicine.disease, Surgery, Settore MED/18 - Chirurgia Generale, Right Colectomy, Operative time, Surgical procedures, operative, business, Mesocolon
Abstract

Background Complete mesocolic excision (CME) for right colectomy increase the technical complexity of a laparoscopic approach especially when an intracorporeal anastomosis (IA) is associated. The robotic platform, with its intrinsic technical advantages, could potentially overcome the limitations of conventional laparoscopy. This study aimed to describe the robotic bottom-up technique and to evaluate short-terms outcomes of robotic right colectomy (RRC) with CME and IA. Methods Data from patients who underwent RRC for cancer with bottom-up suprapubic approach from October 2016 to April 2020 were prospectively collected and retrospectively analyzed. Intraoperative outcomes and complications, conversion rate, 30-day postoperative outcomes, incisional hernia rate and pathological outcomes were the variables assessed. Results A total of 109 patients were submitted to bottom-up suprapubic approach for RRC with CME and IA during the study period. Mean operative time was 179 min, no intraoperative complications were observed, and the conversion rate was 3.6%. Mean postoperative stay was 4.6 days and the overall 30-day complication rate was 15.6%. Thirteen patients (12%) had minor complications, while major postoperative complications occurred in 4 patients (3.6%). Anastomotic leak was recorded in 1 patient (0.9%) and the 30-day re-admission rate was 0.9%. Mean number of harvested lymph nodes was 22.6. Incisional hernia rate at the specimen extraction site was 0.9%. Conclusions Bottom-up approach for RRC with CME and IA carries a low rate of conversions, intraoperative and short-term postoperative complications.

Published
2021

25. Robotic Left Colectomy with CME

Author

Paolo Bianchi, Giuseppe Giuliani, and Giampaolo Formisano

Subjects
Splenic flexure, medicine.medical_specialty, Colorectal cancer, business.industry, education, Left colectomy, Transverse colon, Robotic surgery, medicine.disease, digestive system diseases, Descending colon, Colon cancer, Settore MED/18 - Chirurgia Generale, medicine.anatomical_structure, Lymphatic system, Colonic cancer, medicine, Radiology, Complete mesocolic excision, business
Abstract

Complete mesocolic excision (CME) was introduced by Hohenberger and it is well standardized for right colonic cancer as well as for cancers of the descending colon and sigma. However, for tumors of distal transverse colon, splenic flexure, and proximal descending colon, the CME remains less homogeneous. This is probably due to the complex anatomy around the splenic flexure, subject to many vascular and lymphatic variations.

Published
2021

26. Long-term results of laparoscopic Roux-en-Y gastric bypass for morbid obesity: 105 patients with minimum follow-up of 15 years

Author

Giampaolo Formisano, Luca Ferraro, Paola Iovino, Luigi Angrisani, Antonella Santonicola, Rossella Palma, Angrisani, Luigi, Ferraro, Luca, Santonicola, Antonella, Palma, Rossella, Formisano, Giampaolo, and Iovino, Paola

Subjects
Adult, medicine.medical_specialty, Complications, Roux-en-Y gastric bypass, Gastric bypass, Gastric Bypass, 030209 endocrinology & metabolism, Weight regain, Single Center, Body Mass Index, Morbid obesity, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Long-term, Weight loss, Humans, Medicine, Obesity, Retrospective Studies, Bariatric surgery, business.industry, Long term results, Middle Aged, medicine.disease, Roux-en-Y anastomosis, Obesity, Morbid, Surgery, Settore MED/18 - Chirurgia Generale, Treatment Outcome, Diabetes Mellitus, Type 2, Female, Laparoscopy, 030211 gastroenterology & hepatology, medicine.symptom, business, Body mass index, Follow-Up Studies
Abstract

Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the second most frequently performed bariatric procedure worldwide; however, long-term results are not frequently reported. Objectives To evaluate the outcomes of LRYGB on weight loss and co-morbidities in a single center 15 years after the operation. Setting Tertiary-care referral hospital. Methods From February 2000 to December 2003, 105 patients (86 women; mean age 39.9 ± 17.4; mean body mass index [BMI] 47.2 ± 6.4 kg/m2; 78 with BMI Results The follow-up rate at 15 years was 87.6%. Mean excess weight loss was 58.6 ± 27%, with 74.1% of patients achieving a total weight loss ≥ 20%. According to the Biron et al. criteria, an inadequate outcome was found in 11/21 (52.4%) of patients with an initial BMI ≥ 50 kg/m2 versus 21/64 (32.8%) of patients with a preoperative BMI Conclusion LRYGB provides satisfactory weight loss and resolution of co-morbidities up to 15 years. WR was a common finding. A significant proportion of patients with a preoperative BMI ≥ 50 kg/m2 did not achieve a favorable weight loss outcome. Indications to perform LRYGB in this group of patients should be definitively reconsidered.

Published
2021

27. Robotic Right Colectomy: the italian experience

Author

Adelona Salaj, Giampaolo Formisano, Dimitri Krizzuk, Paolo Bianchi, and Giuseppe Giuliani

Subjects
medicine.medical_specialty, business.industry, Colorectal cancer, General surgery, Intracorporeal anastomosis, Robotic surgery, Anastomosis, medicine.disease, Penetrance, Robotic right colectomy, Laparoscopic colectomy, Colorectal surgery, Settore MED/18 - Chirurgia Generale, Colonic cancer, Right Colectomy, Complete mesocolic excision, Medicine, business
Abstract

Minimally invasive surgery has gained worldwide acceptance in the treatment of colonic cancer in the last decades, thanks to its well-known benefits in terms of 30-day postoperative outcomes and equivalent long-term oncological results. Nevertheless, the penetrance of laparoscopic colectomy still remains low. A main controversial issue remains about whether the anastomosis should be performed intra- or extracorporeally. Furthermore, the introduction of the concept of complete mesocolic excision (CME), together with its potential long-term oncological advantages, has led to another matter of debate when dealing with laparoscopic right colectomy. The principles of CME may potentially increase the technical difficulties of minimally invasive surgery, especially when dealing with right colon cancer.

Published
2021

28. Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Author

Benedetto, Ielpo, Mauro, Podda, Gianluca, Pellino, Pata, Francesco, Gianpiero, Gravante, Salomone Di Saverio, Gallo, Gaetano, Rashid, Lui, Adam, Orengia, Aditya, Chowdary, Aditya, Kulkarni, Adnan, Kuvvetli, Adolfo, Navarro, Adolfo, Pisanu, Adrian, Smith, Adriana Cavero Ibiricu, Aeris Jane, D Nacion, Ahmad, Alsaleh, Ahmad, Alhazmi, Ahmad, Elmabri, Ajaz, Wani, Ahmet, Rencuzogullari, Aingeru Sarriugarte Lasarte, Ainhoa Valle Rubio, Akshay, Bavikatte, Akshay, Kumar, Al-Radjid, Jamiri, Alain Michel Alvarado Padilla, Alban, Cacurri, Alberto de San Ildefonso, Alberto, Porcu, Alberto, Sartori, Aldo, Rocca, Alejandro Paz Yáñez, Alejandro, Becaria, Alejandro, Solís-Peña, Aleksandar, Sretenović, Alex, Urbistondo, Alfonso, Bandin, Alfonso, Najar, Alessandro De Luca, Alex, Boddy, Alexandros, Charalabopoulos, Alexios, Tzivanakis, Alfonso, Amendola, Alfredo Ramirez-Gutierrez de Velasco, Ali Cihat Yildirim, Alice, Frontali, Alpha Oumar Toure, Alvaro, García-Granero, Amaia Martínez Roldan, Amaia Sanz Larrainzar, Amila Sanjiva Ratnayake, Ana María Gonzalez-Ganso, Ana, M Minaya-Bravo, Andre, Das, Andrea, Bondurri, Andrea, Costanzi, Andrea, Lucchi, Andrea, Mazzari, Andrea, Musig, Andrea, Peloso, Andrea, Piano, Andrea, Police, Andrei, Mihailescu, Andrés, Pouy, Angela, Romano, Iossa, Angelo, Anna Carmen Leonetti, Anna, Guariniello, Anna, Isaac, Anna Pia Delli Bovi, Antonella, Chessa, Antonella, Tromba, Antonio Álvarez Martínez, Antonio, Brillantino, Antonio, Caira, Antonio, Castaldi, Antonio, Ferronetti, Antonio, Giuliani, Antonio, Prestera, Antonio Ramos-De la Medina, Antonio, Tarasconi, Antonino, Tornambè, Arcangelo, Picciariello, Argyrios, Ioannidis, Ari, Leppäniemi, Arshad, Khan, Arshad, Rashid, Arteaga Luis Eduardo Pérez-Sánchez, Ashok, Mittal, Ashrarur Rahman Mitul, Asif, Mehraj, Asim, Laharwal, Asnel, Dorismé, Athanasios, Marinis, Atif, Iqbal, Augusto, Moncada, Bartolomeo, Braccio, Basim, Alkhafaji, Beatriz de Andrés Asenjo, Beatriz, Martin-Perez, Belinda Sánchez Pérez, Ben, Creavin, Benedetto, Calì, Beniamino, Pascotto, Benjamin, Stubbs, Benjamin Zavala Retes, Branislav, Jovanovic, Brian Kp Goh, Bruno, Sensi, Carlo, Biddau, Carlo, Gazia, Carlo, Vallicelli, Carlos Alberto Fagundes, Carlos Cerdán Santacruz, Carlos, Chirico, Carlos Javier Gómez, Carlos, Petrola, Carlos Sánchez Rodriguez, Carlos Yánez Benítez, Carmelisa, Dammaro, Carmelo Lo Faro, Caroline, Reinke, Casandra Dominguez Paez, Catalina, Oliva, Charudutt, Paranjape, Charlotte, Thomas, Chi Fung Chia, Chi Kwan Kong, Chiara De Lucia, Christian Ovalle Chao, Claudio, Arcudi, Claudio, Guerci, Clement, Chia, Cristiano, Parise, Cristina, Folliero, Cristopher, Varela, Dalya, M Ferguson, Daniel, Camacho, Daniel, Popowich, Daniel Souza Lima, Daniela, Rega, Daniele, Delogu, Daniele, Zigiotto, Danilo, Vinci, Dario, D'Antonio, Dario, Parini, David Alessio Merlini, David DE Zimmerman, David, Moro-Valdezate, Davide, Pertile, Deborah Maria Giusti, Deborah, S Keller, Delko, Tarik, Denis, Kalivaçi, Dennis, Mazingi, Diana Gabriela Maldonado-Pintado, Diego, Sasia, Dimitrios, Linardoutsos, Dixon, Osilli, Domenico, Murrone, Domenico, Russello, Edgar, Rodas, Edisson Alberto Acuña Roa, Edoardo, Ricciardi, Edoardo, Rosso, Edoardo, Saladino, Eduardo, Flores-Villalba, Eduardo Ruiz Ajs, Eduardo, Smith-Singares, Efstratia, Baili, Efstratios, Kouroumpas, Eirini, Bourmpouteli, Eleftheria, Douka, Elena, Martin-Perez, Eleonora, Guaitoli, Elgun, Samadov, Elisa, Francone, Elisa, Vaterlini, Emilio, Morales, Emilio, Peña, Enhao, Zhao, Eneko Del Pozo Andres, Enrico, Benzoni, Enrico, Erdas, Enrico, Pinotti, Enrique, Colás-Ruiz, Erman, Aytac, Ernesto, Laterza, Ervis, Agastra, Esteban, Foianini, Esteban, Moscoso, Estefania, Laviano, Ester, Marra, Eugenia, Cardamone, Eugenio, Licardie, Eustratia, Mpaili, Eva, Pinna, Evaristo, Varo, Fabian Martín Navarro, Fabio, Marino, Fabio, Medas, Fabio, Romano, Fatlum, Maraska, Fatmir, Saliu, Fausto, Madrid, Fausto, Rosa, Federica, Mastella, Federico, Gheza, Federico, Luvisetto, Felipe, Alconchel, Felipe Monge Vieira, Felipe, Pareja, Ferdinando, Agresta, Fernanda, Luna, Fernando, Bonilla, Fernando, Cordera, Fernando, Burdió, Fernando, Mendoza-Moreno, Fernando Muñoz Flores, Fernando Pardo Aranda, Fiona, Taylor, Flavia, L Ramos, Flavio, Fernandes, Francesca Paola Tropeano, Francesco, Balestra, Francesco, Bianco, Francesco, Ceci, Francesco, Colombo, Francesco Di Marzo, Francesco, Ferrara, Francesco, Lancellotti, Francesco, Lazzarin, Francesco, Litta, Francesco, Martini, Francesco, Pizza, Francesco, Roscio, Francesco, Virdis, Francisco Blanco Antona, Francisco Cervantes Ramírez, Francisco Miguel Fernandez, Francisco Oliver Llinares, Francisco, Quezada, Francisco, Schlottmann, Gabriel, Herrera-Almario, Gabriel, Massaferro, Gabriele, Bislenghi, Gabrielle van Ramshorst, Gaetano, Gallo, Gaetano, Luglio, Georgios, Bointas, Georgios, Kampouroglou, Georgios, Papadopoulos, Gerardo Arredondo Manrique, Giacomo, Calini, Giacomo, Nastri, Giampaolo, Formisano, Giampaolo, Galiffa, Gian Marco Palini, Gianluca, Colucci, Gianluca, Pagano, Gianluca, Vanni, Gianmaria Casoni Pattacini, Gilda De Paola, Giorgio, Lisi, Giovanna, Partida, Giovanni, Bellanova, Giovanni De Nobili, Giovanni Sammy Necchi, Giovanni, Sinibaldi, Giovanni, Tebala, Giulia, Bagaglini, Giuliano, Izzo, Giulio, Argenio, Giuseppe, Brisinda, Giuseppe, Candilio, Giuseppe Di Grezia, Giuseppe, Esposito, Giuseppe, Faillace, Giuseppe, Frazzetta, Giuseppe La Gumina, Giuseppe, Nigri, Giuseppe, Romeo, Gloria Chocarro Amatriaín, Gloria, Ortega, Gonzalo, Martin-Martin, Gregor, A Stavrou, Gunadi, Gustavo Armand Ugon, Gustavo, Machain, Gustavo, Marcucci, Gustavo, Martínez-Mier, Gustavo Miguel Machain, Gustavo, Nari, Haydée, Calvo, Hamada, Fathy, Hamilto, Hazem, Ahmed, Hazem, Faraj, Hector, Nava, Hector Ordas Macias, Herald, Nikaj, Heriberto, Solano, Huma Ahmed Khan, Humberto Sánchez Alarcón, Husam, Ebied, Iacopo, Giani, Ibabe Villalabeitia Ateca, Ignacio, Neri, Igor Alberdi San Roman, Iliya, Fidoshev, Iñaki Martinez Rodriguez, Ionut, Negoi, Irene, Ortega, Irina, Bernescu, Iris Shari Russo, Irune Vincente Rodríguez, Irving, Palomares, Isaac, Baltazar, Isabel Jaén Torrejimeno, Isabel María Cornejo Jurado, Isabella, Reccia, Ishtiyaq, Hussain, Ismael Brito Toledo, Ismael, Mora-Guzmán, Iulia, Dogaru, Ivan, Romic, Izaskun, Balciscueta, J Cleo Kenington, Jackison, Sagolsem, Jae, Y Jang, James, Olivier, Jan, Lammel-Lindemann, Jana, Dziakova, Javier Ismael Roldán Villavicencio, Javier, Salinas, Jelena, Pejanovic, Jose Gustavo Parreira, Jovanovic, Jeny Rincón Pérez, Jeryl, Asreyes, Jesus Antonio Medina Luque, Joanna, Mak, Joanne Salas Rodriguez, Johnn Henry Herrera Kok, Jon, Krook, Jose Antonio Diaz-Elizondo, Jose, Castell, José Eduardo García-Flores, José María Jover Navalón, Jose Mauro Silva Rodrigues, José, Pereira, José Tomas Castell Gómez, Juan Bellido Luque, Juan Carlos Martín Del Olmo, Juan Carlos Salamea, Juan Francisco Coronel Olivier, Juan Luis Blas Laina, Juliana Maria Ordoñez, Julieta, Gutierrez, Julio, Abba, Junaid Ahmad Sofi, Kashaf, Sherafgan, Kapil, Sahnan, Katsuhiko, Yanaga, Kevin, Beatson, Laharwal, Asim, Laura, Alvarez, Leandro, Siragusa, Lee, Farber, Lester, Ong, Liarakos, Athanasios, Lorena, García-Bruña, Luca De Martino, Luca, Ferrario, Luca, Giordano, Luca, Gordini, Luca, Pio, Luca, Ponchietti, Lucia, Moletta, Luciano, Curella, Luciano, Poggi, Lucio, Taglietti, Luigi, Bonavina, Luigi, Conti, Luigi, Goffredi, Luis Angel Garcia Ruiz, Luis, Barrionuevo, Luis Enrique Fregoso, Luis, F Cabrera, Luis, G Rodriguez, Luis, Grande, Luis Gregorio Osoria, Luis Javier Kantun Gonzalez, Luis, Sánchez-Guillén, Luis, Tallon-Aguilar, Luis, Tresierra, Luisa, Giavarini, Mahmoud, Hasabelnabi, Maja, Odovic, Mamoru, Uemura, Mansoor, Khan, Manuel, Artiles-Armas, Mara, David, Marcello Di Martino, Marcello Giuseppe Spampinato, Marcelo A, F Ribeiro, Marcelo, Viola, Marco, Angrisani, Marco, Calussi, Marco, Cannistrà, Marco, Catarci, Marco, Cereda, Marco, Conte, Marco, Giordano, Marco, Pellicciaro, Marco Vito Marino, Maria, E Vaterlini, María, F Jiménez, María Giulia Lolli, Bellini, MARIA IRENE, Maria, Lemma, Maria Michela Chiarello, Maria, Nicola, Mario, Arrigo, Mario Caneda Mejia, Mario Montes Manrique, Mario, Rodriguez-Lopez, Mario, Serradilla-Martín, Mario Zambrano Lara, Marisa, Martínez, Mark, Bagnall, Mark, Peter, Marta Cañón Lara, Marta Jimenez Gomez, Marta, Paniagua-Garcia-Señorans, Marta Perez Gonzalez, Martin, Rutegård, Martin, Salö, Marzia, Franceschilli, Massimiliano, Silveri, Massimiliano, Veroux, Massimo, Pezzulo, Matteo, Nardi, Matteo, Rottoli, Matti, Tolonen, Mauricio Pedraza Ciro, Mauricio, Zuluagua, Maurizio, Cannavò, Maurizio, Cervellera, Maurizio, Iacobone, Mauro, Montuori, Melody García Domínguez, Meltem, Bingol-Kologlu, Mian, Tahir, Michael, Lim, Michael Sj Wilson, Michael, Wilson, Michela, Campanelli, Michele, Bisaccia, Michele De Rosa, Michele, Maruccia, Michele, Paterno, Michele, Pisano, Michele, Torre, Michele, Treviño, Michele, Zuolo, Miguel, A Hernandez Bartolome, Miguel, Farina, Miguel, Pera, Miguel Prieto Calvo, Milagros, Sotelo, Min Myat Thway, Mohamed, Hassan, Mohamed Salah Eldin Hassan, Mohammad, Azfar, Mohammad, Bouhuwaish, Mohammad, Taha, Mohammad, Zaieem, Mohammed, Korkoman, Montserrat, Guraieb, Mostafa, Shalaby, Muhammad Asif Raza, Muhammad Umar Younis, Muhammed, Elhadi, Mujahid Zulfiqar Ali, Nadeem, Quazi, Nagendra, N Dudi-Venkata, Nahar, Alselaim, Natasha, Loria, Nathalie Villan Ramírez, Nay Win Than, Neil, Smart, Nelson, Trelles, Nicanor, Pinto, Niccolò, Allievi, Niccolo, Petrucciani, Nicola, Antonacci, Nicola, Cillara, Nicolae, Gica, Nicolaescu Diana Cristiana, Nicolás, Nicolás, Nicolò, Falco, Nicolò, Pecorelli, Nicolò, Tamini, Nikolaos Andreas Dallas, Nikolaos, Machairas, Noelia, Brito, Nura Ahmed Fieturi, Nuria, Ortega, Octavio, Avilamercado, Oktay, Irkorucu, Omar, Alsherif, Orestes, Valles, Orestis, Ioannidis, Oscar Hernández Palmas, Oscar Isaac Hernandez Palmas, Oscar Sanz Guadarrama, Osman, Bozbiyik, Pablo, Omelanczuk, Pablo, Ottolino, Pablo, Rodrigues, Pablo, Ruiz, Paola, Campenni, Paola, Chiarade, Paola Prieto Olivares, Paolo, Baroffio, Pascal, Wintringer, Pasquale Di Fronzo, Pasquale, Talento, Pasqualino, Favoriti, Patricia, Sendino, Patrizia, Marsanic, Patricia, Mifsut, Paúl, Andrade, Pawel, Ajawin, Valentina, Ferri, Giuseppe Massimiliano de Luca, Sara, Ingallinella, Eva, Pueyo, Francesco, Palmieri, Jesus, Silva, Ken Min Chin, Nicholas, Syn, Brian K, P Goh, Ye Xin Koh, Valeria, Tonini, Ana, Gonzales-Ganso, Vicente, Simó, Maria Victoria Diago, Pedro, Abadía-Barnó, Pedro Alfonso Najar Castañeda, Pedro Omar Sillas Arevalos, Pedro Palazón Bellver, Peng Soon Koh, Petry, Souza, Piotr, Major, Rajandeep Singh Bali, Rakesh Mohan Khattar, Renato Bessa Melo, Reza, Ebrahiminia, Ricardo, Azar, Ricardo López Murga, Riccardo, Caruso, Riccardo, Pirolo, Richard, Brady, Richard Justin Davies, Rishi, Dholakia, Rishi, Rattan, Rishi, Singhal, Robert, Lim, Roberta, Angelico, Roberta Maria Isernia, Roberta, Tutino, Roberto, Faccincani, Roberto, Peltrini, Rocío, Carrera-Ceron, Rodrigo, Tejos, Rohit, Kashyap, Roosevelt, Fajardo, Rosa, Lozito, Royer Madariaga Pareja, Sabrina, Garbarino, Salvador, Morales-Conde, Sami, Benli, Sami, Mansour, Samir, Flores, Samuel Limon Suarez, Santiago Lopez Ben, Sara, Fuentes, Sara, Napetti, Sara Ortiz de Guzmán, Selmy, Awad, Sergio, A Weckmann Luján, Sergio, Gentilli, Sergio, Grimaldi, Sergio Olivares Pizarro, Serkan, Tayar, Shakeeb, Nabi, Shannon, M Chan, Sheikh, Junaid, Sidney, Rojas, Silvana, Monetti, Silvia, García, Silvia, Salvans, Silvia, Tenconi, Simon, Shaw, Simone, Santoni, Sofia Andrea Parra, Sofía, Cárdenas, Sonia, Pérez-Bertólez, Sonja, Chiappetta, Sophie, Dessureault, Spiros, Delis, Stefano Amore Bonapasta, Stefano, Rausei, Stefano, Scaringi, Sundeep, Keswani, Syed Muhammad Ali, Süleyman, Cetinkunar, Tak Lit Derek Fung, Tariq, Rawashdeh, Tatiana Nicolás López, Tercio De Campos, Teresa Calderon Duque, Teresa, Perra, Theodore, Liakakos, Theodoros, Daskalakis, Theodoros, Liakakos, Thomas, Barnes, Tijmen, Koëter, Tiku, Zalla, Tomás, E González, Tomás, Elosua, Tommaso, Campagnaro, Tommy, Brown, Topi, Luoto, Touré Alpha Oumar, Ugo, Giustizieri, Ugo, Grossi, Umberto, Bracale, Uriel, Rivas, Valentina, Sosa, Valentina, Testa, Valeria, Andriola, Valerio, Balassone, Valerio, Celentano, Valerio, Progno, Varun, Raju, Vanessa, Carroni, Venera, Cavallaro, Venkateswara Rao Katta, Veronica De Simone, Vicent Primo Romaguera, Victor Hugo García Orozco, Victor, Luraschi, Victor, Rachkov, Victor, Turrado-L, Victor, Visag-Castillo, Victoria, Dowling, Victoria, Graham, Vincenzo, Papagni, Vincenzo, Vigorita, Vinicius Cordeiro Fonseca, Virginia Jimenez Carneros, Vittoria, Bellato, Walyson, Gonçalves, William, F Powers, William, Grigg, Wolf, O Bechstein, Yu Bing Lim, Yuksel, Altinel, Zoran, Golubović, Zutoia, Balciscueta, Ielpo B., Podda M., Pellino G., Pata F., Caruso R., Gravante G., Di Saverio S., Gallo G., Lui R., Orengia A., Chowdary A., Kulkarni A., Kuvvetli A., Navarro A., Pisanu A., Smith A., Ibiricu A.C., Nacion A.J.D., Alsaleh A., Alhazmi A., Elmabri A., Wani A., Rencuzogullari A., Lasarte A.S., Rubio A.V., Bavikatte A., Kumar A., Jamiri A.-R., Padilla A.M.A., Cacurri A., de San Ildefonso A., Porcu A., Sartori A., Rocca A., Yanez A.P., Becaria A., Solis-Pena A., Sretenovic A., Urbistondo A., Bandin A., Najar A., De Luca A., Boddy A., Charalabopoulos A., Tzivanakis A., Amendola A., de Velasco A.R.-G., Yildirim A.C., Frontali A., Toure A.O., Garcia-Granero A., Roldan A.M., Larrainzar A.S., Ratnayake A.S., Gonzalez-Ganso A.M., Minaya-Bravo A.M., Das A., Bondurri A., Costanzi A., Lucchi A., Mazzari A., Musig A., Peloso A., Piano A., Police A., Mihailescu A., Pouy A., Romano A., Iossa A., Leonetti A.C., Guariniello A., Isaac A., Bovi A.P.D., Chessa A., Tromba A., Martinez A.A., Brillantino A., Caira A., Castaldi A., Ferronetti A., Giuliani A., Prestera A., la Medina A.R.-D., Tarasconi A., Tornambe A., Picciariello A., Ioannidis A., Leppaniemi A., Khan A., Rashid A., Perez-Sanchez A.L.E., Mittal A., Mitul A.R., Mehraj A., Laharwal A., Dorisme A., Marinis A., Iqbal A., Moncada A., Braccio B., Alkhafaji B., de Andres Asenjo B., Martin-Perez B., Perez B.S., Creavin B., Cali B., Pascotto B., Stubbs B., Retes B.Z., Jovanovic B., Goh B.K.P., Sensi B., Biddau C., Gazia C., Vallicelli C., Fagundes C.A., Santacruz C.C., Chirico C., Diaz C.J.G., Petrola C., Rodriguez C.S., Benitez C.Y., Dammaro C., Faro C.L., Reinke C., Paez C.D., Oliva C., Paranjape C., Thomas C., Chia C.F., Kong C.K., De Lucia C., Chao C.O., Arcudi C., Guerci C., Chia C., Parise C., Folliero C., Varela C., Ferguson D.M., Camacho D., Popowich D., Lima D.S., Rega D., Delogu D., Zigiotto D., Vinci D., D'Antonio D., Parini D., Merlini D.A., Zimmerman D.D.E., Moro-Valdezate D., Pertile D., Giusti D.M., Keller D.S., Tarik D., Kalivaci D., Mazingi D., Maldonado-Pintado D.G., Sasia D., Linardoutsos D., Osilli D., Murrone D., Russello D., Rodas E., Roa E.A.A., Ricciardi E., Rosso E., Saladino E., Flores-Villalba E., Ajs E.R., Smith-Singares E., Baili E., Kouroumpas E., Bourmpouteli E., Douka E., Martin-Perez E., Guaitoli E., Samadov E., Francone E., Vaterlini E., Morales E., Pena E., Zhao E., Andres E.D.P., Benzoni E., Erdas E., Pinotti E., Colas-Ruiz E., Aytac E., Laterza E., Agastra E., Foianini E., Moscoso E., Laviano E., Marra E., Cardamone E., Licardie E., Mpaili E., Pinna E., Varo E., Navarro F.M., Marino F., Medas F., Romano F., Maraska F., Saliu F., Madrid F., Rosa F., Mastella F., Gheza F., Luvisetto F., Alconchel F., Vieira F.M., Pareja F., Agresta F., Luna F., Bonilla F., Cordera F., Burdio F., Mendoza-Moreno F., Flores F.M., Aranda F.P., Taylor F., Ramos F.L., Fernandes F., Tropeano F.P., Balestra F., Bianco F., Ceci F., Colombo F., Di Marzo F., Ferrara F., Lancellotti F., Lazzarin F., Litta F., Martini F., Pizza F., Roscio F., Virdis F., Antona F.B., Ramirez F.C., Fernandez F.M., Llinares F.O., Quezada F., Schlottmann F., Herrera-Almario G., Massaferro G., Bislenghi G., van Ramshorst G., Luglio G., Bointas G., Kampouroglou G., Papadopoulos G., Manrique G.A., Calini G., Nastri G., Formisano G., Galiffa G., Palini G.M., Colucci G., Pagano G., Vanni G., Pattacini G.C., De Paola G., Lisi G., Partida G., Bellanova G., De Nobili G., Necchi G.S., Sinibaldi G., Tebala G., Bagaglini G., Izzo G., Argenio G., Brisinda G., Candilio G., Di Grezia G., Esposito G., Faillace G., Frazzetta G., La Gumina G., Nigri G., Romeo G., Amatriain G.C., Ortega G., Martin-Martin G., Stavrou G.A., Gunadi, Ugon G.A., Machain G., Marcucci G., Martinez-Mier G., Machain G.M., Nari G., Calvo H., Fathy H., Hamilto, Ahmed H., Faraj H., Nava H., Macias H.O., Nikaj H., Solano H., Khan H.A., Alarcon H.S., Ebied H., Giani I., Ateca I.V., Neri I., Roman I.A.S., Fidoshev I., Rodriguez I.M., Negoi I., Ortega I., Bernescu I., Russo I.S., Rodriguez I.V., Palomares I., Baltazar I., Torrejimeno I.J., Jurado I.M.C., Reccia I., Hussain I., Toledo I.B., Mora-Guzman I., Dogaru I., Romic I., Balciscueta I., Kenington J.C., Sagolsem J., Jang J.Y., Olivier J., Lammel-Lindemann J., Dziakova J., Villavicencio J.I.R., Salinas J., Parreira J.P.J.G., Jovanovic, Perez J.R., Reyes J.A.S., Luque J.A.M., Mak J., Rodriguez J.S., Kok J.H.H., Krook J., Diaz-Elizondo J.A., Castell J., Garcia-Flores J.E., Navalon J.M.J., Rodrigues J.M.S., Pereira J., Gomez J.T.C., Luque J.B., del Olmo J.C.M., Salamea J.C., Olivier J.F.C., Laina J.L.B., Ordonez J.M., Gutierrez J., Abba J., Sofi J.A., Sherafgan K., Sahnan K., Yanaga K., Beatson K., Asim L., Alvarez L., Siragusa L., Farber L., Ong L., Athanasios L., Garcia-Bruna L., De Martino L., Ferrario L., Giordano L., Gordini L., Pio L., Ponchietti L., Moletta L., Curella L., Poggi L., Taglietti L., Bonavina L., Conti L., Goffredi L., Ruiz L.A.G., Barrionuevo L., Fregoso L.E., Cabrera L.F., Rodriguez L.G., Grande L., Osoria L.G., Gonzalez L.J.K., Sanchez-Guillen L., Tallon-Aguilar L., Tresierra L., Giavarini L., Hasabelnabi M., Odovic M., Uemura M., Khan M., Artiles-Armas M., David M., Di Martino M., Spampinato M.G., Ribeiro M.A.F., Viola M., Angrisani M., Calussi M., Cannistra M., Catarci M., Cereda M., Conte M., Giordano M., Pellicciaro M., Marino M.V., Vaterlini M.E., Jimenez M.F., Lolli M.G., Bellini M.I., Lemma M., Chiarello M.M., Nicola M., Arrigo M., Mejia M.C., Manrique M.M., Rodriguez-Lopez M., Serradilla-Martin M., Lara M.Z., Martinez M., Bagnall M., Peter M., Lara M.C., Gomez M.J., Paniagua-Garcia-Senorans M., Gonzalez M.P., Rutegard M., Salo M., Franceschilli M., Silveri M., Veroux M., Pezzulo M., Nardi M., Rottoli M., Tolonen M., Ciro M.P., Zuluagua M., Cannavo M., Cervellera M., Iacobone M., Montuori M., Dominguez M.G., Bingol-Kologlu M., Tahir M., Lim M., Wilson M.S., Wilson M., Campanelli M., Bisaccia M., De Rosa M., Maruccia M., Paterno M., Pisano M., Torre M., Trevino M., Zuolo M., Hernandez Bartolome M.A., Farina M., Pera M., Calvo M.P., Sotelo M., Thway M.M., Hassan M., Hassan M.S.E., Azfar M., Bouhuwaish M., Taha M., Zaieem M., Korkoman M., Guraieb M., Shalaby M., Raza M.A., Younis M.U., Elhadi M., Ali M.Z., Quazi N., Dudi-Venkata N.N., Alselaim N., Loria N., Ramirez N.V., Than N.W., Smart N., Trelles N., Pinto N., Allievi N., Petrucciani N., Antonacci N., Cillara N., Gica N., Cristiana N.D., Krystek N., Falco N., Pecorelli N., Tamini N., Dallas N.A., Machairas N., Brito N., Fieturi N.A., Ortega N., Mercado O.A., Irkorucu O., Alsherif O., Valles O., Ioannidis O., Palmas O.H., Palmas O.I.H., Guadarrama O.S., Bozbiyik O., Omelanczuk P., Ottolino P., Rodrigues P., Ruiz P., Campenni P., Chiarade P., Olivares P.P., Baroffio P., Panaccio P., Wintringer P., Di Fronzo P., Talento P., Favoriti P., Sendino P., Marsanic P., Mifsut P., Andrade P., Ajawin P., Abadia-Barno P., Castaneda P.A.N., Arevalos P.O.S., Bellver P.P., Koh P.S., Souza P., Major P., Bali R.S., Khattar R.M., Melo R.B., Ebrahiminia R., Azar R., Murga R.L., Pirolo R., Brady R., Davies R.J., Dholakia R., Rattan R., Singhal R., Lim R., Angelico R., Isernia R.M., Tutino R., Faccincani R., Peltrini R., Carrera-Ceron R., Tejos R., Kashyap R., Fajardo R., Lozito R., Pareja R.M., Garbarino S., Morales-Conde S., Benli S., Mansour S., Flores S., Suarez S.L., Ben S.L., Fuentes S., Napetti S., de Guzman S.O., Awad S., Weckmann Lujan S.A., Gentilli S., Grimaldi S., Pizarro S.O., Tayar S., Nabi S., Chan S.M., Junaid S., Rojas S., Monetti S., Garcia S., Salvans S., Tenconi S., Shaw S., Santoni S., Parra S.A., Cardenas S., Perez-Bertolez S., Chiappetta S., Dessureault S., Delis S., Bonapasta S.A., Rausei S., Scaringi S., Keswani S., Ali S.M., Cetinkunar S., Fung T.L.D., Rawashdeh T., Lopez T.N., De Campos T., Duque T.C., Perra T., Liakakos T., Daskalakis T., Barnes T., Koeter T., Zalla T., Gonzalez T.E., Elosua T., Campagnaro T., Brown T., Luoto T., Oumar T.A., Giustizieri U., Grossi U., Bracale U., Rivas U., Sosa V., Testa V., Andriola V., Tonini V., Balassone V., Celentano V., Progno V., Raju V., Carroni V., Cavallaro V., Katta V.R., De Simone V., Romaguera V.P., Orozco V.H.G., Luraschi V., Rachkov V., Turrado-L V., Visag-Castillo V., Dowling V., Graham V., Papagni V., Vigorita V., Fonseca V.C., Carneros V.J., Bellato V., Goncalves W., Powers W.F., Grigg W., Bechstein W.O., Lim Y.B., Altinel Y., Golubovic Z., Balciscueta Z., Ielpo, B., Podda, M., Pellino, G., Pata, F., Caruso, R., Gravante, G., Di Saverio, S., Gallo, G., Lui, R., Orengia, A., Chowdary, A., Kulkarni, A., Kuvvetli, A., Navarro, A., Pisanu, A., Smith, A., Ibiricu, A. C., Nacion, A. J. D., Alsaleh, A., Alhazmi, A., Elmabri, A., Wani, A., Rencuzogullari, A., Lasarte, A. S., Rubio, A. V., Bavikatte, A., Kumar, A., Jamiri, A. -R., Padilla, A. M. A., Cacurri, A., de San Ildefonso, A., Porcu, A., Sartori, A., Rocca, A., Yanez, A. P., Becaria, A., Solis-Pena, A., Sretenovic, A., Urbistondo, A., Bandin, A., Najar, A., De Luca, A., Boddy, A., Charalabopoulos, A., Tzivanakis, A., Amendola, A., de Velasco, A. R. -G., Yildirim, A. C., Frontali, A., Toure, A. O., Garcia-Granero, A., Roldan, A. M., Larrainzar, A. S., Ratnayake, A. S., Gonzalez-Ganso, A. M., Minaya-Bravo, A. M., Das, A., Bondurri, A., Costanzi, A., Lucchi, A., Mazzari, A., Musig, A., Peloso, A., Piano, A., Police, A., Mihailescu, A., Pouy, A., Romano, A., Iossa, A., Leonetti, A. C., Guariniello, A., Isaac, A., Bovi, A. P. D., Chessa, A., Tromba, A., Martinez, A. A., Brillantino, A., Caira, A., Castaldi, A., Ferronetti, A., Giuliani, A., Prestera, A., la Medina, A. R. -D., Tarasconi, A., Tornambe, A., Picciariello, A., Ioannidis, A., Leppaniemi, A., Khan, A., Rashid, A., Perez-Sanchez, A. L. E., Mittal, A., Mitul, A. R., Mehraj, A., Laharwal, A., Dorisme, A., Marinis, A., Iqbal, A., Moncada, A., Braccio, B., Alkhafaji, B., de Andres Asenjo, B., Martin-Perez, B., Perez, B. S., Creavin, B., Cali, B., Pascotto, B., Stubbs, B., Retes, B. Z., Jovanovic, B., Goh, B. K. P., Sensi, B., Biddau, C., Gazia, C., Vallicelli, C., Fagundes, C. A., Santacruz, C. C., Chirico, C., Diaz, C. J. G., Petrola, C., Rodriguez, C. S., Benitez, C. Y., Dammaro, C., Faro, C. L., Reinke, C., Paez, C. D., Oliva, C., Paranjape, C., Thomas, C., Chia, C. F., Kong, C. K., De Lucia, C., Chao, C. O., Arcudi, C., Guerci, C., Chia, C., Parise, C., Folliero, C., Varela, C., Ferguson, D. M., Camacho, D., Popowich, D., Lima, D. S., Rega, D., Delogu, D., Zigiotto, D., Vinci, D., D'Antonio, D., Parini, D., Merlini, D. A., Zimmerman, D. D. E., Moro-Valdezate, D., Pertile, D., Giusti, D. M., Keller, D. S., Tarik, D., Kalivaci, D., Mazingi, D., Maldonado-Pintado, D. G., Sasia, D., Linardoutsos, D., Osilli, D., Murrone, D., Russello, D., Rodas, E., Roa, E. A. A., Ricciardi, E., Rosso, E., Saladino, E., Flores-Villalba, E., Ajs, E. R., Smith-Singares, E., Baili, E., Kouroumpas, E., Bourmpouteli, E., Douka, E., Martin-Perez, E., Guaitoli, E., Samadov, E., Francone, E., Vaterlini, E., Morales, E., Pena, E., Zhao, E., Andres, E. D. P., Benzoni, E., Erdas, E., Pinotti, E., Colas-Ruiz, E., Aytac, E., Laterza, E., Agastra, E., Foianini, E., Moscoso, E., Laviano, E., Marra, E., Cardamone, E., Licardie, E., Mpaili, E., Pinna, E., Varo, E., Navarro, F. M., Marino, F., Medas, F., Romano, F., Maraska, F., Saliu, F., Madrid, F., Rosa, F., Mastella, F., Gheza, F., Luvisetto, F., Alconchel, F., Vieira, F. M., Pareja, F., Agresta, F., Luna, F., Bonilla, F., Cordera, F., Burdio, F., Mendoza-Moreno, F., Flores, F. M., Aranda, F. P., Taylor, F., Ramos, F. L., Fernandes, F., Tropeano, F. P., Balestra, F., Bianco, F., Ceci, F., Colombo, F., Di Marzo, F., Ferrara, F., Lancellotti, F., Lazzarin, F., Litta, F., Martini, F., Pizza, F., Roscio, F., Virdis, F., Antona, F. B., Ramirez, F. C., Fernandez, F. M., Llinares, F. O., Quezada, F., Schlottmann, F., Herrera-Almario, G., Massaferro, G., Bislenghi, G., van Ramshorst, G., Luglio, G., Bointas, G., Kampouroglou, G., Papadopoulos, G., Manrique, G. A., Calini, G., Nastri, G., Formisano, G., Galiffa, G., Palini, G. M., Colucci, G., Pagano, G., Vanni, G., Pattacini, G. C., De Paola, G., Lisi, G., Partida, G., Bellanova, G., De Nobili, G., Necchi, G. S., Sinibaldi, G., Tebala, G., Bagaglini, G., Izzo, G., Argenio, G., Brisinda, G., Candilio, G., Di Grezia, G., Esposito, G., Faillace, G., Frazzetta, G., La Gumina, G., Nigri, G., Romeo, G., Amatriain, G. C., Ortega, G., Martin-Martin, G., Stavrou, G. A., Ugon, G. A., Machain, G., Marcucci, G., Martinez-Mier, G., Machain, G. M., Nari, G., Calvo, H., Fathy, H., Ahmed, H., Faraj, H., Nava, H., Macias, H. O., Nikaj, H., Solano, H., Khan, H. A., Alarcon, H. S., Ebied, H., Giani, I., Ateca, I. V., Neri, I., Roman, I. A. S., Fidoshev, I., Rodriguez, I. M., Negoi, I., Ortega, I., Bernescu, I., Russo, I. S., Rodriguez, I. V., Palomares, I., Baltazar, I., Torrejimeno, I. J., Jurado, I. M. C., Reccia, I., Hussain, I., Toledo, I. B., Mora-Guzman, I., Dogaru, I., Romic, I., Balciscueta, I., Kenington, J. C., Sagolsem, J., Jang, J. Y., Olivier, J., Lammel-Lindemann, J., Dziakova, J., Villavicencio, J. I. R., Salinas, J., Parreira, J. P. J. G., Perez, J. R., Reyes, J. A. S., Luque, J. A. M., Mak, J., Rodriguez, J. S., Kok, J. H. H., Krook, J., Diaz-Elizondo, J. A., Castell, J., Garcia-Flores, J. E., Navalon, J. M. J., Rodrigues, J. M. S., Pereira, J., Gomez, J. T. C., Luque, J. B., del Olmo, J. C. M., Salamea, J. C., Olivier, J. F. C., Laina, J. L. B., Ordonez, J. M., Gutierrez, J., Abba, J., Sofi, J. A., Sherafgan, K., Sahnan, K., Yanaga, K., Beatson, K., Asim, L., Alvarez, L., Siragusa, L., Farber, L., Ong, L., Athanasios, L., Garcia-Bruna, L., De Martino, L., Ferrario, L., Giordano, L., Gordini, L., Pio, L., Ponchietti, L., Moletta, L., Curella, L., Poggi, L., Taglietti, L., Bonavina, L., Conti, L., Goffredi, L., Ruiz, L. A. G., Barrionuevo, L., Fregoso, L. E., Cabrera, L. F., Rodriguez, L. G., Grande, L., Osoria, L. G., Gonzalez, L. J. K., Sanchez-Guillen, L., Tallon-Aguilar, L., Tresierra, L., Giavarini, L., Hasabelnabi, M., Odovic, M., Uemura, M., Khan, M., Artiles-Armas, M., David, M., Di Martino, M., Spampinato, M. G., Ribeiro, M. A. F., Viola, M., Angrisani, M., Calussi, M., Cannistra, M., Catarci, M., Cereda, M., Conte, M., Giordano, M., Pellicciaro, M., Marino, M. V., Vaterlini, M. E., Jimenez, M. F., Lolli, M. G., Bellini, M. I., Lemma, M., Chiarello, M. M., Nicola, M., Arrigo, M., Mejia, M. C., Manrique, M. M., Rodriguez-Lopez, M., Serradilla-Martin, M., Lara, M. Z., Martinez, M., Bagnall, M., Peter, M., Lara, M. C., Gomez, M. J., Paniagua-Garcia-Senorans, M., Gonzalez, M. P., Rutegard, M., Salo, M., Franceschilli, M., Silveri, M., Veroux, M., Pezzulo, M., Nardi, M., Rottoli, M., Tolonen, M., Ciro, M. P., Zuluagua, M., Cannavo, M., Cervellera, M., Iacobone, M., Montuori, M., Dominguez, M. G., Bingol-Kologlu, M., Tahir, M., Lim, M., Wilson, M. S., Wilson, M., Campanelli, M., Bisaccia, M., De Rosa, M., Maruccia, M., Paterno, M., Pisano, M., Torre, M., Trevino, M., Zuolo, M., Hernandez Bartolome, M. A., Farina, M., Pera, M., Calvo, M. P., Sotelo, M., Thway, M. M., Hassan, M., Hassan, M. S. E., Azfar, M., Bouhuwaish, M., Taha, M., Zaieem, M., Korkoman, M., Guraieb, M., Shalaby, M., Raza, M. A., Younis, M. U., Elhadi, M., Ali, M. Z., Quazi, N., Dudi-Venkata, N. N., Alselaim, N., Loria, N., Ramirez, N. V., Than, N. W., Smart, N., Trelles, N., Pinto, N., Allievi, N., Petrucciani, N., Antonacci, N., Cillara, N., Gica, N., Cristiana, N. D., Krystek, N., Falco, N., Pecorelli, N., Tamini, N., Dallas, N. A., Machairas, N., Brito, N., Fieturi, N. A., Ortega, N., Mercado, O. A., Irkorucu, O., Alsherif, O., Valles, O., Ioannidis, O., Palmas, O. H., Palmas, O. I. H., Guadarrama, O. S., Bozbiyik, O., Omelanczuk, P., Ottolino, P., Rodrigues, P., Ruiz, P., Campenni, P., Chiarade, P., Olivares, P. P., Baroffio, P., Panaccio, P., Wintringer, P., Di Fronzo, P., Talento, P., Favoriti, P., Sendino, P., Marsanic, P., Mifsut, P., Andrade, P., Ajawin, P., Abadia-Barno, P., Castaneda, P. A. N., Arevalos, P. O. S., Bellver, P. P., Koh, P. S., Souza, P., Major, P., Bali, R. S., Khattar, R. M., Melo, R. B., Ebrahiminia, R., Azar, R., Murga, R. L., Pirolo, R., Brady, R., Davies, R. J., Dholakia, R., Rattan, R., Singhal, R., Lim, R., Angelico, R., Isernia, R. M., Tutino, R., Faccincani, R., Peltrini, R., Carrera-Ceron, R., Tejos, R., Kashyap, R., Fajardo, R., Lozito, R., Pareja, R. M., Garbarino, S., Morales-Conde, S., Benli, S., Mansour, S., Flores, S., Suarez, S. L., Ben, S. L., Fuentes, S., Napetti, S., de Guzman, S. O., Awad, S., Weckmann Lujan, S. A., Gentilli, S., Grimaldi, S., Pizarro, S. O., Tayar, S., Nabi, S., Chan, S. M., Junaid, S., Rojas, S., Monetti, S., Garcia, S., Salvans, S., Tenconi, S., Shaw, S., Santoni, S., Parra, S. A., Cardenas, S., Perez-Bertolez, S., Chiappetta, S., Dessureault, S., Delis, S., Bonapasta, S. A., Rausei, S., Scaringi, S., Keswani, S., Ali, S. M., Cetinkunar, S., Fung, T. L. D., Rawashdeh, T., Lopez, T. N., De Campos, T., Duque, T. C., Perra, T., Liakakos, T., Daskalakis, T., Barnes, T., Koeter, T., Zalla, T., Gonzalez, T. E., Elosua, T., Campagnaro, T., Brown, T., Luoto, T., Oumar, T. A., Giustizieri, U., Grossi, U., Bracale, U., Rivas, U., Sosa, V., Testa, V., Andriola, V., Tonini, V., Balassone, V., Celentano, V., Progno, V., Raju, V., Carroni, V., Cavallaro, V., Katta, V. R., De Simone, V., Romaguera, V. P., Orozco, V. H. G., Luraschi, V., Rachkov, V., Turrado-L, V., Visag-Castillo, V., Dowling, V., Graham, V., Papagni, V., Vigorita, V., Fonseca, V. C., Carneros, V. J., Bellato, V., Goncalves, W., Powers, W. F., Grigg, W., Bechstein, W. O., Lim, Y. B., Altinel, Y., Golubovic, Z., Balciscueta, Z., Ielpo, B, Podda, M, Pellino, G, Pata, F, Caruso, R, Gravante, G, Di Saverio, S, and Luglio, G

Subjects
medicine.medical_specialty, Anti-Bacterial Agents, Appendectomy, Appendicitis, COVID-19 Testing, Hospital Administration, Humans, Pandemics, Personal Protective Equipment, Practice Patterns, Physicians', Surveys and Questionnaires, Attitude of Health Personnel, COVID-19, Surgeons, Coronavirus disease 2019 (COVID-19), Settore MED/18 - CHIRURGIA GENERALE, COVID-19 pandemic. Acute appendicitis, MEDLINE, Practice Patterns, 030230 surgery, Health administration, 03 medical and health sciences, 0302 clinical medicine, Anti-Bacterial Agent, Pandemic, medicine, Surveys and Questionnaire, Appendiciti, General, Laparoscopy, Personal protective equipment, Physicians', medicine.diagnostic_test, business.industry, General surgery, Original Articles, medicine.disease, Anti-bacterial agents, appendectomy, appendicitis, COVID-19 testing, hospital administration, humans, pandemics, personal protective equipment, practice patterns physicians', surveys and questionnaires, attitude of health personnel, surgeons, appendicitis - COVI-19 - ACIE study - management, Acute appendicitis, Original Article, Surgery, Covid-19, business, Human
Abstract

Background Surgical strategies are being adapted to face the COVID‐19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X‐ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P, The COVID‐19 pandemic required reorganization of surgical services, affecting patients with common surgical diseases including acute appendicitis. No evidence is available on the topic. This study found global variation in screening policies, use of personal protective equipment and intraoperative directives. There has been increased adoption of non‐operative management and open appendicectomy. Hands off

Published
2021

29. Institutional economics in robotic colorectal surgery

Author

Giampaolo Formisano and Paolo Bianchi

Subjects
medicine.medical_specialty, Robotic surgery costs, business.industry, General surgery, Robotic surgery, Colorectal surgery, Institutional economics, Institutional business plan, Structured training program, behavioral disciplines and activities, humanities, body regions, Settore MED/18 - Chirurgia Generale, surgical procedures, operative, Medicine, business, health care economics and organizations
Abstract

In this chapter, the different steps of setting up a robotic colorectal surgical program are analysed from both financial and clinical standpoints.

Published
2021

30. The Specific Role of Minimally Invasive Robotic Digestive Surgery

Author

Felice Borghi, Andrea Peri, Andrea Pietrabissa, Luigi Pugliese, Paolo Bianchi, and Giampaolo Formisano

Subjects
medicine.medical_specialty, Volume, business.industry, Digestive surgery, Pancreatic surgery, Robotic surgery, Colorectal surgery, Low volume, Settore MED/18 - Chirurgia Generale, Invasive surgery, Upper gastrointestinal surgery, medicine, Hub-spoke, Intensive care medicine, business, Outcome
Abstract

Robotic technology has proven to be safe and effective in many surgical fields with comparable or even better outcomes than conventional minimally invasive surgery for several oncological procedures. However, the widespread diffusion of robotic surgical systems has encouraged, despite their significant cost, an uncontrolled adoption of the robot-assisted approach that is being used by an increasing number of centers with low volume and poor experience. Recent publications have shown a strong inverse relationship between hospital caseload of robotic procedures and the related outcomes especially when performed for oncological indications. On this basis, the surgical community is calling for centralization of patients to high-volume centers. In this chapter the current available evidence on this topic is analyzed for specific fields of application.

Published
2020
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31. Consensus Statement of the Italian Polispecialistic Society of Young Surgeons (SPIGC): Diagnosis and Treatment of Acute Appendicitis

Author

Federica Galli, Davide Pertile, Antonio Martino, Vincenzo Pappalardo, Eleonora Guaitoli, Romeo Patini, Andrea Mazzari, Giampaolo Formisano, Gaetano Gallo, Roberto Luca Meniconi, Simone Famularo, Elena Orsenigo, Eleonora Cardone, Fabio Barra, Alessandro Pasculli, Luigi Conti, Marco Sparavigna, Domenico Soriero, Giuseppe Giuliani, and Gianmaria Casoni Pattacini

Subjects
medicine.medical_specialty, Abdominal pain, Consensus, Statement (logic), Settore MED/18 - CHIRURGIA GENERALE, acute appendicitis, 030230 surgery, appendix, laparoscopic appendectomy, 03 medical and health sciences, 0302 clinical medicine, open appendectomy, Intervention (counseling), medicine, Appendectomy, Humans, Child, Aged, Retrospective Studies, Perforated Appendicitis, Surgeons, business.industry, General surgery, Complicated appendicitis, Appendicitis, complicated appendicitis, perforated appendicitis, Appendix, medicine.anatomical_structure, Italy, 030220 oncology & carcinogenesis, Acute appendicitis, Acute Disease, Surgery, Laparoscopy, medicine.symptom, business
Abstract

Acute appendicitis (AA) is one of the most common causes of abdominal pain requiring surgical intervention. Approximately 20% of AA cases are characterized by complications such as gangrene, abscesses, perforation, or diffuse peritonitis, which increase patients' morbidity and mortality. Diagnosis of AA can be difficult, and evaluation of clinical signs, laboratory index and imaging should be part of the management of patients with suspicion of AA.This consensus statement was written in relation to the most recent evidence for diagnosis and treatment of AA, performing a literature review on the most largely adopted scientific sources. The members of the SPIGC (Italian Polispecialistic Society of Young Surgeons) worked jointly to draft it. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by the American College of Chest Physicians (CHEST) for the strength of the recommendations.Fever and migratory pain tend to be present in patients with suspicion of AA. Laboratory and radiological examinations are commonly employed in the clinical practice, but today also scoring systems based on clinical signs and laboratory data have slowly been adopted for diagnostic purpose. The clinical presentation of AA in children, pregnant and elderly patients can be unusual, leading to more difficult and delayed diagnosis. Surgery is the best option in case of complicated AA, whereas it is not mandatory in case of uncomplicated AA. Laparoscopic surgical treatment is feasible and recommended. Postoperative antibiotic treatment is recommended only in patients with complicated AA.

Published
2020

32. Full robotic Hartmann's reversal: technical aspects and preliminary experience

Author

Lucia Salvischiani, Giuseppe Giuliani, Marco Milone, Paolo Bianchi, Adelona Salaj, Giampaolo Formisano, Giuliani, G., Formisano, G., Milone, M., Salaj, A., Salvischiani, L., and Bianchi, P. P.

Subjects
medicine.medical_specialty, medicine.medical_treatment, robotic-assisted surgery, 03 medical and health sciences, Ileostomy, 0302 clinical medicine, Postoperative Complications, Robotic Surgical Procedures, Colostomy, medicine, Operating time, Humans, Major complication, reversal Hartmann', Laparoscopy, Retrospective Studies, medicine.diagnostic_test, business.industry, Anastomosis, Surgical, Gastroenterology, robot, Robotic assisted surgery, Colorectal surgery, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Charlson comorbidity index, colorectal surgery, 030211 gastroenterology & hepatology, business, Body mass index, Hartmann's procedure
Abstract

Aim Laparoscopic Hartmann's reversal (HR) is a major abdominal operation that is associated with considerable morbidity and mortality. The robotic approach, with its intrinsic advantages, could potentially overcome the technical complexity of laparoscopy. The aim of this study was to evaluate the short-term results of a series of 24 robotic HR cases. Method The data from 24 patients who underwent robotic HR between September 2016 and July 2019 at two different institutions were prospectively collected and retrospectively analysed. A full robotic single-docking reversal procedure with intracorporeal anastomosis was performed in all patients. Results The mean age and body mass index of the patients were 69 years and 26 kg/m2 , respectively. Of the patients, 58% were ≥ 70 years old and 42% had comorbidities (mean Charlson Comorbidity Index 3). The mean operating time was 240 min. There were no cases of conversion to the open or laparoscopic approach. No diverting loop ileostomies were constructed. The mean length of hospital stay was 6 days. Minor complications were recorded in three patients. Neither major complications nor 30-day readmissions were registered. Conclusions Robotic HR is a feasible and safe procedure. The robotic approach has low rates of major complications and conversion and could potentially increase the number of patients undergoing HR.

Published
2020

33. Fashioning enterotomy closure after totally laparoscopic ileocolic anastomosis for right colon cancer: a multicenter experience

Author

Luigi Boni, Roberto Persiani, Giovanni Domenico De Palma, Riccardo Rosati, Paolo Bianchi, Francesco Corcione, Maurizio Degiuli, Nunzio Velotti, Nicolò de Manzini, Alberto Biondi, Domenico D'Ugo, Giampaolo Formisano, Mario Morino, Umberto Bracale, Marco E. Allaix, Elisa Cassinotti, Marco Milone, Ugo Elmore, Silvia Palmisano, Fabio Rondelli, Michele Manigrasso, Diego Cuccurullo, Graziano Ceccarelli, Rossella Reddavid, Milone, M., Elmore, U., Allaix, M. E., Bianchi, P. P., Biondi, A., Boni, L., Bracale, U., Cassinotti, E., Ceccarelli, G., Corcione, F., Cuccurullo, D., Degiuli, M., De Manzini, N., D'Ugo, D., Formisano, G., Manigrasso, M., Morino, M., Palmisano, S., Persiani, R., Reddavid, R., Rondelli, F., Velotti, N., Rosati, R., De Palma, G. D., Persiani, Alessandro, Rondelli, Vincenzo, De Manzini, Nicolò, D’Ugo, D., and De Palma, Giovanni Domenico

Subjects
Male, Leak, medicine.medical_specialty, Colon, Anastomosis, Settore MED/18 - CHIRURGIA GENERALE, medicine.medical_treatment, Anastomotic Leak, Enterotomy, Enterotomy closure, Laparoscopic colectomy, Right colon cancer, Colon, Ascending, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Suture (anatomy), Ileum, Ascending, Surgical, Surgical Stapling, medicine, Aged, Case-Control Studies, Colectomy, Colonic Neoplasms, Female, Humans, Laparoscopy, Middle Aged, Neoplasm Staging, Anastomosis, Surgical, Suture Techniques, Wound Closure Techniques, medicine.diagnostic_test, business.industry, Surgery, Barbed suture, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Abdominal surgery
Abstract

Background: Laparoscopic right hemicolectomy is a commonly performed procedure. Little is known on how to perform the enterotomy closure after stapled side-to-side intracorporeal anastomosis. Method: A multicentric case-controlled study has been designed to compare different ways to fashion enterotomy closure: double layer versus single layer, sewn versus stapled, and robotic versus laparoscopic approach. Furthermore, additional characteristics including sutures’ materials, interrupted versus running suture and the presence of deep corner suture has been investigated. Results: We collected data for 1092 patients who underwent right hemicolectomy at ten centers. We analyzed 176 robotic against 916 laparoscopic anastomosis: no significant differences were found in terms of bleedings (p = 0.455) and anastomotic leak (p = 0.405). We collected data from 126 laparoscopic sewn single-layer versus 641 laparoscopic sewn double-layer anastomosis: a significant reduction was recorded in terms of leaks in double-layer group (p = 0.02). About double-layer characteristics, we found a significant reduction of bleedings (p = 0.008) and leaks (p = 0.017) with a running suture; similarly, a reduction of bleedings (p = 0.001) and leaks (p = 0.005) was observed with the usage of deep corner closure. The presence of a barbed suture thread seemed to significantly reduce both bleedings (p = 0.001) and leaks (p = 0.001). We found no significant differences in terms of bleedings (p = 0.245) and anastomotic leak (p = 0.660) comparing sewn versus stapled anastomosis. Conclusions: Fashioning a stapled ileocolic intracorporeal anastomosis, we can recommend the adoption of a double-layer enterotomy closure using a running barbed suture in the first layer. Totally, stapled closure and robotic assistance have to be considered a non-inferior alternative.

Published
2020

34. Correction to: Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients

Author

Dario Ribero, Fabio Priora, Giuseppe Spinoglio, Simona Borin, Ferruccio Ravazzoni, Alessandra Marano, Paolo Bianchi, Luca Matteo Lenti, Wanda Petz, Giampaolo Formisano, and Emilio Bertani

Subjects
medicine.medical_specialty, Oncology, Colorectal cancer, Surgical oncology, business.industry, General surgery, Right Colectomy, medicine, Surgery, Perioperative, medicine.disease, business
Abstract

Dario Ribero's affiliation is corrected as reflected here.

Published
2019

35. Correction to: Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

Author

Francesco Fleres, Andrea Borasi, Elisabetta Travaglio, Gianluca Pellino, Salomone Di Saverio, Lucia Romano, Michele Benedetti, Giampaolo Formisano, Pasquale Cianci, Massimiliano Fabozzi, MD, PhD, Gennaro Perrone, Monica Ortenzi, Domenico Spoletini, Elena Bonati, Enrico Crolla, Riccardo ROSATI, Marco V. Marino, Giuseppe Cavallaro, Mauro Podda, Stefano Magnone, Antonio Azzinnaro, Cristina Bombardini, Nicola Cillara, Andrea Barberis, ENRICO OPOCHER, Giuseppe Brisinda, Guido Fiorentini, Fabio Carbone, Matteo Uccelli, Dario Parini, Daniele Delogu, Federico Selvaggi, Pasquale Tammaro, FLAVIO GIORDANO, Giorgio Ammerata, Michele Santangelo, Giovanni Merola, Raffaele Lombardi, Ferdinando Agresta, and Marino Graziella

Subjects
medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pandemic, MEDLINE, Medicine, Correction, Surgery, business, Intensive care medicine
Published
2021

36. Laparoscopic versus robotic right colectomy: technique and outcomes

Author

Paolo Bianchi, Pasquale Misitano, Giampaolo Formisano, Giulia Calamati, Giuseppe Giuliani, and Lucia Salvischiani

Subjects
Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, Operative Time, Resection, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Robotic surgery, Laparoscopy, Colectomy, Intracorporeal anastomosis, medicine.diagnostic_test, business.industry, Robotics, Colorectal surgery, Surgery, Treatment Outcome, Colonic cancer, 030220 oncology & carcinogenesis, Colonic Neoplasms, Right Colectomy, 030211 gastroenterology & hepatology, business
Abstract

Minimally invasive surgery has gained worldwide acceptance in the treatment of colonic cancer in the last decades, thanks to its well-known advantages in short-term outcomes. Nevertheless, the penetrance of minimally invasive colorectal surgery still remains low. Few studies and metanalysis, to date, have analyzed the results of robotic versus laparoscopic colorectal surgery, often with conflicting conclusions. The robotic platform, thanks to its technological features, may potentially overcome the limitation of standard laparoscopy, especially when performing a complete mesocolic excision resection and an intracorporeal anastomosis. Robotic surgery could also shorten the learning curve of young novice surgeons, provided that strict protocols of structured training are applied. This paper is an update on the current available outcomes of robotic vs laparoscopic surgery in right colectomy.

Published
2016
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37. Structured training program in colorectal surgery: the robotic surgeon as a new paradigm

Author

Francesco Coratti, Paolo Bianchi, Adelona Salaj, Giampaolo Formisano, Giuseppe Giuliani, and S. Esposito

Subjects
Program evaluation, Male, medicine.medical_specialty, Operative Time, Anastomosis, surgery, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Robotic Surgical Procedures, medicine, Humans, Prospective Studies, Technical skills, Program Development, Prospective cohort study, Colectomy, Colorectal surgery, Robotics, surgery, Aged, business.industry, General surgery, Anastomosis, Surgical, Robotics, Length of Stay, Conversion to Open Surgery, Settore MED/18 - Chirurgia Generale, Italy, 030220 oncology & carcinogenesis, Right Colectomy, Colonic Neoplasms, Operative time, Feasibility Studies, 030211 gastroenterology & hepatology, Female, Curriculum, Training program, business, Colorectal Surgery, Program Evaluation
Abstract

Background One major issue in general surgery is how to provide novice surgeons with a structured training program (STP). The aim of our study was to assess the efficacy of a STP in robotic colorectal surgery for young surgeons without prior experience in both open and laparoscopic colorectal surgery, who were autonomous in basic minimally-invasive surgical procedures. Right colectomy with intracorporeal anastomosis has been chosen as a model. Methods Between May 2015 and December 2017 two junior attending surgeons were trained through a STP. Right colectomy was divided into three main learning modules (colonic mobilization, vascular control, intracorporeal anastomosis) and each one was carried out by the trainees for at least two times under direct supervision of the senior surgeon. After the initial robotic cases completely performed under formal proctoring, they were privileged to perform robotic right colectomy independently without a mentor (20 procedures). Operative time, conversion rate, intra- and postoperative complications, length of stay and pathological outcomes were the variables analyzed to assess the effectiveness of the STP. Results The mean operative time was 200 minutes and no conversion was required. Neither intraoperative nor major postoperative complications were recorded and the mean length of hospital stay was 6 days. Mean nodal yield was 21. Conclusions A STP in robotic colorectal surgery is feasible and effective. Right colectomy represents a good model as first step of the program in order to develop multiple technical skills. Previous experience in open or laparoscopic colorectal surgery may not be necessary.

Published
2018

38. Pancreatic Complications After Conventional Laparoscopic Radical Gastrectomy Versus Robotic Radical Gastrectomy: Systematic Review and Meta-Analysis

Author

Giampaolo Formisano, Andrea Coratti, Alberto Patriti, Paolo Bianchi, Francesco Guerra, and Giuseppe Giuliani

Subjects
medicine.medical_specialty, Minimally invasive gastrectomy, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Robotic Surgical Procedures, Gastrectomy, Stomach Neoplasms, Medicine, Humans, Pancreas, Aged, Radical gastrectomy, business.industry, gastric cancer, laparoscopic gastrectomy, Incidence, postoperative pancreatic fistula, robotic gastrectomy, Laparoscopic gastrectomy, Pancreatic Diseases, Robotics, Middle Aged, Surgery, Settore MED/18 - Chirurgia Generale, Treatment Outcome, 030220 oncology & carcinogenesis, Meta-analysis, 030211 gastroenterology & hepatology, Laparoscopy, business
Abstract

Recent reports have suggested that the use of the robot might reduce the rate of pancreatic complications following minimally invasive radical gastrectomy.By meta-analyzing the available literature, we aimed to elucidate possible differences between conventional laparoscopic and robotic radical gastrectomy on pancreatic morbidity.More than 2000 patients from eight studies were eventually included in the analysis. The overall incidence of postoperative pancreatic complications was 2.2%, being 1.7% and 2.5% following robotic and laparoscopic gastrectomy (LG), respectively. In particular, pancreatic fistula occurred in 2.7% of patients receiving robotic gastrectomy (RG) and 3.8% of patients receiving laparoscopy.The use of the robot showed a trend toward better outcomes compared with laparoscopy, despite the presence of more advanced disease and higher body mass index. The meta-analysis resulted in an odd ratio of 0.8 favoring RG over LG on pancreatic morbidity, although without statistical significance.

Published
2018

39. Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients

Author

Giuseppe Spinoglio, Ferruccio Ravazzoni, Fabio Priora, Paolo Bianchi, Wanda Petz, Alessandra Marano, Emilio Bertani, Luca Matteo Lenti, Dario Ribero, Giampaolo Formisano, and Simona Borin

Subjects
Laparoscopic surgery, Adult, Male, Reoperation, medicine.medical_specialty, Pfannenstiel incision, medicine.medical_treatment, Operative Time, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Medicine, Humans, Laparoscopy, Survival rate, Colectomy, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Postoperative complication, Perioperative, Middle Aged, Conversion to Open Surgery, Surgery, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Right Colectomy, Colonic Neoplasms, Lymph Node Excision, 030211 gastroenterology & hepatology, Female, business, Mesocolon
Abstract

During the past decade, the concept of complete mesocolic excision (CME) has emerged as a possible strategy to minimize recurrence for right colon cancers. The purpose of this study was to compare robotic versus laparoscopic CME in performing right colectomy for cancer. Pertinent data of all patients who underwent robotic or laparoscopic right colectomy with CME using a Pfannenstiel incision and intracorporeal anastomosis performed between October 2005 and November 2015 were entered in a prospectively maintained database. A total of 202 patients underwent robotic (n = 101) or laparoscopic (n = 101) right colectomy within the study period. Patient characteristics were equivalent between groups. The robotic group showed a statistically significant reduction in conversion rate (0% vs. 6.9%, p = 0.01) but a longer operative time (279 min vs. 236 min, p

Published
2018

40. Robotic-Assisted Abdominoperineal Resection

Author

Giampaolo Formisano, Paolo Bianchi, and Giuseppe Giuliani

Subjects
medicine.medical_specialty, animal structures, Robotic-assisted total mesorectal excision, Robotic assisted, Abdominoperineal resection, business.industry, General surgery, Robotic surgery, humanities, Rectal cancer, Robotic abdominoperineal resection, Settore MED/18 - Chirurgia Generale, medicine, business, human activities
Abstract

In 1908, Sir Ernest Miles reported his first attempt to develop a radical operation for rectal cancer, publishing his experience with abdominoperineal resection (APR).

Published
2018

42. Epicardial thoracoscopic robotic-assisted catheter navigation in a pig

Author

Antonio Berruezo, Giampaolo Formisano, Paolo Bianchi, Gennaro Miracapillo, Ugo Limbruno, and Francesco De Sensi

Subjects
Cardiac Catheterization, medicine.medical_specialty, Swine, business.industry, Robotic assisted, Thoracoscopy, Surgery, Settore MED/18 - Chirurgia Generale, Catheter, Robotic Surgical Procedures, Surgery, Computer-Assisted, Physiology (medical), Models, Animal, Animals, Medicine, Cardiology and Cardiovascular Medicine, business, Pericardium
Published
2019
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43. Suprapubic approach for robotic complete mesocolic excision in right colectomy: Oncologic safety and short-term outcomes of an original technique

Author

Dario Ribero, Simona Borin, Giuseppe Spinoglio, Wanda Petz, Giampaolo Formisano, Emilio Bertani, Paolo Bianchi, and S. Esposito

Subjects
Laparoscopic surgery, Suprapubic approach, Male, medicine.medical_specialty, Central vessel ligation, Complete mesocolic excision, Right colectomy, Robotic surgery, Colorectal cancer, medicine.medical_treatment, Operative Time, Adenocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, medicine, Humans, Colectomy, Aged, business.industry, Postoperative complication, General Medicine, Length of Stay, medicine.disease, Prognosis, Surgery, Settore MED/18 - Chirurgia Generale, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Right Colectomy, Colonic Neoplasms, 030211 gastroenterology & hepatology, Median body, Female, business
Abstract

Introduction Right-sided colon cancer has a worse prognosis than left-sided colon cancer. Complete mesocolic excision (CME) with central vessels ligation (CVL) reduces local recurrence, but is technically demanding, particularly with a laparoscopic approach. Aim of this study is to describe a new robotic approach to right colectomy with CME and CVL and to report oncologic safety and short term outcomes. Methods Twenty consecutive patients were included. All patients had a right colon adenocarcinoma and underwent right colectomy with a suprapubic approach. Surgery was realized with the Da Vinci Xi ® system and all trocars were placed along a horizontal line 3–6 cm above the pubis. CME with CVL was realized in all the patients. Data analysed were: duration of surgery, conversions to open surgery, intraoperative and postoperative complication by Clavien Dindo classification, margins of resections, length of specimen and number of lymph nodes retrieved. Results Patients median age was 69 years, median body mass index was 27 kg/m 2 . Median operative time was 249 min, blood loss was negligible, no conversions to open or laparoscopic surgery occurred. Median hospital stay was six days; two postoperative grade IIIa Clavien–Dindo complications occurred, no 30-days postoperative death was registered. Resection margins were negative in all patients; median tumour diameter was 3.6 cm, median specimen length was 40 cm, median number of harvested lymph nodes was 40. Conclusions Robotic right colectomy with CME using a suprapubic approach is a feasible and safe technique that allows for an extended lymphadenectomy and provides high quality surgical specimens.

Published
2017

44. Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy

Author

Luigi Angrisani, A. Santonicola, Giampaolo Formisano, Michele Lorenzo, Ariola Hasani, Antonio Vitiello, Angrisani, Luigi, Hasani, Ariola, Vitiello, Antonio, Formisano, Giampaolo, Santonicola, Antonella, and Lorenzo, Michele

Subjects
Internal hernia, Sleeve gastrectomy, medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine, Anastomosis, business, Duodenal switch, Surgery
Published
2017
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45. Bariatric Surgery Worldwide

Author

Ariola Hasani, Antonio Vitiello, Antonella Santonicola, Giampaolo Formisano, Luigi Angrisani, Angrisani, Luigi, Formisano, Giampaolo, Santonicola, Antonella, Hasani, Ariola, and Vitiello, Antonio

Subjects
medicine.medical_specialty, Sleeve gastrectomy, Bariatric Procedure, business.industry, medicine.medical_treatment, Bariatric Surgery, 030209 endocrinology & metabolism, Sleeve Gastrectomy, Surgery, Morbid Obesity, Morbid obesity, 03 medical and health sciences, Settore MED/18 - Chirurgia Generale, 0302 clinical medicine, medicine, Bariatric Surgery, Morbid Obesity, Sleeve Gastrectomy, Adjustable Gastric Banding, Bariatric Procedure, 030211 gastroenterology & hepatology, Adjustable Gastric Banding, business
Published
2017

46. Robotic right colectomy with complete mesocolic excision: bottom-to-up suprapubic approach - a video vignette

Author

Wanda Petz, Paolo Bianchi, Dario Ribero, Emilio Bertani, Giuseppe Spinoglio, and Giampaolo Formisano

Subjects
medicine.medical_specialty, Intracorporeal anastomosis, business.industry, General surgery, medicine.medical_treatment, Gastroenterology, Robotic Surgical Procedures, 030230 surgery, Anastomosis, Suprapubic approach, Surgical methods, Surgery, 03 medical and health sciences, Settore MED/18 - Chirurgia Generale, 0302 clinical medicine, Colon surgery, 030220 oncology & carcinogenesis, Right Colectomy, Medicine, business, Colectomy
Abstract

Complete Mesocolic Excision (CME) with central vascular ligation has been reported to potentially improve oncological results in right colectomy [1-4]. However, along with the intracorporeal anastomosis, it represents a challenging step of the laparoscopic procedure [2,3,5]. The video describes a novel bottom-to-up suprapubic approach for robotic right colectomy with CME and intracorporeal anastomosis using the DaVinci Xi Surgical System. This article is protected by copyright. All rights reserved.

Published
2017

47. Evaluation of technical feasibility and safety of Single-Site™ robotic right colectomy: three case reports

Author

Giampaolo Formisano, Alessandra Marano, Giuseppe Spinoglio, Luca Matteo Lenti, Ferruccio Ravazzoni, and Francesca Pagliardi

Subjects
medicine.medical_specialty, Colectomies, medicine.diagnostic_test, business.industry, General surgery, Biophysics, Anastomosis, Computer Science Applications, Surgery, Port (medical), Colon surgery, Single site, Right Colectomy, medicine, Robotic surgery, business, Laparoscopy
Abstract

Background Robotic Single-Site™ surgery overcomes the technical constraints of single-access laparoscopy. After performing over 130 Single-Site robotic cholecystectomies and stabilizing operative times, we applied this technology to right colon surgery. Methods We successfully completed three Single-Site robotic right colectomies (SSRRCs) using the da Vinci Si Surgical System® with a Single-Site kit (© Intuitive Surgical™) inserted through a suprapubic incision. Results Overall SSRRC operative time was 218.3 ± 75.9 min. A side-to-side anisoperistaltic anastomosis was fashioned intracorporeally (two cases) or extracorporeally (one case). All patients were discharged within 5 days. There were no complications and oncological principles were satisfied. There were no recurrences up to 12 months. Conclusions This is the first report of SSRRC with intracorporeal anastomosis using the da Vinci® Single-Site™ port inserted through a suprapubic incision. This approach is feasible and safe, with oncological outcomes potentially equivalent to those of robotic or laparoscopic multiport surgery. Copyright © 2014 John Wiley & Sons, Ltd.

Published
2014
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48. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial

Author

Luigi Angrisani, Gabriella Nosso, Giampaolo Formisano, Pier Paolo Cutolo, Giuliana Vitolo, Angrisani, Luigi, Cutolo, PIER PAOLO, Formisano, Giampaolo, Nosso, Gabriella, and Vitolo, Giuliana

Subjects
Adult, Male, Reoperation, Internal hernia, medicine.medical_specialty, Gastroplasty, medicine.medical_treatment, Gastric bypass, Gastric Bypass, Lap-Band, Body Mass Index, law.invention, Young Adult, Postoperative Complications, Randomized controlled trial, Gastric bypa, law, Laparotomy, Weight Loss, medicine, Long term weight loss, Prospective, randomized study, Humans, Prospective Studies, Long term weight lo, business.industry, Middle Aged, medicine.disease, Roux-en-Y anastomosis, Obesity, Morbid, Surgery, Bowel obstruction, Settore MED/18 - Chirurgia Generale, Exact test, Female, Laparoscopy, business, Body mass index, Follow-Up Studies
Abstract

BACKGROUND: There are few studies of long-term outcomes for either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to compare outcomes of patients randomly assigned to undergo LAGB or LRYGB at 10 years. METHODS: LAGB, using the pars flaccida technique, and standard LRYGB were performed. From January 2000 to November 2000, 51 patients (mean age 34.0 ± 8.9 years; range 20-49) were randomly allocated to undergo either LAGB (n = 27, 5 men and 22 women; mean age 33.3 years; mean weight 120 kg; mean body mass index [BMI] 43.4 kg/m(2)) or LRYGB (n = 24, 4 men and 20 women; mean age 34.7; mean weight 120 kg; mean BMI 43.8 kg/m(2)). Data on complications, reoperations, weight, BMI, percentage of excess weight loss, and co-morbidities were collected yearly. The data were analyzed using Student's t test and Fisher's exact test, with P

Published
2013
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49. Robotic Right Colectomy with Modified Complete Mesocolic Excision: Long-Term Oncologic Outcomes

Author

Fabio Priora, Ferruccio Ravazzoni, Giuseppe Spinoglio, Alessandra Marano, Paolo Bianchi, Luca Matteo Lenti, and Giampaolo Formisano

Subjects
Male, Time Factors, Organoplatinum Compounds, Colorectal cancer, Leucovorin, Anastomotic Leak, 0302 clinical medicine, Robotic Surgical Procedures, Antineoplastic Combined Chemotherapy Protocols, Major complication, Intraoperative Complications, Colectomy, Aged, 80 and over, Middle Aged, Conversion to Open Surgery, Oxaliplatin, Survival Rate, Oncology, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Right Colectomy, Colonic Neoplasms, Hemoperitoneum, 030211 gastroenterology & hepatology, Female, Fluorouracil, medicine.drug, Mesocolon, Adult, medicine.medical_specialty, Disease-Free Survival, 03 medical and health sciences, medicine, Overall survival, Humans, Survival rate, Aged, Retrospective Studies, Intracorporeal anastomosis, business.industry, General surgery, Retrospective cohort study, medicine.disease, Surgery, Settore MED/18 - Chirurgia Generale, Feasibility Studies, business, Follow-Up Studies
Abstract

A modified complete mesocolic excision (mCME) technique for the treatment of right-sided colon cancer recently was shown by Hohenberger and colleagues to provide impressive long-term oncologic outcomes. This report aims to describe the authors’ experience with robotic right colectomy using mCME. The safety, feasibility, and efficacy of this procedure are measured by complications, conversion rates, and 4-year oncologic outcomes. A retrospective study analyzed 100 consecutive patients who underwent robotic right colectomy with mCME and intracorporeal anastomosis at the authors’ institution between November 2005 and November 2013. Intra- and postoperative clinical outcomes, pathologic data, and survival were analyzed. Robotic right colectomy with mCME was successfully performed for all the patients. No conversions or intraoperative complications occurred. The major complication rate (Dindo 3 or 4) was 4 %. During a median follow-up period of 48.5 months (range 24–114 months), the survival rates were 94.5 % for disease-specific survival, 91.4 % for disease-free survival, and 90.3 % for overall survival. The authors’ experience confirms the feasibility and safety of mCME for the treatment of right-sided colon cancer. This technique provided satisfying short-term outcomes with promising 4-year oncologic results. However, the real benefits of the CME technique should be evaluated further by well-conducted randomized studies before its adoption in routine practice is recommended.

Published
2016

50. Revisional Surgery after LAGB

Author

Giampaolo Formisano, Ariola Hasani, Luigi Angrisani, A. Santonicola, and Michele Lorenzo

Subjects
medicine.medical_specialty, Sleeve gastrectomy, Weight loss failure, Laparoscopic adjustable gastric band, Roux-en-Y gastric bypass, Weight recidivism, Band complications, Revisional surgery, Band repositioning, Band removal, Long term follow up, medicine.medical_treatment, Weight loss, medicine, Grade level, business.industry, Work-up, Surgery, Settore MED/18 - Chirurgia Generale, Redo surgery, Replacement procedure, medicine.symptom, business, Laparoscopic adjustable gastric banding
Abstract

Laparoscopic adjustable gastric banding (LAGB) is generally safe and well tolerated but complications are not infrequent. As with all other bariatric procedures, there are patients who experience poor weight loss or even weight regain at long term follow up. Some of these complications require prompt management whereas more chronic problems require careful work up involving the multidisciplinary team. All complications require a resolution and revision tailored to the individual. Revision of failed or complicated LAGB should be performed by an experienced bariatric team. A wide range of endoscopic and laparoscopic procedures can be offered to patients with LAGB complications. Management of these issues often requires explanting the device, with or without proceeding to more definitive measures. Invariably, there will be a subgroup of patients with interval weight regain, especially if the gastric band is removed without any immediate salvage or replacement procedure. Redo surgery for LAGB is still a gray area of bariatric surgery. Large experiences with long follow up are lacking and high grade level evidence based experiences are also absent. Overall, outcomes in terms of weight loss and complications are controversial according to different experiences.

Published
2016

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