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Long term outcomes of robotic-assisted abdominal wall reconstruction: a single surgeon experience

Halpern, D K; Liu, H; Amodu, L I; Weinman, K; Akerman, M; Petrone, P
INTRODUCTION/BACKGROUND:Robotic abdominal wall reconstruction (RAWR) is one of the most significant advances in the management of complex abdominal wall hernias. The objective of this study was to evaluate long term outcomes in a cohort of patients that underwent complex RAWR in a single center. METHODS:This was a longitudinal retrospective review of a cohort of 56 patients who underwent complex RAWR at least 24 months prior by a single surgeon at a tertiary care institution. All patients underwent bilateral retro-rectus release (rRRR) with or without robotic transversus abdominis release (rTAR). Data collected include demographics, hernia details, operative and technical details. The prospective analysis included a post-procedure visit of at least 24 months from the index procedure with a physical examination and quality of life survey using the Carolinas Comfort Scale (CCS). Patients with reported symptoms concerning for hernia recurrence underwent radiographic imaging. Descriptive statistics (mean ± standard deviation or median) were calculated for continuous variables. Chi-square or Fisher's exact test as deemed appropriate for categorical variables, and analysis of variance or the Kruskal-Wallis test for continuous data, were performed among the separate operative groups. A total score for the CCS was calculated and analyzed in accordance with the user guidelines. RESULTS:for rRRR. The mean length of follow-up was 28.1 months. Fifty-seven percent of patients underwent post-op imaging at an average follow-up of 23.5 months. Recurrence rate was 3.6% for all groups. There were no recurrences in patients that underwent solely bilateral rRRR. Two patients (7.7%) that underwent rTAR procedures were found with recurrence. Average time to recurrence was 23 months. Quality of life survey demonstrated an overall CCS score of 6.63 ± 13.95 at 24 months with 12 (21.4%) patients reporting mesh sensation, 20 (35.7%) reporting pain, and 13 (23.2%) reporting movement limitation. CONCLUSION/CONCLUSIONS:Our study contributes to the paucity of literature describing long term outcomes of RAWR. Robotic techniques offer durable repairs with acceptable quality of life metrics.
PMID: 36977947
ISSN: 1248-9204
CID: 5463192

Robotic-assisted completion cholecystectomy with repair of cholecystoduodenal fistula [Case Report]

Hurwitz, Joshua C; Kolwitz, Christine E; Kim, David Y; Petrone, Patrizio; Halpern, David K
Post-cholecystectomy syndrome (PCS) is a well-documented complication of incomplete cholecystectomy. The etiology is often post-surgical chronic inflammation from unresolved cholelithiasis, which is secondary to anatomical abnormalities, including a retained gallbladder or a large cystic duct remnant (CDR). An exceedingly rare consequence is retained gallstone fistulization into the gastrointestinal tract. We present a case of a 70-year-old female with multiple comorbidities 4 years status-post incomplete cholecystectomy, who developed PCS with cholecystoduodenal fistula secondary to retained gallstone in the remnant gallbladder, with CDR involvement, treated via robotic-assisted surgery. Reoperation in PCS has been traditionally performed via laparoscopic approach with recent advances made in robotic-assisted surgery. However, we report the first documented case of PCS complicated by bilioenteric fistula repaired with robotic-assisted surgery. This highlights the value of robotic-assisted surgery in complicated cases, where one must contend with post-surgical anatomic abnormalities and visualization difficulties. Subsequent investigation is necessary to objectively quantify the safety and reproducibility of our approach.
PMCID:10187471
PMID: 37201105
ISSN: 2042-8812
CID: 5544312

Kwashiorkor after gastric bypass

Howell, R S; Shah, S; Khan, S; Brathwaite, C E M; Petrone, P; Levine, J
Gastric bypass has grown in popularity in recent years due to its high efficacy in achieving long-term weight loss in patients with morbid obesity. Gastric bypass has been described to further exacerbate baseline nutritional deficiencies due to reduced gastric capacity and malabsorption. In rare cases, when protein deficiency is severe, Kwashiorkor disease may arise. The incidence of Kwashiorkor specifically following gastric bypass is rare, with an incidence of 4.7%. We report a case of a female patient who underwent a gastric bypass and subsequently developed Kwashiorkor. Physicians' suspicion of index for Kwashiorkor should be high for patients presenting with signs or symptoms of severe malnutrition following weight-loss procedures.
Copyright
EMBASE:2024509893
ISSN: 2042-8812
CID: 5514572

Arcuate line hernia: a case report

Cohen, K; Kolwitz, C; Petrone, P; Halpern, D
Arcuate line hernias are a rare type of hernia with limited publications regarding their successful repair. The arcuate line is the inferior limit of the posterior leaf of the rectus sheath. An arcuate line hernia is a type of intraparietal hernia, meaning it is not a truly complete fascial defect of the abdominal and, therefore, may present with atypical symptoms. Although published data on arcuate line hernia repairs are limited to a handful of case reports and one literature review, reports regarding robotic repair are exceptionally rare. This case report is the second documented robotic approach to arcuate line hernias known to these authors.
Copyright
EMBASE:2024509934
ISSN: 2042-8812
CID: 5514672

Injury Due to Extremes of Temperature

Chapter by: Petrone, Patrizio
in: Acute Care Surgery in Geriatric Patients by
[S.l.] : Springer International Publishing, 2023
pp. 311-319
ISBN: 9783031306501
CID: 5717952

Nutritional Assessment and Therapy

Chapter by: Petrone, Patrizio; Marini, Corrado P.
in: Acute Care Surgery in Geriatric Patients by
[S.l.] : Springer International Publishing, 2023
pp. 483-487
ISBN: 9783031306501
CID: 5717892

Intestinal obstruction due to volvulus of the cecum in a patient with intestinal malrotation associated with situs ambiguous Obstrucción intestinal por vólvulo de ciego en paciente con malrotación intestinal asociado a situs ambiguous

Ceballos-Esparragón, José; Velaz-Pardo, Leyre; Martin-Camarillo, Rolando; Burbano, Fernando Cano; Petrone, Patrizio
Introduction. Complete or incomplete intestinal obstruction is one of the most frequent acute abdomen conditions. It constitutes between 20% and 35% of the urgent admissions of hospital surgical areas. Clinical case. We present a case of a patient with a history of prostate carcinoma, who began with clinical symptoms of intestinal obstruction and acute abdomen. He was diagnosed with volvulus of the cecum, intestinal malrotation, and situs ambiguous. Surgical treatment of the patient was successful. Conclusion. Knowledge of these pathological conditions is essential to be able to provide correct surgical treatment and reduce the mortality that these can lead to.
SCOPUS:85147228419
ISSN: 2011-7582
CID: 5424432

Sepsis, septic shock, and its treatment

Chapter by: Liveris, Anna; McNelis, John; Petrone, Patrizio; Marini, Corrado P.
in: Current Therapy of Trauma and Surgical Critical Care by
[S.l.] : Elsevier, 2023
pp. 770-783.e2
ISBN: 9780323697873
CID: 5615802

Mature teratoma mimicking a mesothelial cyst of retroperitoneal origin Teratoma maduro que simula quiste mesotelial de origen retroperitoneal

Ceballos-Esparragón, José J.; Camarillo, Rolando M.; Cabrero-Acosta, Antonio; Petrone, Patrizio
SCOPUS:85147217160
ISSN: 2011-7582
CID: 5424402

Acute Care Surgery in Geriatric Patients

Petrone, Patrizio; Brathwaite, Collin E.M.
[S.l.] : Springer International Publishing, 2023
Extent: 1 v.
ISBN: 9783031306501
CID: 5717992