Performance of a multidisciplinary robotic surgery program at a university hospital (2012-2022).

Robotic-assisted surgery has become widely adopted for its ability to expand the indications for minimally invasive procedures. This technology aims to improve precision, accuracy, and outcomes while reducing complications, blood loss, and recovery time. Successful implementation of a robotic surgery program requires careful initial design and a focus on maintenance and expansion to maximize its benefits. This article presents a comprehensive study conducted at a University Hospital on the robotic surgery program from December 2012 to December 2022. Data from hospital databases, including patient demographics, surgical department, surgical time, operating room occupancy, and primary diagnosis, were analyzed. The analysis covered various time periods (surgical sessions, weeks, months, and years) to assess the program's evolution over time. Over the 10-year period, a total of 1847 robotic-assisted interventions were performed across five surgical services. Urology accounted for 57% of the cases, general surgery 17%, gynecology 16%, otorhinolaryngology 6%, and thoracic surgery 4%. The most frequently performed procedures included robotic prostatectomies (643 cases), hysterectomies (261 cases), and colposacropexies (210 cases). The weekly volume of interventions showed a notable increase, rising from 2 cases per week in 2013-2014 cases in 2022. Moreover, the average surgical duration per intervention exhibited a progressive decrease from 275 min in 2013 to 184 min in 2022. This study highlights the potential of a well-managed robotic surgery program as a viable alternative to conventional surgical approaches. Effective coordination and resource utilization contribute to the program's efficiency. The findings underscore the successful integration of robotic-assisted surgery in diverse surgical specialties.

Submental Perforator Flap for Soft-Tissue Reconstruction in Bisphosphonate-Related Osteonecrosis of the Jaws.

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has emerged as an important and increasingly common comorbidity, especially in patients undergoing long-term treatment with high doses of bisphosphonates. The management of BRONJ remains controversial. Surgical treatment is necessary in severe cases. Treatment of the bone requires sequestrectomy or resection. Given the lack of sufficient mucosa to perform the operation and fragility of margins in many patients, local flaps are crucial. We report two cases of stage-3 BRONJ presenting secondary infection with Actinomyces , receiving treatment consisting of marginal resection of the necrotic bone, reinforcement with a reconstruction plate, and reconstruction of soft tissues using a submental perforator artery flap ipsilateral to the lesion. Total cure was achieved in both cases, achieving favorable aesthetic and functional outcomes.

Submental Osteocutaneous Perforator Flap for Maxillary and Mandibular Reconstruction Following Tumor Resection.

Many different flaps have been used for reconstruction of the oral mucosa and the maxilla and mandible after tumor resection. These flaps might contain bone and might be free or locoregional. This study presents 2 cases of intraoral reconstruction using a submental osteocutaneous perforator flap to reconstruct the maxilla in one case and the mandible in the other. A reverse-flow flap was used for maxillary reconstruction In these cases, the functional, esthetic, and oncologic outcomes were favorable at 9 and 12 months of follow-up.