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      Awareness, perception, knowledge, and attitude toward robotic surgery in a general surgical outpatient clinic in Singapore, Asia

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          Abstract

          Background and Aim:

          Robotic surgery is an advancing technology and patients may not be fully aware of these advancements. Social media and advertisements may falsely skew patients’ understanding. This study aims to seek awareness, understanding. and attitude toward robotic surgery in Singapore.

          Materials and Methods:

          A cross-sectional study of 472 patients and/or their relatives (response rate 94.4%) in a specialist outpatient clinic chosen through convenience sampling from May to July 2017 was performed. All healthcare workers or participants <21 years of age were excluded. A 19-point survey questionnaire including patient sociodemographics and awareness and attitudes toward robotic surgery was administered. Univariate and multivariate analysis was performed to assess participants’ preference for robotic surgery.

          Results:

          Two hundred and sixty (55.1%) of the participants were female and the majority were aged 21–40 years old (55.5%). 250 participants (53.0%) reported having heard of robotic surgery; majority ( n=205, 82.0%) were from the media. Two hundred and six (43.6%) participants had the misconception that robotic surgery involved an automated robot. Multivariate analysis showed that perception that robotic surgery yielded better results was independently associated with preference for robotic surgery (prefers robotic surgery: n=56/159 (35.2%), do not prefer robotic surgery: n=81/313 (25.9%), odds ratio (OR) 1.61, 95% confidence interval (CI): 1.06–2.45, P=0.026). Having concerns that wrong surgery may be performed by robotic surgery were also independently associated with disinclination toward robotic surgery (OR 0.51 [95% CI: 0.35–0.76], P=0.001).

          Conclusion:

          Understanding of robotic surgery was poor with several misconceptions. It is paramount to clarify these misconceptions to advocate for informed decision-making.

          Relevance for Patients:

          Measures need to be taken to ensure adequacy of pre-operative counseling in patients undergoing robotic surgery. Misconceptions on benefits and risks of robotic surgery should be cleared before decision on the surgical access and approach.

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          Most cited references32

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          Informed consent: how much and what do patients understand?

          We sought to evaluate the degree of patients' understanding of several aspects of the informed consent process for surgery and clinical research. We conducted a systematic search of PubMed (1961-2006) to identify relevant articles. We retrieved 23 and 30 eligible for inclusion articles regarding informed consent for surgery and clinical research, respectively. Regarding surgery, adequate overall understanding of the information provided and of the risks associated with surgery was shown in 6 of 21 (29%) and 5 of 14 (36%) studies providing relevant data, respectively. Regarding clinical research, adequate understanding of the aim of the study, the process of randomization, voluntarism, withdrawal, and the risks and the benefits of treatment was shown in 14 of 26 (54%), 4 of 8 (50%), 7 of 15 (47%), 7 of 16 (44%), 8 of 16 (50%), and 4 of 7 (57%) of studies providing relevant data, respectively. Satisfaction by the amount of the given information was shown in 7 of 12 (58%) studies involving surgery and 12 of 15 (80%) studies involving clinical research. Further attention should be drawn on enhancing patients' understanding regarding several components of the informed consent process for surgery and clinical research.
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            30 Years of Robotic Surgery.

            The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics.
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              Robotic Versus Laparoscopic Minimally Invasive Surgery for Rectal Cancer

              The aim of this study was to evaluate the safety and efficacy of elective rectal resection for rectal cancer in adults by robotic surgery compared with conventional laparoscopic surgery.
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                Author and article information

                Journal
                J Clin Transl Res
                J Clin Transl Res
                Whioce Publishing Pte. Ltd.
                Journal of Clinical and Translational Research
                Whioce Publishing Pte. Ltd.
                2382-6533
                2424-810X
                25 May 2022
                29 June 2022
                : 8
                : 3
                : 224-233
                Affiliations
                [A1] 1MOH Holdings Private Limited, Singapore
                [A2] 2Department of General Surgery, Tan Tock Seng Hospital, Singapore
                Author notes
                [* ] Corresponding author: Kai Siang Chan MOH Holdings, Singapore, 1 Maritime Square, Singapore 099253. Tel: +65-91389343. Email: kchan023@ 123456e.ntu.edu.sg
                Article
                jctres.08.202203.009
                9260340
                35813899
                8e494c1d-fa3c-467b-a8cc-0e8474bc71ee
                Copyright: © 2022 Whioce Publishing Pte. Ltd.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 November 2021
                : 29 April 2022
                : 01 May 2022
                Categories
                Original Article

                asia,awareness,informed consent,laparoscopy,minimally invasive surgery,patient education,robotic surgery

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