Abstract
Objectives
To describe step-by-step the port placement and the robot docking of the new purpose-built
robotic platform for R-LESS. The feasibility of different approaches to the pelvic
fossa and the retroperitoneum was reported in cadaver models.
Methods
This was a preclinical study on human cadavers to assess the feasibility of the da
Vinci SP1098 surgical system for R-LESS pelvic fossa and retroperitoneal urological
surgeries. We used the SP1098 to perform R-LESS prostatectomies and cystoprostatectomies
with transperineal and transvesical approaches, and nephrectomies (radical or partial)
with retroperitoneal approach. The primary outcome was to report the port placement
and docking. The technical feasibility of the procedures was then demonstrated as
measured by the need for adjunctive ports or the occurrence of intraoperative complications.
Operative times were recorded.
Results
A total of 14 procedures were performed on 12 human cadavers. Namely 4 prostatectomies and 2 cystoprostatectomies with transperineal
approach, 3 transvesical prostatectomies, 1 retroperitoneal radical, and 4 retroperitoneal
partial nephrectomies. Operative times were in line with those of standard multiport robotic surgery. Neither additional ports nor percutaneous
instruments were required. No intraoperative complications occurred. Limitations include
the preclinical model, the small sample size, and the lack of a control group.
Conclusion
In this preclinical model, the port placement and robot docking using the SP1098 robotic
platform is reproducible and feasible for pelvic fossa and retroperitoneal urological
surgeries.
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Article info
Publication history
Published online: June 13, 2018
Accepted:
May 24,
2018
Received in revised form:
May 22,
2018
Received:
April 10,
2018
Footnotes
Conflict of Interest and Financial Disclosures: This study was conducted with financial and logistical support from Intuitive Surgical, Inc (Sunnyvale, CA). Jihad H. Kaouk certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment and/or affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Endocare, Inc, Intuitive. – J.H. Kaouk (consultant).
Juan Garisto and Riccardo Bertolo have no industrial relationship to disclose.
Funding/Support and Role of the Sponsor: This research project was supported by Intuitive Surgical (Sunnyvale, CA) who provided financial and material support.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
