Laparoscopic Radical Prostatectomy with a Remote Controlled Robot
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- 作者：Clé ; ment-Claude Abbou ; Andrá ; s Hoznek ; Laurent Salomon ; Leif Eric Olsson ; Adrian Lobontiu ; Fabien Saint ; Antony Cicco ; Patrick Antiphon ; Dominique Chopin
- 关键词：robotics ; feasibility studies ; laparoscopy ; prostatectomy ; prostatic neoplasms
- 刊名：The Journal of Urology
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：197
- 期：2_supp_S
- 页码：S210-S212
- 全文大小：677 K
- 卷排序：197
文摘
Robotics in surgery is a recent innovation. This technology offers a number of attractive features in laparoscopy. It overcomes the difficulties with fixed port sites by restoring all 6 degrees of freedom at the instrument tips, provides new possibilities for miniaturization of surgical tasks and allows remote controlled surgery. We investigated the applicability of remote controlled robotic surgery to laparoscopic radical prostatectomy.Materials and MethodsOur previous experience with laparoscopic prostatectomy served as a basis for adapting robotic surgery to this procedure. A surgeon at a different location who activated the tele-manipulators of the da Vinci∗ robotic system performed all steps of the intervention. A scrub nurse and second surgeon who stood at patient side had limited roles to port and instrument placement, exposure of the operative field, assistance in hemostasis and removal of the operative specimen. Our patient was a 63-year-old man presenting with a T1c tumor discovered on 1 positive sextant biopsy with a 3+3 Gleason score and 7 ng./ml. preoperative serum prostate specific antigen.ResultsThe robot provided an ergonomic surgical environment and remarkable dexterity enhancement. Operating time was 420 minutes, and the hospital stay lasted 4 days. The bladder catheter was removed 3 days postoperatively, and 1 week later the patient was fully continent. Pathological examination showed a pT3a tumor with negative margins.ConclusionsRobotically assisted laparoscopic radical prostatectomy is feasible. This new technology enhances surgical dexterity. Further developments in this field may have new applications in laparoscopic tele-surgery.