Initial experience of laparoscopic radical nephrectomy using the Senhance® robotic system for renal cell carcinoma

Letter to the editor on "Initial experience of laparoscopic radical nephrectomy using the Senhance® robotic system for renal cell carcinoma"

“…The Senhance is the first novel robotic system that is used worldwide, CE mark and FDA approved, since the Da Vinci, and consequently, the comparisons are inevitable. The Da Vinci is an established, wide spread, gold standard in robotic surgery, but the Senhance is more economical, as was well stated in the article [1]. We share the same opinion, although a direct comparison would be interesting [4].…”

“…The authors describe longer pneumoperitoneum time compared to laparoscopy due to docking of the arms and a limitation on the types of the usable devices [1]. In our experience, the initial docking time can be cut down to 2-3 min, which comes with practice and an experienced team, and the exchange of the robotic instruments during the procedure does not take up significant additional time.…”

“…We read with interest the article by Kaneko et al [1] describing their initial experience with the Senhance robotic system for performing radical nephrectomy. We congratulate the authors for successfully treating two patients using Senhance and publishing the article.…”

“…We started our Senhance robotic program in 2019 and have published two articles describing our experience [2,3] for radical prostatectomy, and very recently one including upper urinary tract surgery (UUT) [4]. There are a few points and technical details mentioned in the publication [1] we wish to comment on.…”

“…We are high volume laparoscopic center and have extensive experience in the UUT laparoscopy (nephrectomy, adrenalectomy, pyeloplasty and renal cyst fenestration), but found these procedures quite challenging while using Senhance, mostly because of the 0° endoscope that we have (traditionally we use 30° for UUT laparoscopy) and limited range of motion of the robotic arms when positioned in configuration as suggested by the manufacturer. Kaneko et al [1] describe their technique that is similar to conventional laparoscopy, although without the mention of the degree of the laparoscope (we presume 30°) and an alternative configuration of robotic arms position. As they do not report the range of motion difficulty, maybe it is minimized by this arm configuration and should be proposed as standard for this procedure.…”