Robotic Flexible Ureteroscopy for Renal Calculi: Initial Clinical Experience

Desai, Mihir; Grover, Rishi; Aron, Monish; Ganpule, Arvind; Joshi, S. S.; Desai, Mahesh; Gill, Inderbir S.

doi:10.1016/j.juro.2011.03.128

Cited by 95 publications

(53 citation statements)

References 7 publications

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“…PCNL is a minimal invasive surgery with many associated benefits, such as small patient incisions and improving postoperative recovery, complications may still arise 3,16,17 . In what concerns PCNL puncture in particular, the most relevant contributions have been provided by the application of medical imaging techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Although fluoroscopy and ultrasounds are the most popular approaches 2 , modifying surgery 9, 10 and patient position [11][12][13] , use of computed tomography 14 , robotic devices 15,16 , and navigation systems [17][18][19] have been proposed to improve and ease the renal puncture during PCNL. However, most of these tools and techniques only assure 2D images, do not provide real-time 3D information, demand preprocessing steps to register all the anatomical structures, are not tested in vivo and may also be affected by operator skill, patient breath movement, and needle deflection 2,17,20 .…”

Section: Introductionmentioning

confidence: 99%

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Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

et al. 2013

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DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain.All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date. Materials and Methods:Six anesthetized female pigs underwent ureterorenoscopies in order to place a catheter with an EMT sensor into the desired puncture site and to ascertain the success of puncture. Subsequently, a tracked needle with a similar EMT sensor was navigated into the sensor inside the catheter. Four punctures were performed by two surgeons in each pig: one in the kidney and one in the middle ureter, on both right and left pig sides. Number of attempts and time needed to evaluate the virtual trajectory and to perform the percutaneous puncture were outcomes measurements. Results:Overall 24 punctures were easily performed without any complications.Surgeons required more time to evaluate the trajectory during ureteral puncture than kidney (median 15 versus 13 seconds, range 14 to 18 and 11 to 16 seconds, respectively; p= 0.1). The median renal and ureteral puncture time were 19 and 51 seconds respectively (range 14 to 45 and 45 to 67; p=0.003). Two attempts were needed to achieve a successful ureteral puncture. The presented technique demands presence of renal stone for testing. Conclusions:The proposed EMT solution for renal collecting system puncture proved to be highly accurate, simple and quicker. This method might represent a paradigm shift in percutaneous kidney access techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

et al. 2013

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“…İlk olarak Desai ve arkadaşları, intrakardiyak olarak kullanılan Hensen cihazını modifiye ederek robot yardımlı fleksibl URS tekniğinin olabilirliğini test etmişlerdir (39,40). Ancak bu sistem geliştirilememiştir.…”

Section: Robot Yardımlı Fleksibl Ursunclassified

URS Konusunda Teknolojik Gelişmeler

Bedir¹

2017

Endouroloji

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“…Several robots with different levels of specialization, precision, and automation have emerged with high potential to improve surgical performance by providing precise and stable movements and decreasing surgeon dependence. 17,18,48 Currently, most of these systems are based on medical imaging information, because it is decisive for all PCNL stages.…”

Section: Medical Robotic For Pcnlmentioning

confidence: 99%

“…In what concerns PCNL puncture in particular, the most relevant contributions have been provided by the application of medical imaging techniques, as well as the fusion of multiple imaging procedures. 10,13,15,16 Aside from medical imaging, robotic systems, 13,17,18 navigation systems, 19 finite element models, 20,21 and recent developments in computer graphics and image processing 13 have been proposed in recent years to improve percutaneous puncture. However, the use of new solutions not dependent on medical imaging, in current surgical practice, is still very limited.…”

mentioning

confidence: 99%

Kidney Targeting and Puncturing During Percutaneous Nephrolithotomy: Recent Advances and Future Perspectives

Rodrigues

Fonseca

et al. 2013

Journal of Endourology

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Background and Purpose: Precise needle puncture of the kidney is a challenging and essential step for successful percutaneous nephrolithotomy (PCNL). Many devices and surgical techniques have been developed to easily achieve suitable renal access. This article presents a critical review to address the methodologies and techniques for conducting kidney targeting and the puncture step during PCNL. Based on this study, research paths are also provided for PCNL procedure improvement. Methods: Most relevant works concerning PCNL puncture were identified by a search of Medline/PubMed, ISI Web of Science, and Scopus databases from 2007 to December 2012. Two authors independently reviewed the studies. Results: A total of 911 abstracts and 346 full-text articles were assessed and discussed; 52 were included in this review as a summary of the main contributions to kidney targeting and puncturing. Conclusions: Multiple paths and technologic advances have been proposed in the field of urology and minimally invasive surgery to improve PCNL puncture. The most relevant contributions, however, have been provided by the application of medical imaging guidance, new surgical tools, motion tracking systems, robotics, and image processing and computer graphics. Despite the multiple research paths for PCNL puncture guidance, no widely acceptable solution has yet been reached, and it remains an active and challenging research field. Future developments should focus on real-time methods, robust and accurate algorithms, and radiation free imaging techniques.

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Robotic Flexible Ureteroscopy for Renal Calculi: Initial Clinical Experience

Abstract: We present a novel flexible robotic platform for retrograde ureteroscopic treatment for intrarenal calculi. Initial experience is encouraging.

Cited by 95 publications

References 7 publications

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

URS Konusunda Teknolojik Gelişmeler

Kidney Targeting and Puncturing During Percutaneous Nephrolithotomy: Recent Advances and Future Perspectives

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