Robotic stone surgery – Current state and future prospects: A systematic review

Abstract

ObjectiveTo provide a comprehensive review of robot-assisted surgery in urolithiasis and to consider the future prospects of robotic approaches in stone surgery.Materials and methodsWe performed a systematic PubMed© literature search using predefined Medical Subject Headings search terms to identify PubMed-listed clinical research studies on robotic stone surgery. All authors screened the results for eligibility and two independent reviewers performed the data extraction.ResultsThe most common approach in robotic stone surgery is a robot-assisted pyelolithotomy using the da Vinci™ system (Intuitive Surgical Inc., Sunnyvale, CA, USA). Several studies show this technique to be comparable to classic laparoscopic and open surgical interventions. One study that focused on ureteric stones showed a similar result. In recent years, promising data on robotic intrarenal surgery have been reported (Roboflex Avicenna™; Elmed Medical Systems, Ankara, Turkey). Initial studies have shown its feasibility and high stone-free rates and prove that this novel endoscopic approach is safe for the patient and comfortable for the surgeon.ConclusionsThe benefits of robotic devices in stone surgery in existing endourological, laparoscopic, and open treatment strategies still need elucidation. Although recent data are promising, more prospective randomised controlled studies are necessary to clarify the impact of this technique on patient safety and stone-free rates.

Aktuelle Trends in der flexiblen Ureterorenoskopie – ein Update

“…Die Robotik spielt in der Behandlung der Urolithiasis noch eine untergeordnete Rolle. In einer systematischen Übersichtsarbeit fassten Müller et al die wenigen Studienergebnisse über die roboterassistierte Steinsanierung zusammen [44]. Desai [44].…”

“…In einer systematischen Übersichtsarbeit fassten Müller et al die wenigen Studienergebnisse über die roboterassistierte Steinsanierung zusammen [44]. Desai [44]. Die umfangreiche apparative Ausstattung und damit verbundene Kosten lassen jedoch kritische Fragen hinsichtlich des realen Mehrwerts in der Patientenversorgung im Vergleich zur konventionellen fURS aufkommen.…”

Utilizing da vinci® surgical system to treat challenging urinary stones

“…[22] A recent systemic review of RSS endorsed the utilization of the da Vinci ® robotic surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA) in pyelolithotomy. [23] Badalato et al published a meta-analysis of four clinical trials with 39 patients that endured robot-assisted stone removal from the kidney with or without pyeloplasty. [24] In fact, the idea of utilizing the da Vinci ® robotic surgical system is not new.…”

Quality of life in patients who undergo conventional or robotic-assisted total laparoscopic hysterectomy

“…[5] Robotic-assisted surgery has also been associated with lower risk of bleeding and infection and has led to reduced postoperative pain scores, with less trauma and faster recovery. The repeatability, stability, accuracy, millimeter-scale dexterity, and use of multiple monitoring sensors are also cited as benefits of the technique.…”

“…[5,6] Surgical procedures can result in complications, prolonged hospitalization, need for recurrent surgery, and difficulty in performing daily postoperative activities, and can be associated with self-image disorders, impaired self-esteem, and depression. [6,7] …”