Robotic surgery in urology: fact or fantasy?

Abstract

Advanced robotic surgery was first introduced into urology in 2000. The first studies showed the feasibility and safety of the daVinci (Intuitive Surgical Inc., Sunnyvale, CA) telemanipulator assistance in radical prostatectomy, pelvi‐ureteric junction obstruction, and radical cystectomy and neobladder formation. The miniature endowristed tools offer a potential advantage over standard laparoscopy in the accuracy of preparation and suturing. Other features are a three‐dimensional vision system and unimpaired hand‐eye coordination. Complex laparoscopic tasks are learned faster by using the robot, which may also explain the shorter training required for radical prostatectomy than for manual laparoscopy. This new and expensive technology has spread rapidly over the last 4 years. By 2004, ≈ 10% of radical prostatectomies in the USA will be robot‐assisted. Data on the functional and oncological outcomes are accruing but not yet conclusive. There will be a further spread of robotic surgery, routine telesurgery, smaller and more affordable systems, the introduction of virtual reality, all developments which have the potential to urological surgeons to improve.

Transoral Robotic Surgery: Supraglottic Partial Laryngectomy

“…1,68 Because the "working portions" of the ro botic system, the surgical instrumentation, are akin to standard surgical instrumentation with computer enhancement, the oncological efficacy of robotic techniques in areas such as the prostate has been as good as or superior to that of standard techniques. 9 Minimally invasive surgical technique has been enhanced with the addition of robotic surgical sys tems.…”

“…For example, ap proximately 10% of radical prostatectomies were performed robotically in 2004. 1 In 2005, Hockstein et al 2,3 reported the feasibility of transoral use of the da Vinci robotic system in mannequin and cadaver models. Subsequently, Weinstein et al 4 coined the acronym TORS (transoral robotic surgery) in a de scription of supraglottic laryngectomy in a canine model by means of the robotic system.…”

Adverse Effects of Robotic-Assisted Laparoscopic Versus Open Retropubic Radical Prostatectomy Among a Nationwide Random Sample of Medicare-Age Men

“…In 2000, the first robotic-assisted laparoscopic radical prostatectomy (RALRP) was performed. 3 Since then, the dissemination of RALRP in the United States has been remarkable, with up to 85% of radical prostatectomies now performed by using this approach. 4 The reasons for this rapid dissemination are unclear.…”

Robotic Prostatectomy: Is it More Advantageous Regarding Quality of Life?

“…1904 yılında ilk açık radikal prostatektomi (ARP) yapılmasından günümüze, teknolojideki gelişmeler sayesinde radikal prostatektomi laparoskopik ve robotik yöntemlerle de yapılabilir hale gelmiştir. Robotik radikal prostatektomi (RRP), minimal invaziv yöntem olarak geleneksel ARP'ye alternatif olmuştur (1). Günümüzde ABD'de prostat kanseri tedavisinde uygulanan cerrahi prosedürlerin %60'ından fazlasını artık robotik cerrahi oluşturmaktadır (2).…”