Single‐port, single‐operator‐light endoscopic robot‐assisted laparoscopic urology: pilot study in a pig model

Abstract

pneumoperitoneum obtained. An operative laparoscope was introduced and securely held using a novel low-profile robot under foot and/or voice control. Using articulating instruments, each pig had bilateral reconstructive and extirpative renal surgery. Salient intraoperative and postmortem data were recorded. Results were analysed statistically to determine if outcomes improved with surgeon experience. RESULTSFive male farm pigs underwent bilateral partial nephrectomy and bilateral pyeloplasty before a completion bilateral radical nephrectomy. There were no intraoperative complications and there was no need for additional ports to be placed. The mean (range) operative duration for partial nephrectomy, pyeloplasty, and nephrectomy were 120(100-150), 110(95-130) and 20(15-30)min, respectively. The mean (range) estimated blood loss for all procedures was 240(200-280)mL. The preparation time decreased with increasing number of cases ( P = 0.002). CONCLUSIONSThe combination of a single-port, a robotic endoscope holder and articulated instruments operated by one surgeon is feasible. With a single-port access, the robot allows more room to the surgeon than an assistant.

Single-port hysterectomy with pelvic lymph node dissection in the porcine model: feasibility and validation of a novel robotic lightweight endoscope positioner

“…Our results are consistent with a previous study by Crouzet et al for reconstructive and extirpative urological surgery using the porcine model [5]. The authors concluded that with singleport access, the robotic endoscope allows more room for the surgeon compared to an assistant.…”

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

“…In an attempt to overcome these limitations, Crouzet et al recently presented their initial translational animal study in which a low-profile robot was used to assist one surgeon to complete LESS reconstructive and extirpative renal procedures. 79 After making a 2-cm umbilical incision, through which a single port was placed and pneumoperitoneum obtained , an operative 5-mm 30°rigid high-definition laparoscope was introduced and securely held using a novel low-profile robot under foot and/or voice control (Light Endoscope Holder Robot, LER, EndoControl, Grenoble, France). Using articulating instruments, each pig had bilateral reconstructive partial nephrectomy and bilateral pyeloplasty before a completion bilateral radical nephrectomy.…”

Natural orifice specimen extraction versus conventional laparoscopically assisted right hemicolectomy

“…In recent times, two innovative techniques have gained much interest as a step towards even less invasive procedures: natural orifice transluminal endoscopic surgery (NOTES), which involves using a natural orifice of the body to perform a surgical procedure, and single‐incision laparoscopic surgery in which the surgical scar is virtually concealed within the umbilicus. Although some reports suggest a promising future for these techniques, most authors have readily conceded that in their current form they are limited by technical constraints3–7.…”