The Emergence of Surgeon-Controlled Robotic Surgery in Urologic Oncology

Abstract

The rise of robotic surgery is transforming medicine. In many ways, urology has taken charge in pioneering a new era of minimally invasive surgery with the emergence of the robot. The unprecedented dissecting precision and the dynamic three-dimensional, high definition view of the surgical field are undoubtedly revolutionizing the field of urology. These unique attributes of robotic surgery confer enormous advantages in dealing with urooncological surgery. The robotic revolution began nearly a decade ago with surgeon-controlled robotic radical prostatectomy and has since expanded to include radical cystectomies and partial nephrectomies. There have been numerous landmark studies published showing that robotic surgery provides comparable oncological and functional outcomes against traditional open or laparoscopic surgery. As a result, it becomes exceedingly imperative that urologists and the oncological community remain up-todate regarding these developments and appreciate the oncological outcomes of surgeon-controlled robotic surgery. This review will assess the impact surgeon-controlled robotic surgery has had in the field of urologic oncology.

Preclinical evaluation of the Versius surgical system: A next‐generation surgical robot for use in minimal access prostate surgery

“…Minimal access surgery (MAS) has been utilised in urological surgeries for several decades and is well established in prostate procedures 1,2 . Prostatectomy by MAS offers significant benefits over open surgery with shorter catheterisation time, less blood loss, less post‐operative pain, shorter hospital stay and recovery, lower rates of complications and comparable oncological outcomes 3,4 . However, MAS is associated with certain limitations, such as a lack of ergonomically designed surgical instruments, restricted reach and access of instruments, limited haptic feedback and the lack of depth perception resulting from two‐dimensional visualisation 5 .…”

Technologic advances in robot-assisted nephron sparing surgery: a narrative review

“…Open partial nephrectomy (PN) was first performed in 1887 but since the advent of minimally invasive surgery in urology, this approach has been favored for many renal tumors ( 2 , 3 ). The first laparoscopic partial nephrectomy (LPN) was performed in 1990 with the robot-assisted approach following approximately a decade later ( 4 - 6 ). Currently, AUA guidelines recommend PN for cT1a tumors; however, with advances in the understanding of vascular anatomy and development of advanced techniques, PN has been performed on complex, unfavorably located, larger tumors, and in solitary kidneys ( 7 - 16 ).…”