Toward Improving Transurethral Prostate Surgery: Development and Initial Experiments with a Prototype Concentric Tube Robotic Platform

Mitchell, CR; Rj, Hendrick; Rj, Webster; Sd, Herrell

doi:10.1089/end.2016.0155

Cited by 14 publications

(8 citation statements)

References 20 publications

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“…However, surgeons achieved good results in treatment of patients with CSDH when the first choice approach was TDC [12, 14]. The surgical community’s reluctance to adopt novel approaches is particularly noted in urethral robotic surgery, which slowly garners clinical interest [31]. Lack of accessible mentorship and the prolonged/challenging learning curve are known causes of delayed dissemination of new, advanced techniques, despite their clinical validity.…”

Section: Discussionmentioning

confidence: 99%

Modified bedside twist drill craniostomy for evacuation of chronic subdural haematoma.

Szmuda

Kierońska

Słoniewski

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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IntroductionStandard craniotomy (SC) and burr hole craniostomy (BHC) are regarded as the standard approaches to chronic subdural haematoma (CSDH). Bedside twist drill craniostomy (TDC), performed at the patient’s bedside, was introduced as an alternative to the standard methods. However, clinical and radiological features of patients treated with TDC and BHC/SC have not been compared.AimTo demonstrate the specific features of CSDH that affect the surgeons’ preferences when selecting patients for TDC.Material and methodsA retrospective analysis of 32 patients treated due to CSDH in the year 2017 at a single institution was performed. Baseline radiological characteristics, clinical status at admission, complication rate and clinical outcomes were compared between BHC/SC and TDC.ResultsOf the 32 patients, 5 (15.6%) were treated using TDC and 27 (84.4%) by SC or BHC. The duration of the TDC procedure was significantly shorter than the time of standard therapies (p < 0.01). There were no differences between TDC and BHC/SC in terms of baseline clinical characteristics, including age, gender, head trauma history, diabetes, hypertension, antiplatelet drug use, clinical manifestation and the Glasgow Coma Scale score (all p > 0.05). Patients treated with TDC had a significantly thicker haematoma (TDC vs. BHC/SC: mean 25.3 mm vs. 14.6 mm) (p < 0.01) and demonstrated a smaller midline shift (TDC vs. BHC/SC: mean 0.5 mm vs. 4.0 mm) (p = 0.01) compared to those treated with BHC/SC.ConclusionsTwist drill craniostomy is a more effective method for CSDH evacuation compared to SC and BHC. This procedure is considered as the first line treatment for patients with a thicker and non-septated haematoma, and with a smaller midline shift.

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Section: Discussionmentioning

confidence: 99%

Modified bedside twist drill craniostomy for evacuation of chronic subdural haematoma.

Szmuda

Kierońska

Słoniewski

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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“…Examples of endoluminal procedures include trans-oral MIS surgery of the airways [14][15][16] esophageal surgery, [17][18][19][20] transanal colorectal microsurgery, 21,22 transurethral prostate and bladder procedures. 23,24 Transluminal procedures use access along bodily lumens but require the creation of an incision in the lumen walls to access the surgical site. These procedures are typically referred to as natural orifice transluminal endoscopic surgeries (NOTES).…”

Section: A Brief Taxonomy Of Mis and Its Derivativesmentioning

confidence: 99%

“…Initial cadaveric experiments showed this system was capable of executing tasks necessary for HoLEP. 24 Russo et al 145 presented another robot for laser-assisted transurethral resection of prostate, called the ASTRO (actuated and sensorized tool for laser-assisted surgery of the prostate). This robot uses a wire-driven multi-lumen catheter to steer a laser-fiber and fiber-optic based contact sensing.…”

Section: Transurethral Systemsmentioning

confidence: 99%

Snake-Like Robots for Minimally Invasive, Single-Port, and Intraluminal Surgeries

Orekhov

Abah

Simaan

2018

The Encyclopedia of Medical Robotics

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The surgical paradigm of Minimally Invasive Surgery (MIS) has been a key driver to the adoption of robotic surgical assistance. Progress in the last three decades has led to a gradual transition from manual laparoscopic surgery with rigid instruments to robot-assisted surgery. In the last decade, the increasing demand for new surgical paradigms to enable access into the anatomy without skin incision (intraluminal surgery) or with a single skin incision (Single Port Access surgery -SPA) has led researchers to investigate snake-like flexible surgical devices. In this chapter, we first present an overview of the background, motivation, and taxonomy of MIS and its newer derivatives. Challenges of MIS and its newer derivatives (SPA and intraluminal surgery) are outlined along with the architectures of new snake-like robots meeting these challenges. We also examine the commercial and research surgical platforms developed over the years, to address the specific functional requirements and constraints imposed by operations in confined spaces. The chapter concludes with an evaluation of open problems in surgical robotics for intraluminal and SPA, and a look at future trends in surgical robot design that could potentially address these unmet needs.

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“…However, complications such as massive hemorrhage or TURP syndrome are also common (9). A study showed that TURP was associated with incidence rate and even mortality of complications (10). Since entering the new century, studies have explored the effectiveness and safety of new surgical methods for the treatment of BPH, such as the use of bilateral electrodes or various laser systems (holmium laser, potassium titanium phosphate laser, thulium laser, diode laser, and so on), prostatic artery embolization (PAE), plasmakinetic resection of the prostate (PKRP), transurethral GreenLight TM laser photovaporization of the prostate (GLL PVP), and so on.…”

Section: Introductionmentioning

confidence: 99%

Comparison of effectiveness and postoperative complications of different surgical methods in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis based on randomized controlled trials

Fu¹,

Wen²,

Yin³

et al. 2022

Transl Androl Urol

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Background: More and more new surgical procedures for the treatment of benign prostate hyperplasia (BPH) are proposed creatively. However, the existing clinical evidence shows that the effectiveness and safety of various procedures exist inconsistent. Methods:The randomized controlled trials comparing the international prostate score, length of hospital stay, maximum urinary flow rate, operation time, and complication rates of prostatic artery embolization (PAE), Greenlight-XPS Laser prostate vaporization procedure (GLL PVP), diode laser enucleation of prostate (DILEP) and plasmakinetic resection of the prostate (PKRP), transurethral resection of the prostate (TURP) in patients with BPH were screened out in databases. The primary outcome was pooled using a restricted maximum likelihood-based random-effect model and inverse variance-based fixed-effect model.Cochrane Q statistics and I2 statistics were computed to quantify between-study heterogeneity. The risk of bias of each included study was assessed using the revised Cochrane risk of bias tool.Results: This meta-analysis ultimately included 14 original research papers, with 1,940 participants enrolled. Eight studies were considered to be at moderate risk of bias, while the others were at mild risk of bias. Although the improvement in functional outcome of the DILEP procedure was equivalent to that of the PKRP procedure, the DILEP procedure group had fewer hospital stays than the PKRP group (P=0.01).In addition, even though the performance of the GLL PVP procedure in the improvement of functional outcome was inferior to the counterpart of TURP (P=0.64), it had a much fewer hospital stays (P=0.01).

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Toward Improving Transurethral Prostate Surgery: Development and Initial Experiments with a Prototype Concentric Tube Robotic Platform

Cited by 14 publications

References 20 publications

Modified bedside twist drill craniostomy for evacuation of chronic subdural haematoma.

Modified bedside twist drill craniostomy for evacuation of chronic subdural haematoma.

Snake-Like Robots for Minimally Invasive, Single-Port, and Intraluminal Surgeries

Comparison of effectiveness and postoperative complications of different surgical methods in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis based on randomized controlled trials

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