LAPAROSCOPIC RADICAL PROSTATECTOMY WITH A REMOTE CONTROLLED ROBOT

Abstract

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2001LAPAROSCOPIC RADICAL PROSTATECTOMY WITH A REMOTE CONTROLLED ROBOT CLÉMENT-CLAUDE ABBOU, ANDRÁS HOZNEK, LAURENT SALOMON, LEIF ERIC OLSSON, ADRIAN LOBONTIU, FABIEN SAINT, ANTONY CICCO, PATRICK ANTIPHON, and DOMINIQUE CHOPIN CLÉMENT-CLAUDE ABBOUCLÉMENT-CLAUDE ABBOU More articles by this author , ANDRÁS HOZNEKANDRÁS HOZNEK More articles by this author , LAURENT SALOMONLAURENT SALOMON More articles by this author , LEIF ERIC OLSSONLEIF ERIC OLSSON More articles by this author , ADRIAN LOBONTIUADRIAN LOBONTIU More articles by this author , FABIEN SAINTFABIEN SAINT More articles by this author , ANTONY CICCOANTONY CICCO More articles by this author , PATRICK ANTIPHONPATRICK ANTIPHON More articles by this author , and DOMINIQUE CHOPINDOMINIQUE CHOPIN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66251-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Robotics in surgery is a recent innovation. This technology offers a number of attractive features in laparoscopy. It overcomes the difficulties with fixed port sites by restoring all 6 degrees of freedom at the instrument tips, provides new possibilities for miniaturization of surgical tasks and allows remote controlled surgery. We investigated the applicability of remote controlled robotic surgery to laparoscopic radical prostatectomy. Materials and Methods: Our previous experience with laparoscopic prostatectomy served as a basis for adapting robotic surgery to this procedure. A surgeon at a different location who activated the tele-manipulators of the da Vinci * Intuitive Surgical, Inc., Mountain View, California. robotic system performed all steps of the intervention. A scrub nurse and second surgeon who stood at patient side had limited roles to port and instrument placement, exposure of the operative field, assistance in hemostasis and removal of the operative specimen. Our patient was a 63-year-old man presenting with a T1c tumor discovered on 1 positive sextant biopsy with a 3+3 Gleason score and 7 ng./ml. preoperative serum prostate specific antigen. Results: The robot provided an ergonomic surgical environment and remarkable dexterity enhancement. Operating time was 420 minutes, and the hospital stay lasted 4 days. The bladder catheter was removed 3 days postoperatively, and 1 week later the patient was fully continent. Pathological examination showed a pT3a tumor with negative margins. Conclusions: Robotically assisted laparoscopic radical prostatectomy is feasible. This new technology enhances surgical dexterity. Further developments in this field may have new applications in laparoscopic tele-surgery. References 1 : Telerobotic assisted laparoscopic surgery: initial laboratory and clinical experience. Urology1994; 44: 15. Google Scholar 2 : Complete robot-assisted laparoscopic urologic surgery: a preliminary report. J Am Coll Surg1995; 181: 552. Google Scholar 3 : Robotic-assisted laparoscopic pyeloplasty: a pilot study. Urology1999; 53: 1099. Google Scholar 4 : Total endoscopic computer enhanced coronary artery bypass grafting. Eur J Cardiothorac Surg2000; 17: 38. Google Scholar 5 : Endoscopic coronary artery bypass grafting with the aid of robotic assisted instruments. J Thorac Cardiovasc Surg1999; 118: 4. Google Scholar 6 : The world’s first obesity surgery performed by a surgeon at a distance. Obes Surg1999; 9: 206. Google Scholar 7 : Laparoscopic radical prostatectomy: preliminary results. Urology2000; 55: 630. Crossref, Medline, Google Scholar 8 : Transcontinental interactive laparoscopic telesurgery between the United States and Europe. J Urol1998; 160: 1413. Link, Google Scholar 9 : Telesurgical mentoring. Initial clinical experience. Surg Endosc1997; 11: 1001. Google Scholar 10 : Comparison of robotic versus human laparoscopic camera control. J Urol1995;