First Clinical Experience in Urologic Surgery with a Novel Robotic Lightweight Laparoscope Holder
This addresses the problem of reducing surgical assistant needs and improving ergonomics for surgeons in urologic surgery, but it is incremental as it builds on existing robotic assistive technologies.
The study tested a surgeon-controlled robotic laparoscope holder in laparoscopic urologic surgery on 20 patients, finding it feasible and safe with a 71% completion rate using the robot, median operative time of 130 minutes, and good surgeon comfort scores.
Purpose: To report the feasibility and the safety of a surgeon-controlled robotic endoscope holder in laparoscopic surgery. Materials and methods: From March 2010 to September 2010, 20 patients were enrolled prospectively to undergo a laparoscopic surgery using an innovative robotic endoscope holder. Two surgeons performed 6 adrenalectomies, 4 sacrocolpopexies, 5 pyeloplasties, 4 radical prostatectomies and 1 radical nephrectomy. Demographic data, overall set-up time, operative time, number of assistants needed were reviewed. Surgeon's satisfaction regarding the ergonomics was assessed using a ten point scale. Postoperative clinical outcomes were reviewed at day 1 and 1 month postoperatively. Results: The per-protocol analysis was performed on 17 patients for whom the robot was effectively used for surgery. Median age was 63 years, 10 patients were female (59%). Median BMI was 26.8. Surgical procedures were completed with the robot in 12 cases (71 %). Median number of surgical assistant was 0. Overall set-up time with the robot was 19 min, operative time was 130 min) during which the robot was used 71% of the time. Mean hospital stay was 6.94 days $\pm$ 2.3. Median score regarding the easiness of use was 7. Median pain level was 1.5/10 at day 1 and 0 at 1 month postoperatively. Open conversion was needed in 1 case (6 %) and 4 minor complications occurred in 2 patients (12%). Conclusion: This use of this novel robotic laparoscope holder is safe, feasible and it provides a good comfort to the surgeon.