Robotic technology allows the beginner surgeon to approach minimally-invasive partial nephrectomy (PN) avoiding the otherwise long learning curve of pure laparoscopy. The present video-article reported the surgical technique and the outcomes of the first 11 cases performed by a young surgeon starting with the experience of robotic PN. Transperitoneal robotic PN, with an off-clamp approach, a simple enucleation technique, and a single-layer medullar renorrhaphy was performed uneventfully in all cases but one, with comparable outcomes to the available literature.
View Article and Find Full Text PDFWe compared perioperative outcomes after on-clamp versus off-clamp robot-assisted partial nephrectomy (RAPN) for >7 cm renal masses. A multicenter dataset was queried for patients who had undergone RAPN for a cT2cN0cM0 kidney tumor from July 2007 to February 2022. The Trifecta achievement (negative surgical margins, no severe complications, and ≤ 30% postoperative estimated glomerular filtration rate (eGFR) reduction) was considered a surrogate of surgical quality.
View Article and Find Full Text PDFObjectives: To report the results of the first quantitative synthesis of literature data from studies comparing Single-Port Robot-Assisted Radical Prostatectomy performed using the novel SP surgical platform (SP-RARP) versus RARP performed by using multi-arms robotic systems.
Methods: Studies comparing the use of da Vinci SP versus that of other available multi-arms da Vinci platforms were eligible for inclusion in the present review. From selected studies, data were extracted by using a standardized data extraction form.
Background: The novel da Vinci Single-Port (SP) robotic platform received the US FDA approval in 2018. The device, specifically conceived for single-site approach, is pushing through the limits of minimally invasive surgery. We sought to provide a comprehensive overview of the current status of the clinical experiences accomplished by the da Vinci SP in urology, and to discuss future perspectives.
View Article and Find Full Text PDFBackground: Compared with the standard open approach, multiport robotic-assisted kidney transplantation (RAKT) has emerged as a less morbid alternative. The use of a single-port robotic approach for kidney transplantation (KT) is presented in this study as having the potential for further reducing the morbidity of KT.
Objective: To present the technique and evaluate perioperative and short-term (≤1 yr) postoperative outcomes of single-port RAKT.
Background: Radical perineal prostatectomy (RPP) has been revived with the advent of single-port (SP) robotic surgery. However, its interest and precise role need to be evaluated and better defined.
Objective: To describe in detail the technique of SP-RPP and compare initial perioperative outcomes with those of multiport robot-assisted transperitoneal radical prostatectomy (MP-RARP).
Introduction: Squamous cell carcinoma (SCC) of the penis is a rare disease comprising 1% of all male cancer. Options for the management of cT1-T2 cN0 penile SCC include partial penectomy (PP), considered the standard, and brachytherapy (BT), which offers acceptable local disease control and organ preservation. The purpose of our study was to assess and describe the oncological outcome for both treatments in a tertiary care center.
View Article and Find Full Text PDFBackground: There is a paucity of data describing the ability of margin, ischemia, complications, score (MIC) and trifecta in predicting long-term outcomes of robotic-assisted partial nephrectomy (RAPN).
Objective: To compare a novel trifecta (negative margins, no significant complications, and perioperative estimated glomerular filtration rate [eGFR] decrease ≤30%) versus standard MIC as predictors of oncologic and functional results in a large series of RAPNs.
Design, Setting, And Participants: Between 2009 and 2019, a multicenter dataset was queried for patients with nonmetastatic renal masses who underwent RAPN at eight participating institutions.
Objective: To assess the safety and feasibility of extraperitoneal single-port robotic assisted laparoscopic radical prostatectomy using the da Vinci SP robotic platform for same-day surgery.
Methods: Extraperitoneal single-port robotic prostatectomy (ESRP) using the da Vinci SP platform was performed on 60 patients with clinically localized prostate cancer and no prior definitive therapy. An enhanced recovery protocol was used in the perioperative period and minimal to no opiates were used in these patients.
Background: To describe our step-by-step techniques for single-port robotic-assisted extraperitoneal and perineal radical prostatectomy as recent technical advancements in this field.
Methods: An English-language literature review was done using search terms including extraperitoneal, transperineal, single-port, robotic surgery, prostate cancer, radical prostatectomy in various combinations. Unique features of the da Vinci SP platform are discussed.
Introduction: Minimally invasive surgery has recently gained interest for kidney transplantation. We aimed to describe the step-by-step technique for single-port robotic transperitoneal kidney transplantation using the SP® surgical system (Intuitive Surgical, Sunnyvale, Ca) in a pre-clinical model.
Materials And Methods: A male fresh cadaver model was placed in a lithotomy position.
Objective: To present our initial experience with single-port percutaneous transvesical simple prostatectomy using the novel SP robotic surgical system.
Methods: Ten patients underwent single-port transvesical simple prostatectomy between February and November 2019. Percutaneous access to the bladder dome was made and all SP instruments were inserted through the SP multichannel cannula directly into the bladder.
Objectives: To present a comprehensive report regarding our experience with single-port robotic surgery in our first 100 consecutive patients. We describe the diversity of procedures that can be performed with this platform as well as the challenges and complications we had with the application of this novel technology.
Methods: Between September 2018 and August 2019, data on 100 patients who underwent single-port robotic surgery were consecutively collected.
Introduction: To present the first case of a concomitant robotic radical prostatectomy and a left robotic partial nephrectomy performed by a single-port approach using the SP® da Vinci surgical system (Intuitive Surgical, Sunnyvale CA, EE.UU.).
View Article and Find Full Text PDFPurpose: We compared intraoperative and perioperative outcomes between extraperitoneal and transperitoneal radical prostatectomy performed using a "purpose-designed" single port robotic platform.
Materials And Methods: A total of 98 patients underwent single port robotic prostatectomy using the da Vinci SP® robotic system with extraperitoneal (group I, 52) vs transperitoneal (group II, 46) approach. Demographics and perioperative data including postoperative recovery outcomes were recorded and compared between the 2 groups.
Background: In order to improve standard reporting of outcomes after partial nephrectomy, different "trifecta" systems have been conceived. The subjective assessment of the included parameters and the unreliability for off-clamp procedures limited their reproducibility; their role in predicting functional and oncologic outcomes has never been assessed. We propose a new trifecta, based on standardized parameters, that summarizes PN outcomes regardless the clamping technique used and predicts main clinical outcomes.
View Article and Find Full Text PDFPurpose: To review the recent advances in terms of surgical technique and new robotic platforms applied to radical perineal prostatectomy (RPP).
Methods: A literature review was performed focusing on original articles on perineal prostatectomy searching via Medline/Pubmed and Embase. The entire spectrum was covered such as development of surgical technique including pelvic lymphadenectomy, adoption of novel surgical platforms, learning curve and future directions.
Objective: To describe the surgical technique for single-port robotic extraperitoneal dual kidney transplantation (DKT) using the SP surgical system (Intuitive Surgical, Sunnyvale, CA, USA) in a preclinical model.
Methods: In 1 male cadaver, the SP Surgical System was used to perform an extraperitoneal DKT. Kidney grafts were obtained from the local organ procurement organization, after being declined by all transplant centers.
Objective: To describe our technique of extraperitoneal single-port (SP) robot-assisted radical prostatectomy (RARP) and present our clinical experience with the first 10 cases.
Patients And Methods: In all, 10 consecutive patients diagnosed with localised prostate cancer underwent extraperitoneal SP-RARP using the da Vinci SP® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). Exclusion criteria included previous surgery through an infra-umbilical midline incision, prostate size >100 g, or preoperative evidence of extraprostatic disease.
Laparoendoscopic single-site surgery was developed to minimize the morbidity associated with laparoscopic surgery. Application of robotics in urologic surgery has been widely adopted given the advantages it provides over standard laparoscopy including 3-dimensional vision, improved ergonomics, enhanced precision and dexterity. The real benefit of robotic laparoendoscopic single-site surgery is still unbalanced by the limitations of this approach and the sole applicability by highly skilled surgeons.
View Article and Find Full Text PDFAim: Uretero-ileal anastomosis strictures (UAS) occur in 3 to 11% of patients who undergo ileal conduit urinary diversion after cystectomy. We aimed to demonstrate our surgical technique for robotic repair of UAS after cystectomy, focusing on the technical points.
Materials And Methods: We present the case of a 75 year-old male with right hydronephrosis status post cystectomy with ileal conduit urinary diversion.