1
|
Ficarra V, Rossanese M, Giannarini G, Longo N, Viganò S, Russo D, Sorce G, Simonato A, Bartoletti R, Crestani A, Di Trapani E. Evaluation of Clinical Research on Novel Multiport Robotic Platforms for Urological Surgery According to the IDEAL Framework: A Systematic Review of the Literature. EUR UROL SUPPL 2024; 67:7-25. [PMID: 39100226 PMCID: PMC11293526 DOI: 10.1016/j.euros.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 08/06/2024] Open
Abstract
Background and objective Several novel multiport robotic systems have been developed and introduced in clinical practice after regulatory approval. The objective of this systematic review was to assess the evolution status of novel robotic platforms approved for clinical use in urological surgery according to the IDEAL framework. Methods A systematic review was conducted using the Medline and Scopus databases according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (CRD42024503227). Comparative or noncomparative studies reporting on any urological procedures performed with novel robotic platforms (Hugo RAS; Versius, KangDuo, Senhance, REVO-I, Avatera, Hinotori, Dexter, or Toumai) were selected and included in the analysis. Key findings and limitations Seventy-four eligible studies were included, of which 67 (90.5%) were noncomparative surgical series representing developmental or explorative studies according to the IDEAL criteria. Only one randomised controlled trial (comparing KangDuo vs da Vinci robot-assisted partial nephrectomy) was included. The trial showed comparable perioperative outcomes between the two robotic systems. Four studies assessed clinical outcomes for patients undergoing urological procedures using a REVO-I (1 study), Senhance (2 studies), or Hinotori (1 study) system in comparison to the same procedures performed using a da Vinci system. All studies revealed outcomes comparable to those with the da Vinci system. Limitations include the small sample size in all studies, and assessment of first-generation novel platforms versus the fourth-generation multiarm da Vinci system in most of the comparative studies. Conclusions and clinical implications A few poor-quality studies have compared the use of novel robotic platforms to da Vinci systems in urological surgery and demonstrated comparable results. Most studies can be classified as developmental or explorative, representing the initial steps of clinical research. Large multicentre series are needed to understand whether these novel robots could offer advantages beyond cost reductions over the da Vinci systems. Patient summary We reviewed research on new robotic systems for surgery in urology. Several studies have shown the feasibility and safety of these new robots during the most common procedures. Very few studies have assessed clinical outcomes with the new robots in comparison to the reference standard, which is a fourth-generation da Vinci robot. Large multicentre studies are needed to understand whether the new robots could offer advantages other than cost savings over the da Vinci robot.
Collapse
Affiliation(s)
- Vincenzo Ficarra
- Department of Clinical and Experimental Medicine, Urologic Section, University of Messina, Messina, Italy
- Department of Oncology, Urologic Section, AOU G. Martino, Messina, Italy
| | - Marta Rossanese
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Gianluca Giannarini
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Nicola Longo
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Silvia Viganò
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Domenico Russo
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| | - Gabriele Sorce
- Department of Oncology, Urologic Section, AOU G. Martino, Messina, Italy
| | - Alchiede Simonato
- Department of Precision Medicine in Medical, Surgical and Critical Care, Urology Unit, University of Palermo, Palermo, Italy
| | - Riccardo Bartoletti
- Department of Translational Research and New Technologies in Medicine and Surgery, Urology Unit, University of Pisa, Pisa, Italy
| | - Alessandro Crestani
- Urology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Ettore Di Trapani
- Gaetano Barresi Department of Human and Paediatric Pathology, Urology Section, University of Messina, Messina, Italy
| |
Collapse
|
2
|
Ma Z, Guo Z, Ding Z, Cao C, He J, Tang H, Hua Y, Hong J, Shen Q, Lubamba GP, Wang X, Yang Z, Zhu G, Li C. Evaluation of a newly developed oral and maxillofacial surgical robotic platform (KD-SR-01) in head and neck surgery: a preclinical trial in porcine models. Int J Oral Sci 2024; 16:51. [PMID: 38987554 PMCID: PMC11237157 DOI: 10.1038/s41368-024-00318-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/12/2024] Open
Abstract
Traditional open head and neck surgery often leaves permanent scars, significantly affecting appearance. The emergence of surgical robots has introduced a new era for minimally invasive surgery. However, the complex anatomy of the head and neck region, particularly the oral and maxillofacial areas, combined with the high costs associated with established systems such as the da Vinci, has limited the widespread adoption of surgical robots in this field. Recently, surgical robotic platform in China has developed rapidly, exemplified by the promise shown by the KangDuo Surgical Robot (KD-SR). Although the KD-SR has achieved some results comparable to the da Vinci surgical robot in urology and colorectal surgery, its performance in complex head and neck regions remains untested. This study evaluated the feasibility, effectiveness, and safety of the newly developed KD-SR-01, comparing it with standard endoscopic systems in head and neck procedures on porcine models. We performed parotidectomy, submandibular gland resection, and neck dissection, collected baseline characteristics, perioperative data, and specifically assessed cognitive workload using the NASA-TLX. None of the robotic procedures were converted to endoscopic or open surgery. The results showed no significant difference in operation time between the two groups (P = 0.126), better intraoperative bleeding control (P = 0.001), and a significant reduction in cognitive workload (P < 0.001) in the robotic group. In conclusion, the KD-SR-01 is feasible, effective, and safe for head and neck surgery. Further investigation through well-designed clinical trials with long-term follow-up is necessary to establish the full potential of this emerging robotic platform.
Collapse
Affiliation(s)
- Zhongkai Ma
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhiyong Guo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhangfan Ding
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chang Cao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jialu He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Heyi Tang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yufei Hua
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiawei Hong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qiang Shen
- School of Mechanical Engineering, Sichuan University, Chengdu, China
| | - Grace Paka Lubamba
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Hospital of the University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Xiaoyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zheng Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Guiquan Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|
3
|
Shen C, Yan W, Chen S, Xu W, Wang X, Dong J, Zhang Z, Yang K, Fan S, Li Z, Chen X, Zhang M, Jin Z, Meng Y, Cai L, Zhang K, Zhang Z, Mu L, Ji Z, Zhou L, Li X. Robot-assisted Radical Prostatectomy with the KangDuo Surgical System Versus the da Vinci Si System: A Prospective, Double-center, Randomized Controlled Trial. Eur Urol Focus 2024:S2405-4569(24)00087-7. [PMID: 38862329 DOI: 10.1016/j.euf.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/28/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND The KangDuo Surgical Robot (KD-SR) is a newly developed surgical robot. OBJECTIVE To compare the safety and efficacy of robot-assisted radical prostatectomy (RARP) using the KD-SR with those of the da Vinci Si Surgical System (DV-SS-Si). DESIGN, SETTING, AND PARTICIPANTS A prospective double-center noninferiority randomized controlled trial was conducted among 18-75-yr-old patients with suspected T1-2N0M0 prostate cancer (PCa) scheduled for RARP. INTERVENTION RARP with the KD-SR (KD-RARP) versus RARP with the DV-SS-Si (DV-RARP). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was surgical success, defined as follows: surgery can be performed according to the established protocol, without switching to other surgical modalities, and without secondary surgery due to surgical complications after surgery. The secondary outcome was short-term functional and oncological outcomes. The noninferiority threshold was set at 10%. RESULTS AND LIMITATIONS Eighty patients were enrolled, while the full analysis set finally included 79 patients (40 with KD-RARP and 39 with DV-RARP). The success rate was 100% in both groups. We could not find differences in urinary continence rate at 1, 2, 3, and 4 wk after catheter removal between the groups (p > 0.05). The rate of Clavien-Dindo grade II adverse events was 20% in the KD-RARP group and 17.9% in the DV-RARP group (p = 0.82), and no grade ≥III adverse events occurred. The median operation time was significantly longer in the KD-RARP group than in the DV-RARP group (177.5 vs 145 min, p = 0.012). The main limitations were the short follow-up period and that survival was not considered as the primary outcome. CONCLUSIONS The KD-SR is a viable option for RARP, with acceptable short-term outcomes compared with the DV-SS-Si for T1-2 PCa. PATIENT SUMMARY This is the first prospective randomized controlled trial to compare the KangDuo Surgical Robot (KD-SR) versus the da Vinci Si Surgical System (DV-SS-Si) for robot-assisted radical prostatectomy, which determines that the KD-SR is noninferior to the DV-SS-Si regarding safety and efficacy for T1-T2 prostate cancer.
Collapse
Affiliation(s)
- Cheng Shen
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Weigang Yan
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Silu Chen
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Weifeng Xu
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Jie Dong
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhongyuan Zhang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Shubo Fan
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Zhihua Li
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China; Department of Nursing, Peking University First Hospital, Peking University, Beijing, China
| | - Xu Chen
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China; Department of Nursing, Peking University First Hospital, Peking University, Beijing, China
| | - Meng Zhang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China; Department of Nursing, Peking University First Hospital, Peking University, Beijing, China
| | - Zaoheng Jin
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yisen Meng
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Lin Cai
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Kai Zhang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Zheng Zhang
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China
| | - Li Mu
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China; Department of Nursing, Peking University First Hospital, Peking University, Beijing, China
| | - Zhigang Ji
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China.
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Peking University, Beijing, China; Institution of Urology, Peking University, Beijing, China; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, China; National Urological Cancer Center, Beijing, China.
| |
Collapse
|
4
|
Leang YJ, Kong JCH, Mosharaf Z, Hensman CS, Burton PR, Brown WA. Emerging multi-port soft tissue robotic systems: a systematic review of clinical outcomes. J Robot Surg 2024; 18:145. [PMID: 38554226 PMCID: PMC10981598 DOI: 10.1007/s11701-024-01887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024]
Abstract
Multiple novel multi-port robotic surgical systems have been introduced into clinical practice. This systematic review aims to evaluate the clinical outcomes of these novel robotic systems to conventional laparoscopic technique and established da Vinci robotic surgical platforms. A literature search of Embase, Medline, Pubmed, Cochrane library, and Google Scholar was performed according to the PRISMA guidelines from 2012 to May 2023. Studies comparing clinical outcomes of novel multi-port robotic surgical systems with laparoscopic or the da Vinci platforms were included. Case series with no comparison groups were excluded. Descriptive statistics were used to report patient and outcome data. A systematic narrative review was provided for each outcome. Twelve studies comprised of 1142 patients were included. A total of 6 novel multi-port robotic systems: Micro Hand S, Senhance, Revo-i MSR-5000, KangDuo, Versius, and Hugo™ RAS were compared against the laparoscopic or the da Vinci robotic platforms. Clinical outcomes of these novel robotic platforms were comparable to the established da Vinci platforms. When compared against conventional laparoscopic approaches, the robotic platforms demonstrated lower volume of blood loss, shorter length of stay but longer operative time. This systematic review highlighted the safe implementation and efficacy of 6 new robotic systems. The clinical outcomes achieved by these new robotic systems are comparable to the established da Vinci robotic system in simple to moderate case complexities. There is emerging evidence that these new robotic systems provide a viable alternative to currently available robotic platforms.
Collapse
Affiliation(s)
- Yit J Leang
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia.
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia.
| | - Joseph C H Kong
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
- Colorectal Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
| | - Zahin Mosharaf
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Chrys S Hensman
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Paul R Burton
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Wendy A Brown
- Oesophago-Gastric and Bariatric Surgical Unit, Department of General Surgery, The Alfred Hospital, Melbourne, VIC, Australia
- Department of Surgery, Central Clinical School, Monash University, 55 Commercial Road, Melbourne, VIC, 3004, Australia
| |
Collapse
|
5
|
Boal M, Di Girasole CG, Tesfai F, Morrison TEM, Higgs S, Ahmad J, Arezzo A, Francis N. Evaluation status of current and emerging minimally invasive robotic surgical platforms. Surg Endosc 2024; 38:554-585. [PMID: 38123746 PMCID: PMC10830826 DOI: 10.1007/s00464-023-10554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/20/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The rapid adoption of robotics within minimally invasive surgical specialties has also seen an explosion of new technology including multi- and single port, natural orifice transluminal endoscopic surgery (NOTES), endoluminal and "on-demand" platforms. This review aims to evaluate the validation status of current and emerging MIS robotic platforms, using the IDEAL Framework. METHODS A scoping review exploring robotic minimally invasive surgical devices, technology and systems in use or being developed was performed, including general surgery, gynaecology, urology and cardiothoracics. Systems operating purely outside the abdomen or thorax and endoluminal or natural orifice platforms were excluded. PubMed, Google Scholar, journal reports and information from the public domain were collected. Each company was approached via email for a virtual interview to discover more about the systems and to quality check data. The IDEAL Framework is an internationally accepted tool to evaluate novel surgical technology, consisting of four stages: idea, development/exploration, assessment, and surveillance. An IDEAL stage, synonymous with validation status in this review, was assigned by reviewing the published literature. RESULTS 21 companies with 23 different robotic platforms were identified for data collection, 13 with national and/or international regulatory approval. Of the 17 multiport systems, 1 is fully evaluated at stage 4, 2 are stage 3, 6 stage 2b, 2 at stage 2a, 2 stage 1, and 4 at the pre-IDEAL stage 0. Of the 6 single-port systems none have been fully evaluated with 1 at stage 3, 3 at stage 1 and 2 at stage 0. CONCLUSIONS The majority of existing robotic platforms are currently at the preclinical to developmental and exploratory stage of evaluation. Using the IDEAL framework will ensure that emerging robotic platforms are fully evaluated with long-term data, to inform the surgical workforce and ensure patient safety.
Collapse
Affiliation(s)
- M Boal
- The Griffin Institute, Northwick Park and St Marks Hospital, London, UK
- Wellcome/EPSRC Centre for Intervention and Surgical Sciences, University College London, London, UK
- Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) Academy, London, UK
| | | | - F Tesfai
- The Griffin Institute, Northwick Park and St Marks Hospital, London, UK
- Wellcome/EPSRC Centre for Intervention and Surgical Sciences, University College London, London, UK
- Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) Academy, London, UK
| | - T E M Morrison
- Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) Academy, London, UK
| | - S Higgs
- Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | - J Ahmad
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - A Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - N Francis
- The Griffin Institute, Northwick Park and St Marks Hospital, London, UK.
- Yeovil District Hospital, Somerset NHS Foundation Trust, Yeovil, UK.
| |
Collapse
|
6
|
Xu L, Li X, Fan S, Li Z, Zuo W, Chen S, Zhang P, Cui L, Zhou L, Yang K, Li X. Analysis of KangDuo-SR-1500 and KangDuo-SR-2000 robotic partial nephrectomy from an operative and ergonomic perspective: a prospective controlled study in porcine models. J Robot Surg 2024; 18:26. [PMID: 38217779 DOI: 10.1007/s11701-023-01770-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/22/2023] [Indexed: 01/15/2024]
Abstract
The objective of this study is to explore the safety and effectiveness of two new models of KangDuo surgical robots for partial nephrectomy in porcine models, and evaluate the ergonomic characteristics from both subjective and objective perspectives. Twelve porcine models were equally divided for KD-SR-1500 (three-arm) and KD-SR-2000 (four-arm). The perioperative outcomes, and physical and mental workload of the surgeon were compared. Physical workload was evaluated with surface electromyography. Mental workload was evaluated with NASA-TLX. All surgeries were performed successfully. There were no differences in perioperative variables (p > 0.05). There were no perioperative complications. The mental workload in both groups was at a low level. KD-SR-2000 showed advantages in physical workload (p < 0.01). KD-SR-1500 and KD-SR-2000 are technically feasible, valid, and safe for RAPN in porcine models. KD-SR-2000 had ergonomic advantages over KD-SR-1500.
Collapse
Affiliation(s)
- Liqing Xu
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xinfei Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Shubo Fan
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Zhihua Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Wei Zuo
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Silu Chen
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Peng Zhang
- Department of Urology, Emergency General Hospital, Beijing, 100028, China
| | - Liang Cui
- Department of Urology, School of Clinical Medicine, Civil Aviation General Hospital, Peking University Aerospace, Beijing, 100080, China
| | - Liqun Zhou
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Kunlin Yang
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Xuesong Li
- Department of Urology, Institute of Urology, Peking University First Hospital, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| |
Collapse
|
7
|
Xiong S, Fan S, Chen S, Wang X, Han G, Li Z, Zuo W, Li Z, Yang K, Zhang Z, Shen C, Zhou L, Li X. Robotic urologic surgery using the KangDuo-Surgical Robot-01 system: A single-center prospective analysis. Chin Med J (Engl) 2023; 136:2960-2966. [PMID: 38013503 PMCID: PMC10752469 DOI: 10.1097/cm9.0000000000002920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. METHODS From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. RESULTS A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. CONCLUSION The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Collapse
Affiliation(s)
- Shengwei Xiong
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Shubo Fan
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Silu Chen
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Guanpeng Han
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Zhihua Li
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Wei Zuo
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Zhenyu Li
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Zhongyuan Zhang
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Cheng Shen
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Beijing 100034, China
- Institute of Urology, Peking University, Beijing 100034, China
- National Urological Cancer Center, Beijing 100034, China
| |
Collapse
|
8
|
Chen S, Fan S, Guan H, Yang K, Li Z, Xiong S, Wang X, Li Z, Shen C, Zhou L, Li X. The application of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy with a new robotic system KangDuo Surgical Robot-01: Initial experience. Asian J Urol 2023; 10:482-487. [PMID: 38024439 PMCID: PMC10659978 DOI: 10.1016/j.ajur.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/21/2023] [Accepted: 03/15/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To assess the feasibility of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy (rRAPN) with a new robotic platform called KangDuo Surgical Robot-01 (KD-SR-01) system (Suzhou KangDuo Robot Co., Ltd., Suzhou, China) and discuss its surgical technique. Methods A 44-year-old male patient was admitted with a 2.5 cm tumor on dorsolateral upper pole of the left kidney. The R.E.N.A.L. nephrometry score of this patient was 4x. This patient underwent rRAPN with KD-SR-01. The perinephric fat between the tumor and Gerota's fascia was preserved, which was used for internal suspension traction during tumor resection. Postoperative follow-up data were collected. Results The surgery was successfully carried out with a duration of 127 min, in which the docking time was 6 min 25 s and console time was 60 min. The warm ischemia time was 19 min 53 s, and the estimated blood loss was 0 mL. The pathological histology showed a pathological tumor stage 1a clear cell renal cell carcinoma, with a negative surgical margin. The World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade of this patient was Grade 2. No recurrence was observed during the 6-month follow-up. Conclusion Internal suspension in rRAPN is feasible and effective with use of the new robotic system KD-SR-01.
Collapse
Affiliation(s)
| | | | | | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Zhihua Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Shengwei Xiong
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Xiang Wang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Zhenyu Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Cheng Shen
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Xicheng District, Beijing, China
| |
Collapse
|
9
|
Di Maida F, Cadenar A, Mari A, Minervini A. Re: Xuesong Li, Weifeng Xu, Shubo Fan, et al. Robot-assisted Partial Nephrectomy with the Newly Developed KangDuo Surgical Robot Versus the da Vinci Si Surgical System: A Double-center Prospective Randomized Controlled Noninferiority Trial. Eur Urol Focus 2023:9:133-40. Eur Urol Focus 2023; 9:853-854. [PMID: 37028985 DOI: 10.1016/j.euf.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Fabrizio Di Maida
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence, Italy.
| | - Anna Cadenar
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Unit of Oncologic Minimally Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| |
Collapse
|