1
|
Noshiro H, Ide T, Nomura A, Yoda Y, Hiraki M, Manabe T. Introduction of a new surgical robot platform "hinotori™" in an institution with established da Vinci surgery™ for digestive organ operations. Surg Endosc 2024; 38:3929-3939. [PMID: 38839604 DOI: 10.1007/s00464-024-10918-4] [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: 03/13/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND New platforms for robotic surgery have recently become available for clinical use; however, information on the introduction of new surgical robotic platforms compared with the da Vinci™ surgical system is lacking. In this study, we retrospectively determined the safe introduction of the new "hinotori™" surgical robot in an institution with established da Vinci surgery using four representative digestive organ operations. METHODS Sixty-one patients underwent robotic esophageal, gastric, rectal, and pancreatic operations using the hinotori system in our department in 2023. Among these, 22 patients with McKeown esophagectomy, 12 with distal gastrectomy, 11 with high- and low-anterior resection of the rectum, and eight with distal pancreatectomy procedures performed by hinotori were compared with historical controls treated using da Vinci surgery. RESULTS The console (cockpit) operation time for distal gastrectomy and rectal surgery was shorter in the hinotori group compared with the da Vinci procedure, and there were no significant differences in the console times for the other two operations. Other surgical results were almost similar between the two robot surgical groups. Notably, the console times for hinotori surgeries showed no significant learning curves, determined by the cumulative sum method, for any of the operations, with similar values to the late phase of da Vinci surgery. CONCLUSIONS This study suggests that no additional learning curve might be required to achieve proficient surgical outcomes using the new hinotori surgical robotic platform, compared with the established da Vinci surgery.
Collapse
Affiliation(s)
- Hirokazu Noshiro
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Takao Ide
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Akinari Nomura
- Department of Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yukie Yoda
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Masatsugu Hiraki
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Tatsuya Manabe
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| |
Collapse
|
2
|
Rocco B, Moschovas MC, Saikali S, Gaia G, Patel V, Sighinolfi MC. Insights from telesurgery expert conference on recent clinical experience and current status of remote surgery. J Robot Surg 2024; 18:240. [PMID: 38833111 PMCID: PMC11150305 DOI: 10.1007/s11701-024-01984-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: 05/10/2024] [Accepted: 05/11/2024] [Indexed: 06/06/2024]
Abstract
Remote surgery provides opportunity for enhanced surgical capabilities, wider healthcare reach, and potentially improved patient outcomes. The network reliability is the foundation of successful implementation of telesurgery. It relies on a robust, high-speed communication network, with ultra-low latency. Significant lag has been shown to endanger precision and safety. Furthermore, the full-fledged adoption of telerobotics demands careful consideration of ethical challenges too. A deep insight into these issues has been investigated during the first Telesurgery Consensus Conference that took place in Orlando, Florida, USA, on the 3rd and 4th of February, 2024. During the Conference, the state of the art of remote surgery has been reported from robotic systems displaying telesurgery potential. The Hinotori, a robotic-assisted surgery platform developed by Medicaroid, experienced remote surgery as pre-clinical testing only; the Edge Medical Company, Shenzen, China, reported more than one hundred animal and 30 live human surgeries; the KanGuo reported human telesurgical cases performed with distances more than 3000 km; the Microport, China, collected more than 100 human operations at a distance up to 5000 km. Though, several issues-cybersecurity, data privacy, technical malfunctions - are yet to be addressed before a successful telesurgery implementation. Expanding the discussion to encompass ethical, financial, regulatory, and legal considerations is essential too. The Telesurgery collaborative community is working together to address and establish the best practices in the field.
Collapse
Affiliation(s)
- Bernardo Rocco
- Urology Unit, ASST Santi Paolo and Carlo, University of Milan, via Rudini 8, Milan, Italy
| | | | - Shady Saikali
- Adventhealth, Global Robotic Institute, Celebration, FL, 34747, USA
| | - Giorgia Gaia
- Gynecology Unit, ASST Santi Paolo and Carlo, University of Milan, Milan, Italy
| | - Vipul Patel
- Adventhealth, Global Robotic Institute, Celebration, FL, 34747, USA
| | | |
Collapse
|
3
|
Miyake H, Fujisawa M. Early experience and future prospects regarding use of newly developed surgical robot system, hinotori, in the field of urologic cancer surgery. Int J Clin Oncol 2024; 29:640-646. [PMID: 38625439 PMCID: PMC11130061 DOI: 10.1007/s10147-024-02503-5] [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: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
In the field of urology, robotic surgery has gained rapid and wide acceptance as a standard surgical approach in the majority of major surgeries over the last decade. To date, the da Vinci surgical system has been the dominant platform in robotic surgery; however, several newly developed robotic systems have recently been introduced in routine clinical practice. Of these, hinotori, the first made-in-Japan robotic system, is characterized by various unique and attractive features different from the existing system, and the use of this system has gradually increased mainly in urologic cancer surgeries, including radical prostatectomy, partial nephrectomy, radical nephrectomy, and radical nephroureterectomy. This review initially describes detailed characteristics of hinotori, then summarizes the early experience with urologic cancer surgeries using hinotori at our institution, and finally discusses the future prospects of robotic surgery using hinotori, considering problems associated with the use of this robotic system.
Collapse
Affiliation(s)
- Hideaki Miyake
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
| | - Masato Fujisawa
- Division of Urology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| |
Collapse
|
4
|
Sasaki Y, Kusuhara Y, Oyama T, Nishiyama M, Kobayashi S, Daizumoto K, Tomida R, Ueno Y, Fukawa T, Yamaguchi K, Yamamoto Y, Takahashi M, Kanayama H, Furukawa J. Radical prostatectomy using the Hinotori robot-assisted surgical system: Docking-free design may contribute to reduction in postoperative pain. Int J Med Robot 2024; 20:e2648. [PMID: 38824454 DOI: 10.1002/rcs.2648] [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: 01/12/2024] [Revised: 05/01/2024] [Accepted: 05/24/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND The docking-free design of the Japanese Hinotori surgical robotic system allows the robotic arm to avoid trocar grasping, thereby minimising excessive abdominal wall stress. The aim of this study was to evaluate the safety and efficacy of robotic-assisted radical prostatectomy (RARP) using the Hinotori system and to explore the potential contribution of its docking-free design to postoperative pain reduction. METHODS This study reviewed the clinical records of 94 patients who underwent RARP: 48 patients in the Hinotori group and 46 in the da Vinci Xi group. RESULTS Hinotori group had significantly longer operative and console times (p = 0.030 and p = 0.029, respectively). Perioperative complications and oncologic outcomes did not differ between the two groups. On postoperative day 4, the rate of decline from the maximum visual analogue scale score was marginally significant in the Hinotori group (p = 0.062). CONCLUSIONS The docking-free design may contribute to reducing postoperative pain.
Collapse
Affiliation(s)
- Yutaro Sasaki
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoshito Kusuhara
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takuro Oyama
- Department of Anesthesiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mitsuki Nishiyama
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Saki Kobayashi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kei Daizumoto
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Ryotaro Tomida
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoshiteru Ueno
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Tomoya Fukawa
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kunihisa Yamaguchi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yasuyo Yamamoto
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masayuki Takahashi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | | | - Junya Furukawa
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| |
Collapse
|
5
|
Kohjimoto Y, Yamashita S, Iwagami S, Muraoka S, Wakamiya T, Hara I. hinotori TM vs. da Vinci ®: propensity score-matched analysis of surgical outcomes of robot-assisted radical prostatectomy. J Robot Surg 2024; 18:130. [PMID: 38498237 DOI: 10.1007/s11701-024-01877-y] [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: 01/15/2024] [Accepted: 02/20/2024] [Indexed: 03/20/2024]
Abstract
hinotori™ is a recently developed surgical robot system. The present study aims to compare intraoperative and postoperative outcomes of robot-assisted radical prostatectomy (RARP) by the hinotori™ system compared with those of the longer-established da Vinci® system. This study includes 100 consecutive patients who underwent RARP by da Vinci® and 60 patients who underwent RARP by hinotori™. To minimize imbalances of patient demographics between the two groups, 1:1 propensity score-matching was performed, and 43 patients each were assigned to the da Vinci® and hinotori™ groups after matching. In the propensity score-matched cohort, we could not find significant differences in patient demographics between the two groups. Surgical outcomes, operative time, and console time in the hinotori™ group were significantly longer than those in the da Vinci® group. Meanwhile, we could not find significant differences in other outcomes between the two groups, such as estimated blood loss, intraoperative complications, major postoperative complications (Clavien-Dindo grade 3 or 4) or length of hospital stay after surgery. The rate of positive cancer margin in the hinotori™ group was higher than that in the da Vinci® group, but significant difference could not be found between the two groups. Moreover, we could not find significant differences in urinary continence rates after surgery between the da Vinci® and hinotori™ groups. Our results suggest that the hinotori™ surgical robot system could provide comparable surgical outcomes to that of the da Vinci® system for patients undergoing RARP.
Collapse
Affiliation(s)
- Yasuo Kohjimoto
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Shimpei Yamashita
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan.
| | - Sohei Iwagami
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Satoshi Muraoka
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Takahito Wakamiya
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| | - Isao Hara
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan
| |
Collapse
|
6
|
Inoue S, Nakauchi M, Umeki Y, Suzuki K, Serizawa A, Akimoto S, Watanabe Y, Tanaka T, Shibasaki S, Inaba K, Uyama I, Suda K. First clinical experiences of robotic gastrectomy for gastric cancer using the hinotori™ surgical robot system. Surg Endosc 2024; 38:1626-1636. [PMID: 38332175 DOI: 10.1007/s00464-024-10695-0] [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: 11/19/2023] [Accepted: 01/02/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Although the da Vinci™ Surgical System is the most predominantly used surgical robot worldwide, other surgical robots are being developed. The Japanese surgical robot hinotori™ Surgical Robot System was launched and approved for clinical use in Japan in November 2022. We performed the first robotic gastrectomy for gastric cancer using hinotori in the world. Here, we report our initial experience and evaluation of the feasibility and safety of robotic gastrectomy for gastric cancer using hinotori. METHODS A single-institution retrospective study was conducted. Between November 2022 and October 2023, 24 patients with gastric cancer underwent robotic gastrectomy with hinotori. Five ports, including one for an assistant, were placed in the upper abdomen, and gastric resection with standard lymphadenectomy and intracorporeal reconstruction were performed. The primary endpoint was the postoperative complication rate within 30 days after surgery. The secondary outcomes were surgical outcomes, including intraoperative adverse events, operative time, blood loss, and the number of dissected nodes. RESULTS Of the 24 patients, 16 (66.7%) were male. The median age and body mass index were 73.5 years and 22.9 kg/m2, respectively. Twenty-three patients (95.8%) had tumors in the middle to lower stomach. Sixteen (66.7%) and seven (29.2%) patients had clinical stage I and II diseases, respectively. Twenty-three (95.8%) patients underwent distal gastrectomy. No patient had postoperative complications of Clavien-Dindo classification IIIa or higher, whereas two (8.3%) had the grade II complications (enteritis and pneumonia). No intraoperative adverse events, including conversion to other approaches, were observed. All patients received R0 resection. The median operative and console times were 400 and 305 min, respectively. The median blood loss was 14.5 mL, and the number of lymph nodes dissected was 51.5. CONCLUSIONS This study found that robotic gastrectomy with standard lymphadenectomy for gastric cancer using hinotori can be safely performed.
Collapse
Affiliation(s)
- Seiji Inoue
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | - Masaya Nakauchi
- Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Yusuke Umeki
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | | | - Akiko Serizawa
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | - Shingo Akimoto
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | - Yusuke Watanabe
- Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Tsuyoshi Tanaka
- Department of Surgery, Fujita Health University, Toyoake, Japan
| | | | - Kazuki Inaba
- Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Ichiro Uyama
- Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
- Collaborative Laboratory for Research and Development in Advanced Surgical Technology, Fujita Health University, Toyoake, Japan
| | - Koichi Suda
- Department of Surgery, Fujita Health University, Toyoake, Japan
- Collaborative Laboratory for Research and Development in Advanced Surgical Intelligence, Fujita Health University, Toyoake, Japan
| |
Collapse
|
7
|
Motoyama D, Matsushita Y, Watanabe H, Tamura K, Otsuka A, Fujisawa M, Miyake H. Robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using the novel surgical robot platform, hinotori: Initial experience with two cases. IJU Case Rep 2024; 7:96-99. [PMID: 38440702 PMCID: PMC10909141 DOI: 10.1002/iju5.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction A newly developed surgical robot system, hinotori, with various unique advantages has been in clinical use in Japan; however, there have not been any studies of robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori. Case presentation We describe two male patients aged 67 and 76 years old with right renal cell carcinoma and a level II and I inferior vena cava tumor thrombus, respectively, undergoing robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori. Both operations were successfully completed with a purely robotic procedure without any major perioperative complications, resulting in the following findings: time using robotic system, 158 and 156 min; total operative time, 228 and 214 min; estimated blood loss, 535 and 200 mL, respectively. Conclusion Based on our first experience, robot-assisted radical nephrectomy and inferior vena cava tumor thrombectomy using hinotori may be an effective treatment for renal cell carcinoma with inferior vena cava tumor thrombus ≤level II.
Collapse
Affiliation(s)
- Daisuke Motoyama
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
- Department of Developed Studies for Advanced Robotic SurgeryHamamatsu University School of MedicineHamamatsuJapan
| | - Yuto Matsushita
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| | - Hiromitsu Watanabe
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| | - Keita Tamura
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| | - Atsushi Otsuka
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| | - Masato Fujisawa
- Division of UrologyKobe University Graduate School of MedicineKobeJapan
| | - Hideaki Miyake
- Department of UrologyHamamatsu University School of MedicineHamamatsuJapan
| |
Collapse
|
8
|
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
|
9
|
Gamal A, Moschovas MC, Jaber AR, Saikali S, Perera R, Headley C, Patel E, Rogers T, Roche MW, Leveillee RJ, Albala D, Patel V. Clinical applications of robotic surgery platforms: a comprehensive review. J Robot Surg 2024; 18:29. [PMID: 38231279 DOI: 10.1007/s11701-023-01815-4] [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: 10/23/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024]
Abstract
Robotic surgery has expanded globally across various medical specialties since its inception more than 20 years ago. Accompanying this expansion were significant technological improvements, providing tremendous benefits to patients and allowing the surgeon to perform with more precision and accuracy. This review lists some of the different types of platforms available for use in various clinical applications. We performed a literature review of PubMed and Web of Science databases in May 2023, searching for all available articles describing surgical robotic platforms from January 2000 (the year of the first approved surgical robot, da Vinci® System, by Intuitive Surgical) until May 1st, 2023. All retrieved robotic platforms were then divided according to their clinical application into four distinct groups: soft tissue robotic platforms, orthopedic robotic platforms, neurosurgery and spine platforms, and endoluminal robotic platforms. Robotic surgical technology has undergone a rapid expansion over the last few years. Currently, multiple robotic platforms with specialty-specific applications are entering the market. Many of the fields of surgery are now embracing robotic surgical technology. We review some of the most important systems in clinical practice at this time.
Collapse
Affiliation(s)
- Ahmed Gamal
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA.
| | - Marcio Covas Moschovas
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
- University of Central Florida (UCF), Orlando, FL, USA
| | - Abdel Rahman Jaber
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Shady Saikali
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Roshane Perera
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Chris Headley
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Ela Patel
- Stanford University, Palo Alto, CA, USA
| | - Travis Rogers
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
| | - Martin W Roche
- Department of Arthroplasty, Hospital for Special Surgery Florida, West Palm Beach, FL, USA
| | | | - David Albala
- Associated Medical Professionals, Urology, Syracuse, NY, USA
| | - Vipul Patel
- Adventhealth Global Robotics Institute, 380 Celebration Place, Orlando, FL, 34747, USA
- University of Central Florida (UCF), Orlando, FL, USA
| |
Collapse
|
10
|
Kilic S, Sambel M, Inal MR, Berk BF, Yilmaz K, Olcucu MT, Ates M. Early outcomes of robotic retroperitoneal partial nephrectomy: evaluating surgical success with margin, ischemia, and complication score. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230825. [PMID: 38055454 DOI: 10.1590/1806-9282.20230825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/26/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the minimum number of required cases for successful robotic retroperitoneal partial nephrectomy for an experienced surgeon in transperitoneal robotic surgery. METHODS Our prospectively collected clinic database was evaluated retrospectively, and 50 patients who underwent robotic retroperitoneal partial nephrectomy by a single experienced surgeon from January 2019 to February 2023 were included in this study. Demographic and perioperative data and R.E.N.A.L. nephrometry scores were noted. margin, ischemia, and complication score was used to predict surgical success. Receiver operating characteristic curve analysis was used to determine how many cases were required to achieve margin, ischemia, and complication score positivity and to apply the off-clamp technique. Also, the first 25 patients were assigned to Group 1 and the second 25 patients to Group 2, and the data were compared between the groups. RESULTS The patients' demographic data and tumor characteristics were similar in the groups. The off-clamp technique and sutureless technique rates in Group 2 were significantly higher than that in Group 1. Margin, ischemia, and complication score positivity was observed in 60% (n=15) of Group 1 and 96% (n=24) of Group 2. At receiver operating characteristic curve analysis, the 25th and later cases were statistically significant in terms of margin, ischemia, and complication score positivity. In terms of performing surgery with the off-clamp technique, the 28th and subsequent cases were statistically significant. CONCLUSION A total of 25 or more cases appear to be sufficient to provide optimal surgical results in robotic retroperitoneal partial nephrectomy for an experienced surgeon.
Collapse
Affiliation(s)
- Sahin Kilic
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Murat Sambel
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Mehmet Resat Inal
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Batuhan Furkan Berk
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Kayhan Yilmaz
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Mahmut Taha Olcucu
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| | - Mutlu Ates
- Antalya Training and Research Hospital, Department of Urology - Antalya, Turkey
| |
Collapse
|
11
|
Salkowski M, Checcucci E, Chow AK, Rogers CC, Adbollah F, Liatsikos E, Dasgupta P, Guimaraes GC, Rassweiler J, Mottrie A, Breda A, Crivellaro S, Kaouk J, Porpiglia F, Autorino R. New multiport robotic surgical systems: a comprehensive literature review of clinical outcomes in urology. Ther Adv Urol 2023; 15:17562872231177781. [PMID: 37325289 PMCID: PMC10265325 DOI: 10.1177/17562872231177781] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/08/2023] [Indexed: 06/17/2023] Open
Abstract
Over the past 20 years, the field of robotic surgery has largely been dominated by the da Vinci robotic platform. Nevertheless, numerous novel multiport robotic surgical systems have been developed over the past decade, and some have recently been introduced into clinical practice. This nonsystematic review aims to describe novel surgical robotic systems, their individual designs, and their reported uses and clinical outcomes within the field of urologic surgery. Specifically, we performed a comprehensive review of the literature regarding the use of the Senhance robotic system, the CMR-Versius robotic system, and the Hugo RAS in urologic procedures. Systems with fewer published uses are also described, including the Avatera, Hintori, and Dexter. Notable features of each system are compared, with a particular emphasis on factors differentiating each system from the da Vinci robotic system.
Collapse
Affiliation(s)
| | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy
| | | | - Craig C. Rogers
- Department of Urology, VCORE-Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation, Henry Ford Hospital, Detroit, MI, USA
| | - Firas Adbollah
- Department of Urology, VCORE-Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation, Henry Ford Hospital, Detroit, MI, USA
| | - Evangelos Liatsikos
- Department of Urology, University General Hospital of Patras, Patras, Greece
| | - Prokar Dasgupta
- King’s Health Partners Academic Surgery, King’s College London, London, UK
| | | | - Jens Rassweiler
- Department of Urology and Andrology, Danube Private University, Krems, Austria
| | - Alexander Mottrie
- ORSI Academy, Ghent, Belgium
- Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - Simone Crivellaro
- Department of Urology, University of Illinois Chicago, Chicago, IL, USA
| | - Jihad Kaouk
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology and San Luigi Gonzaga Hospital, University of Turin, Torino, Italy
| | | |
Collapse
|