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Farré A, Angerri O, Kanashiro A, Casadevall M, Uleri A, Balañà J, Sánchez Martin F, Millan F, Palou J, Emiliani E. Robot-assisted retrograde intrarenal surgery: first clinical experience with the ILY® system. BJU Int 2024. [PMID: 38654441 DOI: 10.1111/bju.16381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
- Alba Farré
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Oriol Angerri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Andrés Kanashiro
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Marta Casadevall
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Alessandro Uleri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Josep Balañà
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Félix Millan
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Esteban Emiliani
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
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Łaszkiewicz J, Krajewski W, Nowak Ł, Chorbińska J, Del Giudice F, Sójka A, Mazur M, Pisarski S, Tomczak W, Małkiewicz B, Szydełko T. Retrograde intrarenal surgery using the ILY robotic flexible ureteroscope: a single centre experience. Cent European J Urol 2024; 77:136-139. [PMID: 38645814 PMCID: PMC11032040 DOI: 10.5173/ceju.2023.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 09/30/2023] [Accepted: 12/10/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction The ILY robotic flexible ureteroscope has been introduced in order to improve intraoperative ergonomics, reduce operator distance from radiation and shorten the learning curve. In this study we aimed to assess the clinical performance and feasibility of the ILY robot during retrograde intrarenal surgery (RIRS) and combined endoscopic procedures (miniECIRS). Material and methods The RIRS procedures were performed using the ILY robotic arm in 57 adult patients (46 RIRS and 11 miniECIRS) from 2022 to 2023. All procedures were performed in the supine position. Pre-stenting was not the standard of care. Results Turning on and calibration of the device took approximately 100 s. Average draping time was 93 s using original ILY drapes and 47 s using classic drapes designed for C-arm covering. Mean docking time was 73 s in procedures with ureteral access sheath (UAS) and 61 s in procedures without it. The undocking took less than 60 s in every case. Average procedure time was 63 min for RIRS and 55 min for miniECIRS. Endoscopically proven stone-free rate was achieved in 37 (80.4%) RIRS and 10 (90.9%) miniECIRS patients. A total of 17 (36.9%) RIRS and 8 (72.7%) miniECIRS procedures required conversion in order to perform basketing and stone fragments retrieval/transposition. Conclusions The use of ILY robot during endourological procedures is feasible and urologists that are familiar with the device controller do not require extensive training. The time needed for device draping, docking and undocking was approximately 4 minutes. Moreover, use of the robot resulted in satisfactory stone-free rates.
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Affiliation(s)
- Jan Łaszkiewicz
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology Wrocław Medical University, Wrocław, Poland
| | - Łukasz Nowak
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology Wrocław Medical University, Wrocław, Poland
| | - Joanna Chorbińska
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology Wrocław Medical University, Wrocław, Poland
| | - Francesco Del Giudice
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Aleksandra Sójka
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Małgorzata Mazur
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Szymon Pisarski
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Wojciech Tomczak
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
| | - Bartosz Małkiewicz
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology Wrocław Medical University, Wrocław, Poland
| | - Tomasz Szydełko
- University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland
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Jahrreiss V, Nedbal C, Castellani D, Gauhar V, Seitz C, Zeng G, Juliebø-Jones P, Keller E, Tzelves L, Geraghty R, Rangarajan K, Traxer O, Philip J, Skolarikos A, Kallidonis P, Bres-Niewada E, Somani B. Is suction the future of endourology? Overview from EAU Section of Urolithiasis. Ther Adv Urol 2024; 16:17562872241232275. [PMID: 38405421 PMCID: PMC10893777 DOI: 10.1177/17562872241232275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Affiliation(s)
- Victoria Jahrreiss
- Department of Urology, Medical University of Vienna, Vienna, Austria
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- EAU Section of Urolithiasis
| | - Carlotta Nedbal
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica Delle Marche, Ancona, Italy
| | - Daniele Castellani
- Urology Unit, Azienda Ospedaliero-Universitaria Delle Marche, Università Politecnica Delle Marche, Ancona, Italy
| | - Vineet Gauhar
- EAU Section on Urolithiasis
- Department of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore
| | - Christian Seitz
- Department of Urology, Medical University of Vienna, Vienna, Austria
- EAU Section on Urolithiasis
| | - Guohua Zeng
- Guangdong Key Laboratory of Urology, Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Etienne Keller
- EAU Section on Urolithiasis
- Department of Urology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Lazaros Tzelves
- Second Department of Urology, Sismanoglio General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Rob Geraghty
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, UK
| | - Karan Rangarajan
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Olivier Traxer
- Department of Urology, AP-HP, Tenon Hospital, Sorbonne University, Paris, France
| | - Joe Philip
- Bristol Urological Institute, Southmead Hospital, Westbury on Trym, Bristol, UK
| | - Andreas Skolarikos
- Second Department of Urology, Sismanoglio General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Ewa Bres-Niewada
- EAU Section on Urolithiasis
- Department of Urology, Roefler Memorial Hospital, Pruszków, Poland
- Faculty of Medicine, Lazarski University, Warsaw, Poland
| | - Bhaskar Somani
- University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
- EAU Section of Urolithiasis
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Fiori C, Cossu M, Poggio M, Quarà A, Di Dio M, De Luca S, Checcucci E, Manfredi M, Amparore D, Porpiglia F. Initial experience with robot-assisted ureteroscopy with Ily® Robot. Minerva Urol Nephrol 2023; 75:761-765. [PMID: 38126287 DOI: 10.23736/s2724-6051.23.05572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The aim of this study is to present the first Italian experience with robotic-assisted retrograde intrarenal surgery (rRIRS) using the Ily® platform. Procedures were performed for renal stones using the Ily® Robot (STERLAB, Vallauris, France), which is a ureteroscope holder with multiple degrees of freedom that can be controlled remotely through a wireless controller. In March 2023, consecutive patients with indications for rRIRS were included in the study. Demographic variables and stone characteristics were collected, and standard perioperative data were assessed. The one-month stone-free rate (SFR, i.e. no residual fragments) was evaluated using ultrasound. All participating surgeons filled out a Surgeons' Satisfaction Questionnaire (SSQ) based on a Likert-type scale. The questionnaire focused on: 1) ease of use; 2) ergonomics during renal cavity exploration; 3) stability during stone fragmentation. Among the patients, one had bilateral stones, while two had stones on the right side. The mean stone size was 13 mm. The average operative time was 70 minutes and the mean docking time was three minutes. No perioperative complications were recorded, and all patients were discharged on the first postoperative day. The one-month SFR was 100%. The SSQ scores were as follows: 1) ease of use: 4/5; 2) ergonomics: 5/5; 3) stability during stone fragmentation: 5/5. Based on the initial experience, the results indicate the feasibility, safety, and effectiveness of rRIRS. The ergonomic efficiency of the system was highly appreciated by the surgeons. While a cost-effectiveness analysis within clinical trials is necessary, rRIRS shows the potential for a more sustainable future for endoscopists and an improved workplace environment.
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Affiliation(s)
- Cristian Fiori
- Department of Oncology, University of Turin, Turin, Italy -
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy -
| | - Marco Cossu
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | | | - Alberto Quarà
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Michele Di Dio
- Department of Surgery, Division of Urology, SS Annunziata Hospital, Cosenza, Italy
| | - Stefano De Luca
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | | | - Matteo Manfredi
- Department of Oncology, University of Turin, Turin, Italy
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Daniele Amparore
- Department of Oncology, University of Turin, Turin, Italy
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Department of Oncology, University of Turin, Turin, Italy
- Division of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
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Juliebø‐Jones P, Ventimiglia E, Somani BK, Æsøy MS, Gjengstø P, Beisland C, Ulvik Ø. Single use flexible ureteroscopes: Current status and future directions. BJUI COMPASS 2023; 4:613-621. [PMID: 37818020 PMCID: PMC10560621 DOI: 10.1002/bco2.265] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/18/2023] [Accepted: 06/04/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Single use ureteroscopes are a technological innovation that have become available in the past decade and gained increased popularity. To this end, there are now an increasing number of both benchside and clinical studies reporting outcomes associated with their use. Our aim was to deliver a narrative review in order to provide an overview of this new technology. Methods A narrative review was performed to gain overview of the history of the technology's development, equipment specifications and to highlight potential advantages and disadvantages. Results Findings from preclinical studies highlight potenial advantages in terms of the design of single use ureteroscopes such as the lower weight and more recent modifications such as pressure control. However, concerns regarding plastic waste and environmental impact still remain unanswered. Clinical studies reveal them to have a non inferior status for outcomes such as stone free rate. However, the volume of evidence, especially in terms of randomised trials remains limited. From a cost perspective, study conclusions are still conflicting and centres are recommended to perform their own micro cost analyses. Conclusions Most clinical outcomes for single use ureteroscopes currently match those achieved by reusable ureteroscopes but the data pool is still limited. Areas of continued debate include their environmental impact and cost efficiency.
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Affiliation(s)
- Patrick Juliebø‐Jones
- Department of UrologyHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
- EAU YAU Urolithiasis groupArmhemNetherlands
| | - Eugenio Ventimiglia
- EAU YAU Urolithiasis groupArmhemNetherlands
- Department of UrologyIRCCS Ospedale San RaffaeleMilanItaly
| | | | | | - Peder Gjengstø
- Department of UrologyHaukeland University HospitalBergenNorway
| | - Christian Beisland
- Department of UrologyHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
| | - Øyvind Ulvik
- Department of UrologyHaukeland University HospitalBergenNorway
- Department of Clinical MedicineUniversity of BergenBergenNorway
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Kim J, Jung HD, Moon YJ, Han H, Cheon B, Han J, Cho SY, Lee JY, Kwon DS. In Vivo Feasibility Test of a New Flexible Ureteroscopic Robotic System, easyUretero, for Renal Stone Retrieval in a Porcine Model. Yonsei Med J 2022; 63:1106-1112. [PMID: 36444546 PMCID: PMC9760888 DOI: 10.3349/ymj.2022.0367] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Using a new robotic endoscopic platform system developed for retrograde intrarenal surgery (RIRS) called easyUretero (ROEN Surgical Inc.), we evaluated the feasibility and safety of renal stone retrieval in a porcine model. MATERIALS AND METHODS Six female pigs were used for our in vivo study. First, 0.3-cm-sized phantom stones were inserted into the kidneys of each pig via the ureteral access sheath. Next, renal stone retrieval was attempted using manual RIRS in three pigs and robotic RIRS in three pigs. Three surgeons performed extraction of 10 stones in each session. RESULTS The mean stone retrieval time by manual RIRS was significantly shorter than that by robotic RIRS (399.9±185.4 sec vs. 1127.6±374.5 sec, p=0.001). In contrast, the questionnaire regarding usability showed high satisfaction in the surgeons' fatigue category for surgeons using robotic RIRS. The radiation exposure dose was also lower in robotic RIRS than in manual RIRS (0.14 µSv vs. 45.5 µSv). Postoperative ureteral injury assessment revealed Grade 0 in manual RIRS cases and Grades 0, 1, and 2 in robotic RIRS cases. CONCLUSION The easyUretero system is a new robotic RIRS system that was developed in Korea. The results of the present study suggest that using easyUretero for stone retrieval during RIRS is safe and ergonomic.
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Affiliation(s)
| | - Hae Do Jung
- Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Young Joon Moon
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunho Han
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Byungsik Cheon
- ROEN Surgical Inc., Daejeon, Korea
- Robotics Program, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Jungmin Han
- ROEN Surgical Inc., Daejeon, Korea
- Robotics Program, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea
| | - Sung Yong Cho
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joo Yong Lee
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Korea.
| | - Dong-Soo Kwon
- ROEN Surgical Inc., Daejeon, Korea
- Department of Mechanical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Korea.
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