MP50-09 ROBOTIC FLEXIBLE URETEROSCOPIC TREATMENT OF RENAL AND URETERAL CALCULI: FIRST-IN-MAN EXPERIENCE WITH A NOVEL ROBOTIC SYSTEM

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy V1 Apr 2017MP50-09 ROBOTIC FLEXIBLE URETEROSCOPIC TREATMENT OF RENAL AND URETERAL CALCULI: FIRST-IN-MAN EXPERIENCE WITH A NOVEL ROBOTIC SYSTEM Mihir Desai, Shashikant Mishra, Abhishek Singh, Ravindra Sabnis, Arvind Ganpule, and Mahesh Desai Mihir DesaiMihir Desai More articles by this author , Shashikant MishraShashikant Mishra More articles by this author , Abhishek SinghAbhishek Singh More articles by this author , Ravindra SabnisRavindra Sabnis More articles by this author , Arvind GanpuleArvind Ganpule More articles by this author , and Mahesh DesaiMahesh Desai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1597AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To present the first in man experience with the Robotic Endoscopy System (RES) for the treatment of renal and ureteral calculi. METHODS The RES is a novel system comprised of a remote-driven robotic flexible ureteroscope and robotic access sheath. The robotic ureteroscope incorporates digital optics and the system has the ability to control the laser fiber and irrigation inflow-outflow remotely. The system has a stroke length to navigate the collecting system from the urethra to the kidney. The primary performance endpoint was completion of the intended procedure; the primary safety endpoint was incidence of perioperative complication. The RES performance was graded on a visual analog scale of 1 (worst) to 10 (best) for stability, ease of locating stones, ability to fragment, control and visualization. P values were calculated using the Mann-Whitney U test or Fisher's exact test. RESULTS Of 18 screened adult patients, 16 underwent flexible robotic ureteroscopy (11 with 1; 4 with 2 and 1 with 3 stones). Two patients were excluded intraoperatively due to ureteral strictures. The twenty-two treated stones were distributed throughout the collecting system (n = 7 lower pole, n = 5 renal pelvis, n = 5 interpolar, n = 3 upper ureter, n = 1 upper pole and n = 1 distal ureter). Median stone size was 10 (6 to 20) mm. All procedures were completed successfully using robotic control. One patient experienced fever (101°F) that resolved without intervention. Overall, median total procedure time (TPT) was 73.5 (range = 21 to 131) minutes; median total robot time (TRT) was 42 (6 to 99) minutes. In patients with a single stone only, median TPT decreased from 98 (50 to 131) minutes (first 5 cases) to 40 (21 to 77) minutes (last 6 cases), P = 0.036; median TRT also decreased from 44 (20 to 89) minutes (first 5 cases) to 19.5 (6 to 43) minutes (last 6 cases), P = 0.055. In 5 patients with lower pole stones, median TPT was 50 (21 to 131) minutes; median TRT was 20 (16 to 76) minutes. Stability, ease of locating stone and control, as evaluated by number of scores greater than 9, improved significantly in the last 6 cases(P = 0.035). CONCLUSIONS The robotic ureteroscopy with calculi lithotripsy is safe and feasible using the RES. Future comparative studies to manual ureteroscopy are warranted. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e687 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mihir Desai More articles by this author Shashikant Mishra More articles by this author Abhishek Singh More articles by this author Ravindra Sabnis More articles by this author Arvind Ganpule More articles by this author Mahesh Desai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...