Abstract

Robotic technology for use in surgery has advanced considerably in the past 10 years. This has become particularly apparent in urology where robotic-assisted radical prostatectomy using the da Vinci surgical system (Intuitive Surgical, CA) has become very popular. The use of robotic assistance for benign urological procedures is less well documented. This article considers the current robotic technology and reviews the situation with regard to robotic surgery for benign urological conditions.

Highlights

  • Urologists have been very quick to embrace some of the most exciting technological advances in surgery over the past 10 years

  • The published literature regarding robotic-assisted urological procedures is dominated by references to robotic-assisted laparoscopic radical prostatectomy, a procedure gaining increasing acceptance

  • The literature pertaining to robotic-assisted surgery for benign urological conditions is dominated by case reports and small cohort series, making it difficult to draw conclusions about the merit or otherwise of robotic procedures described far

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Summary

INTRODUCTION

Urologists have been very quick to embrace some of the most exciting technological advances in surgery over the past 10 years. Though as a specialty we were somewhat reticent about joining the laparoscopic revolution in the 1980s, it is clear that some of the most innovative advances in minimally invasive surgery in recent years have been spearheaded by the urologists Nowhere is this better demonstrated than the proliferation in robot-assisted surgery, especially robot-assisted laparoscopic radical prostatectomy. The development of laparoscope manipulators such as the Automated Endoscopic System for Optimum Positioning (AESOPTM) and EndoAssistTM has certainly found a niche in laparoscopic urological procedures These devices hold the laparoscope under voice, pedal, or infrared motion control and provide steadier images with less instrument collisions than a human assistant[6]. The combination of 3D vision and extra DoF should decrease the difficulty associated with laparoscopic suturing, thereby encouraging the use of the da VinciTM for reconstructive procedures This is already apparent with the reduced learning curve reported for RALP[10]. For ablative procedures such as nephrectomy, it is less clear where the advantage of using this technology may lie

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