V2158 INTRA-OPERATIVE ULTRASONOGRAPHY USING MINIATURE DROP-TYPE ULTRASOUND PROBE MANIPULATED BY SURGEON DURING ROBOT-ASSISTED PARTIAL NEPHRECTOMY

Abstract

You have accessJournal of UrologyRobotics, Single Port Surgery, LESS, NOTES1 Apr 2013V2158 INTRA-OPERATIVE ULTRASONOGRAPHY USING MINIATURE DROP-TYPE ULTRASOUND PROBE MANIPULATED BY SURGEON DURING ROBOT-ASSISTED PARTIAL NEPHRECTOMY Sunao Shoji, Andre Luis De Castro Abreu, Andrew Hung, James Yu, Scott Leslie, Adrian Fairey, Toyoaki Uchida, Monish Aron, Mihir Desai, Inderbir Gill, and Osamu Ukimura Sunao ShojiSunao Shoji Los Angeles, CA More articles by this author , Andre Luis De Castro AbreuAndre Luis De Castro Abreu Los Angeles, CA More articles by this author , Andrew HungAndrew Hung Los Angeles, CA More articles by this author , James YuJames Yu Los Angeles, CA More articles by this author , Scott LeslieScott Leslie Los Angeles, CA More articles by this author , Adrian FaireyAdrian Fairey Los Angeles, CA More articles by this author , Toyoaki UchidaToyoaki Uchida Hachioji, Japan More articles by this author , Monish AronMonish Aron Los Angeles, CA More articles by this author , Mihir DesaiMihir Desai Los Angeles, CA More articles by this author , Inderbir GillInderbir Gill Los Angeles, CA More articles by this author , and Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2067AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Conventional flexible laparoscopic ultrasound (US) probe or drop-type finger-sized US probe have been used for US guidance during robotic-assisted partial nephrectomy (RAPN). However, disadvantage of the flexible US probe included limited angulations, and requirement of additional assistant to manipulate US probe, while the size of drop-type finger-sized US probe may be suboptimal. We evaluated the utility of miniature US probe (Hitachi Aloka Medical Ltd. CT, USA) manipulated by console surgeon. METHODS Ten patients with age (61 years), median body mass index (27.7), tumor size (3.5 cm), C-index (1.6), RENAL score (8) and PAUDA score (8) were enrolled, including 6 cases of zero-ischemia partial nephrectomy. Mini probe was designed as gdrop-type h to be manipulated by robotic arm with a flexible cord through the laparoscopic port. The size was 9 ∼16 ∼6 mm in diameter, and multi-frequency from 5 to 13 MHz was available, to allow various penetration of US. Intra-operative US data was transferred to the da Vinci console to provide the real-time US image shown directly to surgeon in parallel to the surgical view in the Tile-pro display. RESULTS 9 renal cell carcinomas and 1 angiomyolipoma were dissected with negative margin in all cases (100%). The median time to use intra-operative use of the mini probe was 3minutes. Based on the expert surgeon's rating for the utility of the probe, its utilities were excellent regarding 2 aspects as following: (a) visualization of tumor vascularity and peri-tumor vascularity, and (b) superiority in manipulation of the probe in comparison to the finger-size drop-type US probe. However, the optimal size of the drop-type US probe remained debatable, since the scanned area (9mm) of the miniature US probe seems too small to visualize the tumor margin in case of the tumor with larger diameter. Values of serum creatinine at the time of preoperative (1.18) and discharge (1.10) had no statistical difference (p=0.6). CONCLUSIONS To visualize anatomy beyond the endoscopic view such as tumor margin and feeding artery in console display using intra-operative drop-type US probe manipulated by console surgeon provided a new opportunity of image-guided RAPN. The optimal size of intra-operative drop-type US probe remained debatable. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e884 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sunao Shoji Los Angeles, CA More articles by this author Andre Luis De Castro Abreu Los Angeles, CA More articles by this author Andrew Hung Los Angeles, CA More articles by this author James Yu Los Angeles, CA More articles by this author Scott Leslie Los Angeles, CA More articles by this author Adrian Fairey Los Angeles, CA More articles by this author Toyoaki Uchida Hachioji, Japan More articles by this author Monish Aron Los Angeles, CA More articles by this author Mihir Desai Los Angeles, CA More articles by this author Inderbir Gill Los Angeles, CA More articles by this author Osamu Ukimura Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...