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Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience

PURPOSE: Laparoendoscopic single-site surgery (LESS) reduces the limited invasiveness of conventional laparoscopy while providing superior cosmetic results. However, LESS remains a challenging surgical technique, even in robotic surgery, primarily due to the lack of triangulation and limited instrum...

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Autores principales: Heo, Ji Eun, Kang, Sung Ku, Koh, Dong Hoon, Na, Joon Chae, Lee, Yong Seung, Han, Woong Kyu, Choi, Young Deuk, Jang, Won Sik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607072/
https://www.ncbi.nlm.nih.gov/pubmed/31294143
http://dx.doi.org/10.4111/icu.2019.60.4.326
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author Heo, Ji Eun
Kang, Sung Ku
Koh, Dong Hoon
Na, Joon Chae
Lee, Yong Seung
Han, Woong Kyu
Choi, Young Deuk
Jang, Won Sik
author_facet Heo, Ji Eun
Kang, Sung Ku
Koh, Dong Hoon
Na, Joon Chae
Lee, Yong Seung
Han, Woong Kyu
Choi, Young Deuk
Jang, Won Sik
author_sort Heo, Ji Eun
collection PubMed
description PURPOSE: Laparoendoscopic single-site surgery (LESS) reduces the limited invasiveness of conventional laparoscopy while providing superior cosmetic results. However, LESS remains a challenging surgical technique, even in robotic surgery, primarily due to the lack of triangulation and limited instrument movement. The da Vinci SP surgical system (Intuitive Surgical) was recently introduced to overcome these limitations. We describe our initial experience with pure single-site robot-assisted pyeloplasty (RAP) for ureteropelvic junction obstruction (UPJO) using the da Vinci SP surgical system. MATERIALS AND METHODS: Three consecutive patients who were diagnosed with UPJO underwent RAP with the da Vinci SP surgical system from December 2018 to February 2019 at our institution. The surgical technique involved reproducing the steps of multi-port RAP. A 30-mm umbilical incision was made and the GelPOINT was inserted. The multichannel robotic port and the assistant's port were placed through the GelSeal cap. In all patients, Anderson–Hynes dismembered pyeloplasty was performed. The ureteral double J stent was inserted antegrade, and the drain was not placed. RESULTS: The procedures were successfully completed using a pure single-site approach. There was no need for additional port placement or conversion to laparoscopic or open surgery. Total operative time in the three patients was 139, 180, and 213 minutes, respectively. No intraoperative complications occurred, and blood loss was minimal. The postoperative course of all patients was uneventful with no complications greater than Clavien–Dindo grade I surgical complications. CONCLUSIONS: Pure single-site RAP using the da Vinci SP surgical system is feasible and safe.
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spelling pubmed-66070722019-07-10 Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience Heo, Ji Eun Kang, Sung Ku Koh, Dong Hoon Na, Joon Chae Lee, Yong Seung Han, Woong Kyu Choi, Young Deuk Jang, Won Sik Investig Clin Urol Innovations in Urology PURPOSE: Laparoendoscopic single-site surgery (LESS) reduces the limited invasiveness of conventional laparoscopy while providing superior cosmetic results. However, LESS remains a challenging surgical technique, even in robotic surgery, primarily due to the lack of triangulation and limited instrument movement. The da Vinci SP surgical system (Intuitive Surgical) was recently introduced to overcome these limitations. We describe our initial experience with pure single-site robot-assisted pyeloplasty (RAP) for ureteropelvic junction obstruction (UPJO) using the da Vinci SP surgical system. MATERIALS AND METHODS: Three consecutive patients who were diagnosed with UPJO underwent RAP with the da Vinci SP surgical system from December 2018 to February 2019 at our institution. The surgical technique involved reproducing the steps of multi-port RAP. A 30-mm umbilical incision was made and the GelPOINT was inserted. The multichannel robotic port and the assistant's port were placed through the GelSeal cap. In all patients, Anderson–Hynes dismembered pyeloplasty was performed. The ureteral double J stent was inserted antegrade, and the drain was not placed. RESULTS: The procedures were successfully completed using a pure single-site approach. There was no need for additional port placement or conversion to laparoscopic or open surgery. Total operative time in the three patients was 139, 180, and 213 minutes, respectively. No intraoperative complications occurred, and blood loss was minimal. The postoperative course of all patients was uneventful with no complications greater than Clavien–Dindo grade I surgical complications. CONCLUSIONS: Pure single-site RAP using the da Vinci SP surgical system is feasible and safe. The Korean Urological Association 2019-07 2019-06-25 /pmc/articles/PMC6607072/ /pubmed/31294143 http://dx.doi.org/10.4111/icu.2019.60.4.326 Text en © The Korean Urological Association, 2019 http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Innovations in Urology
Heo, Ji Eun
Kang, Sung Ku
Koh, Dong Hoon
Na, Joon Chae
Lee, Yong Seung
Han, Woong Kyu
Choi, Young Deuk
Jang, Won Sik
Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title_full Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title_fullStr Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title_full_unstemmed Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title_short Pure single-site robot-assisted pyeloplasty with the da Vinci SP surgical system: Initial experience
title_sort pure single-site robot-assisted pyeloplasty with the da vinci sp surgical system: initial experience
topic Innovations in Urology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607072/
https://www.ncbi.nlm.nih.gov/pubmed/31294143
http://dx.doi.org/10.4111/icu.2019.60.4.326
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