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Rapid communication: robot-assisted NOTES nephrectomy: initial report.

Geoffrey N Box1, Hak J Lee, Ricardo J S Santos

  • 1Department of Urology, University of California, Irvine, California, USA.

Journal of Endourology
|March 22, 2008
PubMed
Summary
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This study demonstrates the first robot-assisted Natural Orifice Transluminal Endoscopic Surgery (NOTES) nephrectomy in a porcine model. The novel combined transvaginal and transcolonic approach achieved successful kidney removal with minimal blood loss.

Area of Science:

  • Minimally Invasive Surgery
  • Urologic Oncology
  • Robotic Surgery

Background:

  • Natural Orifice Transluminal Endoscopic Surgery (NOTES) has not been applied to urologic surgery.
  • The daVinci robotic system offers advanced capabilities for minimally invasive procedures.

Purpose of the Study:

  • To present the initial experience of a combined transvaginal and transcolonic, single-port, robot-assisted NOTES nephrectomy.
  • To evaluate the feasibility of this novel approach in a preclinical setting.

Main Methods:

  • An acute experiment was conducted in a female farm pig.
  • A single-port robotic system was utilized with transvaginal and transcolonic access.
  • The daVinci S robot facilitated dissection and renal vessel ligation.

Related Experiment Videos

Main Results:

  • The procedure, a robot-assisted NOTES nephrectomy, was completed in 150 minutes.
  • Estimated blood loss was minimal, less than 50 mL.
  • No intraoperative complications were observed during the acute experiment.

Conclusions:

  • Robot-assisted NOTES nephrectomy is feasible in a porcine model.
  • Further investigation in survival animal models is warranted to validate this approach.