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Robotic single-port transumbilical surgery in humans: initial report
Jihad H Kaouk1, Raj K Goel, Georges-Pascal Haber
1Section of Laparoscopic and Robotic Surgery, Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA. kaoukj@ccf.org
BJU International
|September 10, 2008
Summary
Robotic single-port (RSP) surgery shows promise for complex procedures like radical prostatectomy and nephrectomy. This initial experience demonstrates feasibility and safety, with minimal patient pain and no complications.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Single-port surgery aims to reduce invasiveness but faces technical challenges.
- Robotic assistance may overcome limitations of traditional laparoscopic single-port approaches.
Purpose of the Study:
- To evaluate the initial clinical feasibility and outcomes of robotic single-port (RSP) surgery.
- To assess the application of RSP surgery for radical prostatectomy, pyeloplasty, and radical nephrectomy.
Main Methods:
- Utilized the da Vinci S robot for three different urological procedures.
- Introduced robotic instruments through a multichannel single port and an additional robotic port within a 2 cm umbilical incision.
- Performed intracorporeal suturing for vesico-urethral and pelvi-ureteric anastomoses.
Main Results:
- All procedures were successfully completed via a single umbilical incision without additional ports.
- Operative times ranged from 2.5 to 5 hours with minimal blood loss (250 mL for RP).
- Hospital stays were short (36-50 hours), with no intraoperative or postoperative complications and minimal pain (VAS 0/10) at 1 week.
Conclusions:
- Robotic technology can effectively address technical challenges in single-port surgery.
- Robotic instrument articulation may redefine laparoscopic principles, particularly for intracorporeal suturing.
- This series represents the initial application of robotic surgery through a single transumbilical incision.
