Single-port, single-operator-light endoscopic robot-assisted laparoscopic urology: pilot study in a pig model

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Single-port surgery offers potential benefits in reducing invasiveness.
• Robotic assistance can enhance surgeon control and dexterity.
• Evaluating novel surgical approaches is crucial for advancing patient care.

Purpose of the Study:

• To assess the feasibility and safety of single-port, single-surgeon robot-assisted reconstructive and extirpative urological surgery.
• To evaluate the utility of a novel robotic endoscope holder in a preclinical model.
• To determine if surgeon experience improves outcomes in this technique.

Main Methods:

• A pilot study was conducted on male farm pigs undergoing bilateral partial nephrectomy, pyeloplasty, and radical nephrectomy.
• Procedures were performed using a single 2-cm umbilical incision with a novel robotic endoscope holder and articulating instruments.
• Intraoperative and postmortem data were collected and analyzed for complications and operative times.

Main Results:

• Five pigs completed bilateral partial nephrectomy, pyeloplasty, and radical nephrectomy without intraoperative complications.
• No additional ports were required during any procedure.
• Mean operative times for partial nephrectomy, pyeloplasty, and nephrectomy were 120, 110, and 20 minutes, respectively.
• Mean estimated blood loss was 240 mL.
• Preparation time decreased significantly with increasing surgical experience (P = 0.002).

Conclusions:

• Single-port robot-assisted urological surgery performed by a single surgeon is feasible and safe.
• The robotic endoscope holder provides enhanced operative space compared to traditional methods.
• This approach holds promise for future minimally invasive urological procedures.