Use of a Novel Articulating Laparoscopic Needle Driver for Partial nephrectomy: An Initial Experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Partial nephrectomy (PN) is often underutilized with minimally invasive techniques.
• Articulating instruments may enhance capabilities in laparoscopic partial nephrectomy (LPN).

Purpose of the Study:

• To assess the clinical feasibility and safety of an articulated laparoscopic needle driver for LPN.
• To compare outcomes of LPN using this novel device with robot-assisted laparoscopic PN (RALPN).

Main Methods:

• A prospective cohort of 20 patients underwent LPN using an articulating needle driver.
• A retrospective comparison group of 10 patients who had RALPN was selected.
• Preoperative, perioperative, and postoperative data were collected and analyzed.

Main Results:

• The articulating needle driver group (LPN) and RALPN group had similar R.E.N.A.L. nephrometry scores and warm ischemia times.
• Estimated blood loss was significantly lower in the RALPN group (50 mL) compared to the LPN group (200 mL) (P= .03).
• Operative time, length of stay, and transfusion rates were comparable between the LPN and RALPN cohorts.

Conclusions:

• The novel articulating laparoscopic needle driver is clinically safe and feasible for performing LPN.
• Outcomes using the articulating needle driver for LPN were equivalent to those achieved with RALPN.
• This device shows promise for enhancing minimally invasive approaches to partial nephrectomy.