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Related Experiment Videos

Stereotactic mechanical percutaneous renal access

J A Cadeddu1, D Stoianovici, R N Chen

  • 1The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.

Journal of Endourology
|June 2, 1998
PubMed
Summary
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A new robotic arm, PAKY, precisely guides needles for percutaneous renal access, improving accuracy and safety in kidney treatments. This system offers a steady platform for robotic surgery, potentially enabling future advancements in minimally invasive procedures.

Area of Science:

  • Urology
  • Robotic Surgery
  • Medical Devices

Background:

  • Percutaneous renal access for intrarenal disease treatment demands high surgical skill.
  • Robotic devices show promise in enhancing accuracy and success rates for percutaneous procedures.
  • Existing robotic systems for renal access face technical challenges, particularly at the device-patient interface.

Purpose of the Study:

  • To develop and clinically assess a novel mechanical arm (PAKY) with active translational motion for percutaneous renal access.
  • To evaluate the PAKY system's accuracy, safety, and efficiency in both in vitro and clinical settings.
  • To establish a foundational mechanical platform for a comprehensive robotic system for percutaneous renal access.

Main Methods:

  • Development of the PAKY system, featuring a passive mechanical arm and a radiolucent needle driver with active translational control.

Related Experiment Videos

  • Utilization of real-time fluoroscopic imaging for needle alignment and placement monitoring.
  • In vitro testing on porcine kidneys with targets and clinical evaluation in nine patients, assessing access accuracy, target location, and procedure time.

    • Main Results:

    • In vitro studies demonstrated 100% successful needle contact with targets, including small 3-mm targets.
    • Clinical application achieved first-attempt percutaneous access to the desired calix in all nine patients.
    • The mean procedure time for access was 8.2 minutes, with no access-related perioperative complications.

    Conclusions:

    • The PAKY system functions as a stable needle holder and an effective, safe end-effector for percutaneous renal access.
    • Early clinical experience suggests the PAKY system is accurate and reliable for guiding needle placement.
    • This device represents a significant step towards developing a fully robotic system for percutaneous renal access procedures.