Re: Initial complete laparoendoscopic single-site surgery robotic assisted radical prostatectomy(LESS-RARP)

Barret, Éric; Sánchez-Salas, Rafael; Cathelineau, Xavier; Rozet, François; Galiano, Marc; Vallancien, Guy

doi:10.1590/s1677-55382009000100015

Cited by 35 publications

(10 citation statements)

References 3 publications

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“…A number of groups have reported their experience with R-LESS radical prostatectomy,[3031] the largest including 20 patients by White et al . [17] They used a single-site approach, with a SILS port and two 8 mm standard robotic trocars (or one 8 mm and one 5 mm trocar) placed through separate fascial incisions.…”

Section: Resultsmentioning

confidence: 99%

Robotic single port surgery: Current status and future considerations

Samarasekera

Kaouk

2014

Indian J Urol

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Introduction and Objectives:It has been established that robotic-assisted laparoscopic surgery has several advantages when compared with standard laparoscopic surgery. Optics, ergonomics, dexterity and precision are all enhanced with the use of a robotic platform. For these reasons, it was postulated that the application of robotics to laparoendoscopic single-site surgery (LESS) could overcome some of the constraints seen with the conventional laparoscopic approach. Issues such as instrument clashing, inability to achieve effective triangulation for dissection and difficulties with intracorporeal suturing have limited the widespread adoption of conventional LESS. The application of robotics has eliminated many of the constraints experienced with conventional LESS; however, challenges still remain.Materials and Methods:A systematic literature review was performed using PubMed to identify relevant studies. There were no time restrictions applied to the search, but only studies in English were included. We used the following search terms: Robotic single site surgery, robotic single port surgery, robotic single incision surgery and robotic laparoendoscopic single site surgery.Results:A number of centers have published their experience with robotic-laparoendoscopic single-site surgery (R-LESS); however, no prospective studies exist. What is clear is that R-LESS minimizes several of the difficulties experienced with conventional LESS, including intracorporeal suturing and triangulation during dissection. Outcomes are comparable to standard robotic surgery, with a trend toward improved cosmesis and reduced pain. However, a significant advantage with regard to these two factors has yet to be demonstrated.Conclusions:R-LESS is technically feasible and the benefits of robotic surgery eliminate many of the challenges seen with conventional LESS. However, despite the advantages of the robotic platform, R-LESS is not free of challenges. Instrument clashing remains an issue due to the bulky profile of the current robotic system. Other issues include lack of space for the assistant at the bedside, inability to incorporate the 4th robotic arm for retraction and difficulties with triangulation. Although solutions for some of these issues are currently under development, R-LESS is still very much in its infancy.

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Section: Resultsmentioning

confidence: 99%

Robotic single port surgery: Current status and future considerations

Samarasekera

Kaouk

2014

Indian J Urol

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“…The technical challenges of single‐port surgery that may limit its widespread acceptance can be addressed by using robotic technology . Single‐site robotic surgeries have been reported for radical prostatectomy , pyeloplasty, partial nephrectomy , radical prostatectomy , and transvesical enucleation of the prostate . Despite the advantages of the robotic arms’ 7 degrees of freedom, the bulky robotic instruments can easily collide around a single port.…”

Section: Notesmentioning

confidence: 99%

Recent advances in urologic laparoscopic surgeries: laparoendoscopic single‐site surgery, natural orifice transluminal endoscopic surgery, robotics and navigation

Matsuda

2013

Asian J Endoscop Surgery

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Laparoscopic surgery was developed at the end of the 1980s and has been utilized in almost all urologic surgical procedures. It offers the benefits of less invasiveness and earlier recovery than open surgery. The introduction of laparoendoscopic single-site surgery has offered reduced pain and improved cosmetic satisfaction to patients. Scarless nephrectomy has been realized with transvaginal natural orifice transluminal endoscopic surgery in women. The development of surgical robots has decreased the technical difficulty of complicated procedures, shortened the learning curve, and improved perioperative outcomes relative to laparoscopic surgery. Surgical navigation using real-time sonography, augmented reality, fluorescence, or radioisotope images will improve the quality of these surgeries.

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“…In 2009, Barret et al . [28] reported their initial case of R‐LESS radical prostatectomy. They used one umbilical incision through which they placed a single 12‐mm camera port, two 8‐mm robotic ports, and a 5‐mm assistant port.…”

Section: Development and Evolution Of Robotics In Lessmentioning

confidence: 99%

Is robotics the future of laparoendoscopic single‐site surgery (LESS)?

2011

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What's known on the subject? and What does the study add? LESS is a surgical technique that is utilized in many urological surgeries. The recent fusion of robotics and conventional LESS has significant implications for the future direction of LESS. This study is a review of LESS surgery, with a discussion about emerging technologies and the future directions of LESS surgery. Laparoendoscopic single‐site surgery (LESS) is a term that covers a spectrum of surgical techniques that perform laparoscopic surgery by consolidating all ports into one surgical incision. In recent years, there has been an expansion of LESS surgical techniques with a wide spectrum of urological procedures being performed using LESS surgery. Paralleling the clinical expansion of LESS are efforts to improve the instrumentation and access devices as well as incorporation of robotic platforms to the LESS arena. This expansion in technology has generated the essential question: is robotics the future of LESS?

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Re: Initial complete laparoendoscopic single-site surgery robotic assisted radical prostatectomy(LESS-RARP)

Cited by 35 publications

References 3 publications

Robotic single port surgery: Current status and future considerations

Robotic single port surgery: Current status and future considerations

Recent advances in urologic laparoscopic surgeries: laparoendoscopic single‐site surgery, natural orifice transluminal endoscopic surgery, robotics and navigation

Is robotics the future of laparoendoscopic single‐site surgery (LESS)?

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