Robot-Assisted Mini-Endoscopic Combined Intrarenal Surgery for Complex and Multiple Calculi: What Are the Real Advantages?

Tokatlı, Zafer; İbiş, Muhammed Arif; Sarıca, Kemal

doi:10.1089/lap.2022.0124

Cited by 6 publications

(9 citation statements)

References 15 publications

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“…In most cases, the development of technology is aimed at improving the results of the surgery, but some implementations are aimed at the comfort of the operating surgeon, including. This combination of qualities is predicted from the use of robotic system Avicenna Roboflex in retrograde access for ECIRS, which is confirmed by the results of a study conducted by Z. Tokatli et al high rates of single-stage SFR (95.5 %) with a low rate and severity of complications Review (only Grade I according to the Clavien-Dindo -7.1 %), low average duration of surgery (103.7 ± 20.6 min) and radioscopy (71.0 ± 13.7 sec), increase interest in further research and implementation of robotic systems [58]. However, the high cost of existing robotic systems is a major obstacle to implementing their use.…”

Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

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Section: Resultsmentioning

confidence: 99%

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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“…However, they also reiterated as has been considered a limitation of ECIRS that the assumed disadvantages like ureteral damage because of using an ureteroscope and a ureteral access sheath, the requirement of two or more urologists and the destruction of the surgical instruments by the contact of an ureteroscope and a nephroscope should be noted. Tokatli et al [25 ▪▪ ] studied the outcomes of mini-ECIRS in 42 consecutive patients (44 renal units) diagnosed with complex/multiple renal stones. Retrograde access with the flexible scope was performed by using Avicenna Roboflex, mini-PCNL was performed through a 16.5 F sheath.…”

Section: Discussionmentioning

confidence: 99%

“…The remaining 162 full-text articles were further evaluated for appropriateness and 127 articles were excluded. Finally, 35 articles were considered eligible and included [1,2 ▪ ,6–13,14 ▪ ,15–17,18 ▪▪ ,19 ▪ ,20–22,23 ▪▪ ,24,25 ▪▪ ,26–36,37 ▪ ,38]. Figure 1 shows the flow diagram of the literature search.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…There were 22 retrospective [6–13,14 ▪ ,17,19 ▪ ,20,24,25 ▪▪ ,26,28,31–34,36,38] and 7 prospective studies [1,2 ▪ ,18 ▪▪ ,21,23 ▪▪ ,27,29], and only one among the latter was randomized [29]. There were 16 single-arm studies [1,2 ▪ ,6,7,9–11,13,17,20,21,25 ▪▪ ,28,31,33,36], whilst 7 studies compared ECIRS with other procedures [8,12,14 ▪ ,18 ▪▪ ,24,26,34]. Yet, four studies compared ECIRS in different patient positions [19 ▪ ,27,32,38].…”

Section: Evidence Synthesismentioning

confidence: 99%

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Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Gauhar

Traxer

Fuligni

et al. 2023

Current Opinion in Urology

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Purpose of reviewTo systematically review the evolution of techniques, technology, clinical utility, limitations and possible future applications of endoscopic combined intrarenal surgery (ECIRS) for ureteral and kidney stones. Recent findingsThe literature search was performed on 18th January 2023 using PubMed, EMBASE and Scopus. 35 studies were included. Among them, six were reviews. Since its introduction in 2008, ECIRS has evolved and improved. ECIRS can be performed in different patient position, such as modified supine Valdivia position by Galdakao, prone position with split-leg and supine position with good outcomes. Instrument miniaturization has also been introduced in ECIRS making it doable in an ambulatory setting. ECIRS showed shorter operative time, lower complication rate, and retreatment compared with conventional PCNL. Operative outcomes of mini-ECIRS are better than mini-PCNL alone. ECIRS also showed good outcomes in impacted upper ureteric stones. Recently, some studies have explored the robotic-assisted kidney puncture in ECIRS that avoided multitrack surgery, especially in anomalous kidney and staghorn stones. SummaryECIRS is ready for primetime in endourology and can be considered the next gold-standard for a personalized stone approach in complex kidney stones.

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“…Recently, robot-assisted endoscopic surgery has been applied in urolithiasis surgery. Tokatli et al [ 46 ] reported the results of robot-assisted mini-endoscopic combined with intrarenal surgery for multiple stones. Forty-four renal units with complex or multiple renal stones were treated using robot-assisted mini-endoscopic combined intrarenal surgery.…”

Section: Future Strategies For Nephron-sparing Approachesmentioning

confidence: 99%

Nephron-Sparing Approaches in Upper Tract Urothelial Carcinoma: Current and Future Strategies

et al. 2022

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Upper tract urothelial carcinoma (UTUC) is a relatively rare cancer, and much of the approach to treatment has been derived from strategies employed in treating bladder cancer. Radical nephroureterectomy (RNU) is regarded as the gold standard treatment for UTUC. However, due to potential complications, such as renal function impairment, that can affect oncologic outcomes, the demand for nephron-sparing treatment to effectively treat cancer while preserving renal function has increased. As a result, various treatment methods for low-grade, low-volume UTUC, such as segmental ureterectomy, endoscopic resection, and intraluminal therapy, have been attempted and reported. Although these treatment modalities have exhibited acceptable oncological results, further studies are required. In the future, the introduction of new technologies, such as improved diagnostic and surgical equipment, and new drug delivery systems, could enhance the effectiveness of nephron-sparing strategies in the treatment of UTUC. Additionally, understanding the biological and genetic characteristics of UTUC that distinguish it from those of bladder cancer will also aid in establishing strategies for nephron-sparing.

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Robot-Assisted Mini-Endoscopic Combined Intrarenal Surgery for Complex and Multiple Calculi: What Are the Real Advantages?

Cited by 6 publications

References 15 publications

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Evolution and current applications of endoscopic combined intrarenal surgery: a scoping review from back to the future

Nephron-Sparing Approaches in Upper Tract Urothelial Carcinoma: Current and Future Strategies

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