Application in robotic urologic surgery

Background: The da Vinci robot system has become the mainstay of minimally invasive surgery and has been used in numerous complex reconstructive procedures. Due to the success of this innovative technology, we attempted to expand our practical model and application of the da Vinci robot system into other urologic surgeries, beginning with robotic-assisted laparoscopic radical prostatectomy (RALRP). Methods: We retrospectively reviewed a total of 683 patients who underwent robotic-assisted urologic surgery between December 2005 and December 2012. We divided this 8-year course of device use into three periods, and analyzed the surgical capability of operations in 1 day over different periods through a retrospective analysis. Results: In the first period (2005-2008), 159 cases of robotic-assisted urologic surgeries were performed. A total of 195 cases were performed in the second group (2009-2010), and 329 cases in the third (2011-2012). Starting with radical prostatectomy in December 2005, we performed various types of procedures such as partial nephrectomy, pyeloplasty, nephroureterectomy with cystoprostatectomy, nephroureterectomy with bladder cuff, radical cystoprostatectomy/cystectomy with ileal conduit reconstruction, partial cystectomy, adrenalectomy, nephropexy, simple prostatectomy, ureteral reconstruction, and pyelolithotomy/ureterolithotomy. The mean operation times of prostatectomy, partial nephrectomy, nephroureterectomy with radical cystectomy/cystectoprostatectomy, and nephroureterectomy were 154, 140, 295, and 129 minutes, respectively. Conclusion: Based on our experience, a robotic system can be applied to many different types of urologic surgeries both safely and efficiently. Copyright (C) 2014 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.