Abstract
Gasless single-port RoboSurgeon retroperitoneoscopic radical nephrectomy, which is an affordable procedure for patients with renal cell carcinoma, is carried out in a wide retroperitoneal working space made along the anatomical plane through a roughly coin-sized single port and is assisted by a system (RoboSurgeon) that involves the robotization of the surgeon. The RoboSurgeon system consists of three components: a three-dimensional head-mounted display (3D-HMD), handheld robot-like devices, and an endoscope manipulation robot. Depending on the situation, part or all of this system is used, but the 3D-HMD, which provides six fields of vision in front of the eyes regardless of head position, is always used by surgeons. Using the direct vision obtained by moving the angle of sight downward, the surgeons receive instruments from the scrub nurse as well as observe the operative field to ensure safety. This surgery achieves four key “nos”: no high costs, no CO2, no multiple ports, and no intraperitoneal injury. The adjustable port size provides safety and ease of learning. The aforementioned direct vision and adjustable port size facilitate the transition from open surgery. Without the RoboSurgeon system, single-port-like surgery, in which the port size is somewhat larger, can be performed using the procedures described herein.
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Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, Colombel M, Klotz L, Skinner E, Keane T, Marreaud S, Collette S, Sylvester R. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59:543–52. doi:10.1016/j.eururo.2010.12.013.
Gratzke C, Seitz M, Bayrle F, Schlenker B, Bastian PJ, Haseke N, Bader M, Tilki D, Roosen A, Karl A, Reich O, Khoder WY, Wyler S, Stief CG, Staehler M, Bachmann A. Quality of life and perioperative outcomes after retroperitoneoscopic radical nephrectomy (RN), open RN and nephron-sparing surgery in patients with renal cell carcinoma. BJU Int. 2009;104:470–5. doi:10.1111/j.1464-410X.2009.08439.x.
Butler BP, Novick AC, Miller DP, Campbell SA, Licht MR. Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology. 1995;45:34–40. doi:10.1016/S0090-4295(95)96306-5. discussion 40–1.
Kihara K, Fujii Y, Masuda H, Saito K, Koga F, Matsuoka Y, Numao N, Kojima K. New three-dimensional head-mounted display system, TMDU-S-3D system, for minimally invasive surgery application: procedures for gasless single-port radical nephrectomy. Int J Urol. 2012;19:886–9. doi:10.1111/j.1442-2042.2012.03044.x. author reply 890.
Kihara K, Masuda H, Saito K, Koga F, Numao N, Matsuoka Y, Ishioka J, Yokoyama M, Sakura M, Fujii Y. Gasless laparoendoscopic single-port retroperitoneal radical nephrectomy for renal tumors in dialysis patients: perioperative outcomes of 81 consecutive cases. Eur Urol Suppl. 2012;11:e92. doi:10.1016/S1569-9056(12)60091-8.
Kihara K, Takeshita H, Masuda H, Koga F, Saito K, Matsuoka Y, Numao N, Fujii Y. Novel three-dimensional head-mounted display system (RoboSurgeon system): application to the initial 60 cases of gasless single-port access urologic surgeries. Eur Urol Suppl. 2013;12:e950–1. doi:10.1016/S1569-9056(13)61429-3.
Kihara K, Takeshita H, Matsuoka Y, Numao N, Saito K, Koga F, Masuda H, Fujii Y. New three-dimensional head-mounted display system (RoboSurgeon system): application to the initial 80 cases of gasless single-port access urologic surgeries. J Urol. 2013;189(Suppl):e344–5. doi:10.1016/j.juro.2013.02.407.
Kihara K, Kawakami S, Fujii Y, Masuda H, Koga F, Saito K. Gasless single port access radical nephrectomy. Eur Urol Suppl. 2009;8:392. doi:10.1016/S1569-9056(09)61054-X.
Yoshida S, Masuda H, Yokoyama M, Kobayashi T, Kawakami S, Kihara K. Absence of prophylactic antibiotics in minimum incision endoscopic urological surgery (MEUS) of adrenal and renal tumors. Int J Urol. 2007;14:384–7. doi:10.1111/j.1442-2042.2006.01728.x.
Saito K, Yoshida S, Yokoyama M, Sakura M, Sakai Y, Koga F, Masuda H, Fujii Y, Kobayashi T, Kawakami S, Kihara K. Absence of prophylactic antibiotics in minimum incision endoscopic surgery (MIES) of adrenal and renal tumour. Eur Urol Suppl. 2008;7:322. doi:10.1016/S1569-9056(08)61001-5.
Kijima T, Masuda H, Yoshida S, Tatokoro M, Yokoyama M, Numao N, Saito K, Koga F, Fujii Y, Kihara K. Antimicrobial prophylaxis is not necessary in clean category minimally invasive surgery for renal and adrenal tumors: a prospective study of 373 consecutive patients. Urology. 2012;80:570–5. doi:10.1016/j.urology.2012.05.003.
Tatokoro M, Kihara K, Masuda H, Ito M, Yoshida S, Kijima T, Yokoyama M, Saito K, Koga F, Kawakami S, Fujii Y. Successful reduction of hospital-acquired methicillin-resistant Staphylococcus aureus in a urology ward: a 10-year study. BMC Urol. 2013;13:35. doi:10.1186/1471-2490-13-35.
Kihara K, Kageyama Y, Yano M, Kobayashi T, Kawakami S, Fujii Y, Masuda H, Hyochi N. Portless endoscopic radical nephrectomy via a single minimum incision in 80 patients. Int J Urol. 2004;11:714–20. doi:10.1111/j.1442-2042.2004.00895.x.
Kihara K, Kawakami S, Fujii Y, Masuda H, Koga F. Gasless single-port access endoscopic surgery in urology: minimum incision endoscopic surgery, MIES. Int J Urol. 2009;16:791–800. doi:10.1111/j.1442-2042.2009.02366.x.
Iimura Y, Kihara K, Saito K, Masuda H, Kobayashi T, Kawakami S. Oncological outcome of minimum incision endoscopic radical nephrectomy for pathologically organ confined renal cell carcinoma. Int J Urol. 2008;15:44–7. doi:10.1111/j.1442-2042.2007.01922.x.
Sakura M, Kawakami S, Masuda H, Kobayashi T, Kageyama Y, Kihara K. Sequential bilateral minimum incision endoscopic radical nephrectomy in dialysis patients with bilateral renal cell carcinomas. Int J Urol. 2007;14:1109–12. doi:10.1111/j.1442-2042.2007.01906.x.
Okada Y, Masuda H, Saito K, Limura Y, Yokoyarna M, Komai Y, Numao N, Koga F, Fujii Y, Kihara K. Surgical outcomes of gasless single port retroperitoneal radical nephrectomy for dialysis patients: a comparative analysis with nondialysis patients. J Clin Oncol. 2011;29(Suppl):376. http://meeting.ascopubs.org/cgi/content/abstract/29/7_suppl/376?sid=aa4e9084-bfdd-42bd-a085-312d0b1babde
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Kihara, K. et al. (2015). Gasless Single-Port RoboSurgeon Retroperitoneoscopic Radical Nephrectomy. In: Kihara, K. (eds) Gasless Single-Port RoboSurgeon Surgery in Urology. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54505-7_2
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DOI: https://doi.org/10.1007/978-4-431-54505-7_2
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