Skip to main content

Gasless Single-Port RoboSurgeon Retroperitoneoscopic Radical Nephrectomy

  • Chapter
Gasless Single-Port RoboSurgeon Surgery in Urology

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  CAS  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  Google Scholar 

  6. 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.

    Article  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed Central  PubMed  Google Scholar 

  13. 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.

    Article  PubMed  Google Scholar 

  14. 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.

    Article  PubMed  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. 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

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kazunori Kihara .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Japan

About this chapter

Cite this chapter

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

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-54505-7_2

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54504-0

  • Online ISBN: 978-4-431-54505-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics