Abstract
Gasless single-port RoboSurgeon total cystectomy with urinary diversion is carried out in the wide pelvic retroperitoneal working space made along the anatomical plane through a single port, around 4–5 cm in diameter, assisted by the robotization of the surgeon using a system called RoboSurgeon. The RoboSurgeon system consists of three components: a three-dimensional head-mounted display (3D-HMD), handheld robot-like devices, and an endoscope manipulation robot. Part or all of this system is used depending on the situation, 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. Along with total cystectomy, urinary diversion (either orthotopic neobladder or ileal conduit) is performed by extracting the ileum through the single port. Performing this surgery achieves three key “nos”: no high costs, no CO2, and no multiple ports, along with minimal intraperitoneal injury. Patients who had previously undergone extensive intraperitoneal surgery would benefit the most. Transition from open surgery can be accomplished without much difficulty. 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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References
Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, Raghavan D, Skinner DG. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19:666–75. http://www.ncbi.nlm.nih.gov/pubmed/11157016.
Miller DC, Taub DA, Dunn RL, Montie JE, Wei JT. The impact of co-morbid disease on cancer control and survival following radical cystectomy. J Urol. 2003;169:105–9. doi:10.1016/S0022-5347(05)64046-3.
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(9):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(1):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 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: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 (2008) Absence of prophylactic antibiotics in minimum incision endoscopic surgery (MIES) of adrenal and renal tumour. Eur Urol Suppl 7:322–322. 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.
Koga F, Kihara K, Fujii Y, Yoshida S, Saito K, Masuda H, Kageyama Y, Kawakami S. Favorable outcomes of patients with clinical stage T3N0M0 bladder cancer treated with induction low-dose chemo-radiotherapy plus partial or radical cystectomy vs immediate radical cystectomy: a single-institutional retrospective comparative study. BJU Int. 2009;104:189–94. doi:10.1111/j.1464-410X.2008.08297.x.
Iwai A, Koga F, Fujii Y, Masuda H, Saito K, Numao N, Sakura M, Kawakami S, Kihara K. Perioperative complications of radical cystectomy after induction chemoradiotherapy in bladder-sparing protocol against muscle-invasive bladder cancer: a single institutional retrospective comparative study with primary radical cystectomy. Jpn J Clin Oncol. 2011;41:1373–9. doi:10.1093/jjco/hyr150.
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Kihara, K. et al. (2015). Gasless Single-Port RoboSurgeon Total Cystectomy with Urinary Diversion. In: Kihara, K. (eds) Gasless Single-Port RoboSurgeon Surgery in Urology. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54505-7_7
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DOI: https://doi.org/10.1007/978-4-431-54505-7_7
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