Abstract
Laparoendoscopic single-site surgery (LESS) has been increasingly expanded in recent years, but due to ergonomic limitations, limited triangulation, and clashing of instruments, adoption of LESS has been restricted. With ergonomics as one of robotic surgery’s biggest advantages, we have applied robotic-LESS (R-LESS) to a variety of procedures. R-LESS renal and ureteral surgery is feasible and safe at the short-term stage of evaluation. While prospective comparisons with more established techniques are needed, R-LESS has clearly superior ergonomics in comparison to conventional LESS, which may encourage more surgeons to adopt single-site surgery. In this chapter, we discuss unique aspects of R-LESS as applied to renal and ureteral surgery and present “tips and tricks” from our experience for those interested in this approach.
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References
Autorino R, Cadeddu JA, Desai MM, et al. Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology: a critical analysis of the literature. Eur Urol. 2011;59(1):26–45.
Kaouk JH, Autorino R, Kim FJ, et al. Laparoendoscopic single-site surgery in urology: worldwide multi-institutional analysis of 1076 cases. Eur Urol. 2011;60(5):998–1005.
Box G, Averch T, Cadeddu J, et al. Urologic NOTES Working Group. Nomenclature of natural orifice translumenal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) procedures in urology. J Endourol. 2008;22(11):2575–81.
Kaouk JH, Goel RK, Haber GP, et al. Robotic single-port transumbilical surgery in humans: initial report. BJU Int. 2009;103(3):366–9.
White MA, Autorino R, Spana G, et al. Robotic laparoendoscopic single site urological surgery: analysis of 50 consecutive cases. J Urol. 2012;187(5):1696–701.
Joseph RA, Goh AC, Cuevas SP, Donovan MA, Kauffman MG, Salas NA, et al. “Chopstick” surgery: a novel technique improves surgeon performance and eliminates arm collision in robotic single-incision laparoscopic surgery. Surg Endosc. 2010;24(6):1331–5.
Abaza R. The robotic surgery era and the role of laparoscopy training. Ther Adv Urol. 2009;1(3):161–5.
Kaouk JH, Goel RK. Single-port laparoscopic and robotic partial nephrectomy. Eur Urol. 2009;55(5):1163–9.
Barret E, Sanchez-Salas R, Cathelineau X, et al. Re: Initial complete laparoendoscopic single-site surgery robotic assisted radical prostatectomy (LESS-RARP). Int Braz J Urol. 2009;35(1):92–3.
Stein RJ, White WM, Goel RK, et al. Robotic laparoendoscopic single-site surgery using GelPort as the access platform. Eur Urol. 2010;57(1):132–6.
Jeon HG, Jeong W, Oh CK, et al. Initial experience with 50 laparoendoscopic single site surgeries using a homemade, single port device at a single center. J Urol. 2010;183(5):1866–71.
White MA, Haber GP, Autorino R, et al. Robotic laparoendoscopic single-site radical prostatectomy: technique and early outcomes. Eur Urol. 2010;58(4):544–50.
White MA, Autorino R, Spana G, et al. Robotic laparoendoscopic single-site radical nephrectomy: surgical technique and comparative outcomes. Eur Urol. 2011;59(5):815–22.
Won Lee J, Arkoncel FR, Rha KH, et al. Urologic robot-assisted laparoendoscopic single-site surgery using a homemade single-port device: a single-center experience of 68 cases. J Endourol. 2011;25(9):1481–5.
Han WK, Kim DS, Jeon HG, et al. Robot-assisted laparoendoscopic single-site surgery: partial nephrectomy for renal malignancy. Urology. 2011;77(3):612–6.
Olweny EO, Park SK, Tan YK, et al. Perioperative comparison of robotic assisted laparoendoscopic single-site (LESS) pyeloplasty versus conventional LESS pyeloplasty. Eur Urol. 2012;61(2):410–4.
Khanna R, Stein RJ, White MA, et al. Single institution experience with robot-assisted laparoendoscopic single-site renal procedures. J Endourol. 2012;26(3):230–4.
Seideman CA, Tan YK, Faddegon S, et al. Robot-assisted laparoendoscopic single-site pyeloplasty: technique using the da Vinci Si robotic platform. J Endourol. 2012;26(8):971–4.doi: 10.1089/end.2011.0573 [Epub ahead of print].
Cestari A, Buffi NM, Lista G, et al. Feasibility and preliminary clinical outcomes of robotic laparoendoscopic single-site (R-LESS) pyeloplasty using a new single-port platform. Eur Urol. 2012;62(1):175–9. doi:10.1016/j.eururo.2012.03.041 [Epub ahead of print].
Kaouk JH, Hillyer SP, Autorino R, et al. 252 robotic partial nephrectomies: evolving renorrhaphy technique and surgical outcomes at a single institution. Urology. 2011;78(6):1338–44.
Park YH, Kang MY, Jeong MS, et al. Laparoendoscopic single-site nephrectomyusing a homemade single-port device for single-system ectopic ureter in a child: initial case report. J Endourol. 2009;23(5):833–5.
Haber GP, White MA, Autorino R, et al. Novel robotic da Vinci instruments for laparoendoscopic single-site surgery. Urology. 2010;76(6):1279–82.
Kaouk JH, Autorino R, Laydner H, et al. Robotic single-site kidney surgery: evaluation of second-generation instruments in a cadaver model. Urology. 2012;79(5):975–9.
White MA, Haber GP, Autorino R, et al. Robotic laparoendoscopic single-site surgery. BJU Int. 2010;106:923–7.
Mahvash M, Zenati M. Toward a hybrid snake robot for single-port surgery. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:5372–5.
Dolghi O, Strabala KW, Wortman TD, et al. Miniature in vivo robot for laparoendoscopic single-site surgery. Surg Endosc. 2011;25(10):3453–8.
Vyas L, Aquino D, Kuo CH, et al. Flexible robotics. BJU Int. 2011;107(2):187–9.
Harada K, Oetomo D, Susilo E, et al. A reconfigurable modular robotic endoluminal surgical system: vision and preliminary results. Robotica. 2010;28(2):171–83. doi:10.1017/S0263574709990610.
Boxerbaum AS, Shaw KM, Chiel HJ, et al. Continuous wave peristaltic motion in a robot. Int J Robot Res. 2012;31:302–18.
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Laydner, H., Kaouk, J.H. (2013). Single-Incision Robotic Renal and Ureteral Surgery. In: Abaza, R. (eds) Robotic Renal Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-6522-5_15
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DOI: https://doi.org/10.1007/978-1-4614-6522-5_15
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