Journal of Robotic Surgery

, Volume 3, Issue 4, pp 239–244 | Cite as

Robotic hypospadias surgery: a new evolution

Case Report


The dictum that “there is nothing new in surgery not previously described,” is quoted regularly and is particularly true of hypospadias. There is an ongoing search for solutions to many troublesome issues concerning surgical treatment of hypospadias, such as what age is the most appropriate to apply surgery, or in how many stages surgery should be performed. We present a case report of the first robotic hypospadias surgery to propose a departure from the standard practice, in the hope of expanding medical expertise and teaching globally. The use of a robot for reconstructive surgery is not novel; its use for extracorporeal surgery is, but we contend that there is no difference in the surgical steps to carry out a hypospadias repair. In addition, we envision that the benefits of applying robotic surgery for extracorporeal reconstructive procedures will greatly impact the current paradigm of surgery and surgical education. For those surgeons who already possess comfort with robotic skills, reconstructive procedures outside of a major cavity are feasible, and time will provide safety and efficacy data. Our hope is that others will join in the advancement of telesurgery and its applications and appreciate the potential expansion of surgical knowledge that will be afforded by this change in how we teach and operate.


Hypospadias Robotic Surgery Urethra Penis Child Simulation 


  1. 1.
    Baskin LS (2000) Hypospadias, anatomy, embryology, and reconstructive techniques. Braz J Urol 26:621–629Google Scholar
  2. 2.
    Durham Smith E (1997) The history of hypospadias. Pediatr Surg Int 12(2–3):81–85CrossRefGoogle Scholar
  3. 3.
    Papanikolaou ED, Yonkov AS (2006) Historical aspects of hypospadias—a literature review. Folia Med (Plovdiv) 48(3–4):29–35Google Scholar
  4. 4.
    Chang A, Fan J, Kim S, Leone N, Carr M, Zderic S, Snyder H, Kolon T, Canning D (2008) Complications of hypospadias surgery are higher in boys with cryptorchidism. J Urol 179(4):409–409CrossRefGoogle Scholar
  5. 5.
    Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring. Review of early clinical results. Surg Endosc 16:1389CrossRefPubMedGoogle Scholar
  6. 6.
    Abbou C-C, Hoznek A, Salomon L, Olsson LE, Lobontiu A, Saint F et al (2001) Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 165:1964CrossRefPubMedGoogle Scholar
  7. 7.
    Menon M, Tewari A, Baize B, Guillonneau B, Vallencien G (2002) Prospective comparison of radical retropubic prostatectomy and robot-assisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 60:864CrossRefPubMedGoogle Scholar
  8. 8.
    Casale P (2008) Robotic pediatric urology. Expert Rev Med Dev 5(1):59–64CrossRefGoogle Scholar
  9. 9.
    Schoor RA, Ross L, Niederberger C (2003) Robotic assisted microsurgical vassal reconstruction in a model system. World J Urol 21:48PubMedGoogle Scholar
  10. 10.
    Schiff J, Li PS, Goldstein M (2004) Robotic microsurgical vasovasostomy and vasoepididymostomy: a prospective randomized study in a rat model. J Urol 171(4):1720–1725CrossRefPubMedGoogle Scholar
  11. 11.
    Marescaux J, Smith MK, Fölscher D, Jamali F, Malassagne B, Leroy J (2001) Telerobotic laparoscopic cholecystectomy: initial clinical experience with 25 patients. Ann Surg 234(1):1–7CrossRefPubMedGoogle Scholar
  12. 12.
    Bagrodia A, Raman JD (2009) Ergonomics considerations of radical prostatectomy: physician perspective of open, laparoscopic, and robot-assisted techniques. J Endourol 23(4):627–633CrossRefPubMedGoogle Scholar
  13. 13.
    Kitagawa M, Dokko D, Okamura AM, Yuh DD (2005) Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. J Thorac Cardiovasc Surg 129(1):151–158CrossRefPubMedGoogle Scholar
  14. 14.
    De S, Rosen J, Dagan A, Hannaford B, Swanson P, Sinanan M (2007) Assessment of tissue damage due to mechanical stresses. Int J Robotics Res 26:1159–1171CrossRefGoogle Scholar
  15. 15.
    Xia T, Baird C, Jallo G, Hayes K, Nakajima N, Hata N, Kazanzides P (2008) An integrated system for planning, navigation and robotic assistance for skull base surgery. Int J Med Robot 4(4):321–330PubMedGoogle Scholar
  16. 16.
    Valentine RJ, Rege RV (2004) Integrating technical competency into the surgical curriculum: doing more with less. Surg Clin North Am 84(6):1647–1667CrossRefPubMedGoogle Scholar
  17. 17.
    Maizels M, Yerkes EB, Macejko A, Hagerty J, Chaviano AH, Cheng EY, Liu D, Sarwark JP, Corcoran JF, Meyer T, Kaplan WE (2008) A new computer enhanced visual learning method to train urology residents in pediatric orchiopexy: a prototype for Accreditation Council for Graduate Medical Education documentation. J Urol 180(4 Suppl):1814–1818CrossRefPubMedGoogle Scholar
  18. 18.
    Lendvay TS, Casale P, Sweet R, Peters C (2008) VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Stud Health Technol Inform 132:242–244PubMedGoogle Scholar
  19. 19.
    Kenney PA, Wszolek MF, Gould JJ, Libertino JA, Moinzadeh A (2009) Face, content, and construct validity of dV-trainer, a novel virtual reality simulator for robotic surgery. Urology 73(6):1288–1292CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London Ltd 2009

Authors and Affiliations

  1. 1.Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Seattle Children’s HospitalUniversity of WashingtonSeattleUSA

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