Current Status and Future Directions of Robotic Single-Site Surgery: A Systematic Review

被引:113
作者
Autorino, Riccardo [1 ,2 ]
Kaouk, Jihad H. [1 ]
Stolzenburg, Jens-Uwe [3 ]
Gill, Inderbir S. [4 ]
Mottrie, Alex [5 ]
Tewari, Ash [6 ,7 ]
Cadeddu, Jeffrey A. [8 ]
机构
[1] Cleveland Clin, Glickman Urol & Kidney Inst, Cleveland, OH 44106 USA
[2] Univ Naples 2, Urol Unit, Naples, Italy
[3] Univ Leipzig, Dept Urol, D-04109 Leipzig, Germany
[4] Univ So Calif, Keck Sch Med, USC Inst Urol, Los Angeles, CA 90033 USA
[5] OLV Robot Surg Inst, Aalst, Belgium
[6] Weill Cornell Med Coll, Dept Urol, Lefrak Ctr Robot Surg, New York, NY USA
[7] Weill Cornell Med Coll, Dept Urol, Prostate Canc Inst, New York, NY USA
[8] Univ Texas SW Med Ctr Dallas, Dept Urol, Dallas, TX 75390 USA
关键词
Robotic; Laparoendoscopic single-site surgery; LESS; R-LESS; Single-site surgery; Urology; TRANSLUMENAL ENDOSCOPIC SURGERY; VISION FIELD CONTROL; LAPAROSCOPIC CHOLECYSTECTOMY; TRANSVESICAL ENUCLEATION; RADICAL PROSTATECTOMY; INITIAL-EXPERIENCE; LESS PYELOPLASTY; SURGICAL ROBOT; INCISION; NEPHRECTOMY;
D O I
10.1016/j.eururo.2012.08.028
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Context: Despite the increasing interest in laparoendoscopic single-site surgery (LESS) worldwide, the actual role of this novel approach in the field of minimally invasive urologic surgery remains to be determined. It has been postulated that robotic technology could be applied to LESS to overcome the current constraints. Objective: To summarize and critically analyze the available evidence on the current status and future of robotic applications in single-site surgery. Evidence acquisition: A systematic literature review was performed in April 2011 using PubMed and the Thomson-Reuters Web of Science. In the free-text protocol, the following terms were applied: robotic single site surgery, robotic single port surgery, robotic single incision surgery, and robotic laparoendoscopic single site surgery. Review articles, editorials, commentaries, and letters to the editor were included only if deemed to contain relevant information. In addition, cited references from the selected articles and from review articles retrieved in the search were assessed for significant manuscripts not previously included. The authors selected 55 articles according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria. Evidence synthesis: The volume of available clinical outcomes of robotic LESS (R-LESS) has considerably grown since the pioneering description of the first successful clinical series of single-port robotic procedures. So far, a cumulative number of roughly 150 robotic urologic LESS cases have been reported by different institutions across the globe with a variety of techniques and port configurations. The feasibility of robot-assisted single-incision colorectal procedures, as well as of many gynecologic procedures, has also been demonstrated. A novel set of single-site instruments specifically dedicated to LESS is now commercially available for use with the da Vinci Si surgical system, and both experimental and clinical use have been reported. However, the current robotic systems were specifically designed for LESS. The ideal robotic platform should have a low external profile, the possibility of being deployed through a single access site, and the possibility of restoring intra-abdominal triangulation while maintaining the maximum degree of freedom for precise maneuvers and strength for reliable traction. Several purpose-built robotic prototypes for single-port surgery are being tested. Conclusions: Significant advances have been achieved in the field of R-LESS since the first reported clinical series in 2009. Given the several advantages offered by current the da Vinci system, it is likely that its adoption in this field will increase. The recent introduction of purpose-built instrumentation is likely to further foster the application of robotics to LESS. However, we are still far from the ideal robotic platform. Significant improvements are needed before this technique might reach widespread adoption beyond selected centers. Further advances in the field of robotic technology are expected to provide the optimal interface to facilitate LESS. (C) 2012 European Association of Urology. Published by Elsevier B. V. All rights reserved.
引用
收藏
页码:266 / 280
页数:15
相关论文
共 77 条
[1]   Robotics May Overcome Technical Limitations of Single-Trocar Surgery An Experimental Prospective Study of Nissen Fundoplication [J].
Allemann, Pierre ;
Leroy, Joel ;
Asakuma, Mitsuhiro ;
Al Abeidi, Fahad ;
Dallemagne, Bernard ;
Marescaux, Jacques .
ARCHIVES OF SURGERY, 2010, 145 (03) :267-271
[2]  
[Anonymous], IEEE INT C ROB AUT M
[3]  
[Anonymous], SURG INNOV IN PRESS
[4]   Single-incision laparoscopic cholecystectomy: a systematic review [J].
Antoniou, Stavros A. ;
Pointner, Rudolph ;
Granderath, Frank A. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (02) :367-377
[5]   Two-port Robot-assisted vs Standard Robot-assisted Laparoscopic Partial Nephrectomy: A Matched-pair Comparison [J].
Arkoncel, Francis Raymond P. ;
Lee, Jae Won ;
Rha, Koon Ho ;
Han, Woong Kyu ;
Jeoung, Ha Bum ;
Oh, Cheol Kyu .
UROLOGY, 2011, 78 (03) :581-585
[6]   Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature [J].
Autorino, Riccardo ;
Cadeddu, Jeffrey A. ;
Desai, Mihir M. ;
Gettman, Matthew ;
Gill, Inderbir S. ;
Kavoussi, Louis R. ;
Lima, Estevao ;
Montorsi, Francesco ;
Richstone, Lee ;
Stolzenburg, Jens U. ;
Kaouk, Jihad H. .
EUROPEAN UROLOGY, 2011, 59 (01) :26-45
[7]   Re: Initial Complete Laparoendoscopic Single-Site Surgery Robotic Assisted Radical Prostatectomy(LESS-RARP) [J].
Barret, Eric ;
Sanchez-Salas, Rafael ;
Cathelineau, Xavier ;
Rozet, Francois ;
Galiano, Marc ;
Vallancien, Guy .
INTERNATIONAL BRAZ J UROL, 2009, 35 (01) :92-93
[8]   A Transition to Laparoendoscopic Single-Site Surgery (LESS) Radical Prostatectomy: Human Cadaver Experimental and Initial Clinical Experience [J].
Barret, Eric ;
Sanchez-Salas, Rafael ;
Kasraeian, Ali ;
Benoist, Nicolas ;
Ganatra, Anjali ;
Cathelineau, Xavier ;
Rozet, Francois ;
Galiano, Marc ;
Vallancien, Guy .
JOURNAL OF ENDOUROLOGY, 2009, 23 (01) :135-140
[9]   Complications during the initial experience with laparoendoscopic single-site pyeloplasty [J].
Best, Sara L. ;
Donnally, Chester ;
Mir, Saad A. ;
Tracy, Chad R. ;
Raman, Jay D. ;
Cadeddu, Jeffrey A. .
BJU INTERNATIONAL, 2011, 108 (08) :1326-1329
[10]   Nomenclature of Natural Orifice Translumenal Endoscopic Surgery (NOTES™) and Laparoendoscopic Single-Site Surgery (LESS) Procedures in Urology [J].
Box, Geoffrey ;
Averch, Timothy ;
Cadeddu, Jeffrey ;
Cherullo, Edward ;
Clayman, Ralph ;
Desai, Mihir ;
Frank, Igor ;
Gettman, Matthew ;
Gill, Inderbir ;
Gupta, Mantu ;
Haber, Georges-Pascal ;
Kaouk, Jihad ;
Landman, Jaime ;
Lima, Esteavao ;
Ponsky, Lee ;
Rane, Abhay ;
Sawyer, Mark ;
Humphreys, Mitchell .
JOURNAL OF ENDOUROLOGY, 2008, 22 (11) :2575-2581