[Use of robotics in laparoscopic urological surgery: state of the art].
OBJECTIVE
To evaluate the current place of robotics in laparoscopic urological surgery.


METHODS
A review of the international literature was conducted to evaluate the various available endoscope robot systems and telemanipulator robots and to establish their practical limitations and their contribution to surgery.


RESULTS
Robotic systems are based on various structures, which each present specific disadvantages. Two types of systems can be distinguished: endoscope robots and telemanipulator robots (complete robotic systems) with different degrees of complexity, dimensions and costs. Each system is different in terms of service rendered. Endoscope robot systems (EndoAssist, AESOP, LapMan) are reliable and eliminate the need for an assistant to hold the camera. Man-machine interfaces can be manual, by pedal or by voice recognition. They are relatively large and expensive, limiting their diffusion at the present time. Complete instrument-handling robots (master-slave manipulators) are currently represented by 2 robots (Zeus and Da Vinci) which have demonstrated their efficacy in many difficult operations. Their very high cost and their large dimensions also constitute limitations to their diffusion, making them inaccessible to the majority of centres. The urological community has largely contributed to the evaluation of robots in laparoscopic operations, as reflected by the large number of publications.


CONCLUSIONS
Considerable technological progress has been made over recent years to make laparoscopic surgery more accessible. Current robotized tools are still imperfect systems, but, in the future, may possibly facilitate difficult laparoscopic operations, particularly in urology.
Long
Jean-Alexandre
JA
Service de Chirurgie urologique et de la Transplantation rénale, CHU de Grenoble, France. j.long@libertysurf.fr
Descotes
Jean-Luc
JL
Skowron
Olivier
O
Troccaz
Jocelyne
J
Cinquin
Philippe
P
Boillot
Bernard
B
Terrier
Nicolas
N
Rambeaud
Jean-Jacques
JJ
D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy; D012371:Robotics / Q000295:instrumentation; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*