title: The radius surgical system - a new device for complex minimally invasive procedures in urology?
abstract: OBJECTIVE
  Complex laparoscopic procedures in urology are technically demanding with an extended learning curve. Robotic systems add significant cost to laparoscopic procedures. We therefore evaluated the use of the Radius Surgical System (RSS), a mechanical manipulator, for complex laparoscopic cases in urology.
  
  
  METHODS
  The RSS (Tuebingen Scientific) consists of two hand-guided surgical manipulators and provides a deflectable and rotatable tip allowing six degrees of freedom. We evaluated the system by using a series of standardized models in the pelvitrainer. We analyzed the effectiveness of the system and the learning curve. We then evaluated the system in the clinical setting during laparoscopic radical prostatectomy.
  
  
  RESULTS
  Surgeons with experience on the RSS were compared to surgeons without previous experience on the system. We identified a learning curve in those participants without experience on the system only when performing complete anastomoses in the pelvitrainer. However, this learning curve included less than 10 anastomoses. The first clinical experiences during laparoscopic extraperitoneal radical prostatectomy (n=10) are promising. All anastomoses were patent on routine (X-ray) examination 8 days after surgery.
  
  
  CONCLUSIONS
  The RSS system is easy to use and we identified a very short learning curve. We now optimize the system for use in urology. This device may facilitate complex laparoscopic procedures without the use of costly robotic systems and should be further evaluated in the experimental and clinical setting.
authors.affiliation: Department of Urology, HELIOS-Klinik Müllheim, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Frede
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hammady
authors.forename: Jan
authors.initials: J
authors.lastname: Klein
authors.forename: Dogu
authors.initials: D
authors.lastname: Teber
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Inaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Waseda
authors.forename: Gerhard
authors.initials: G
authors.lastname: Buess
authors.forename: Jens
authors.initials: J
authors.lastname: Rassweiler
mesh_terms: D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000193:education / Q000295:instrumentation*; D011468:Prostatectomy / Q000193:education / Q000295:instrumentation* / Q000379:methods; D013520:Urologic Surgical Procedures / Q000193:education / Q000295:instrumentation