Robotic single-site surgery.
OBJECTIVE
Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing.


RESULTS
The da Vinci surgical system, with its Endowrist technology, three-dimensional visualization, and motion scaling, has recently been used during single-site surgery, with the aim of reducing technical challenges posed by single-site surgery. To date, we have completed a total of 13 robotic single-site surgeries utilizing the da Vinci system. A total of seven kidney procedures and six pelvic procedures were completed. Total operative time of 195 and 258 min, estimated blood loss of 184 and 175 ml, and hospital stay of 2.3 and 2.8 days were observed for the kidney and pelvic single-site robotic surgery, respectively.


CONCLUSIONS
Robotic single-site surgery is feasible and effective using current robotic system, however, with considerable limitations. Robotic systems designed specifically for single-site approach have the potential of alleviating several of the limitations, which exist with traditional laparoendoscopic single-site surgery.
White
Michael A
MA
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.
Haber
Georges-Pascal
GP
Kaouk
Jihad H
JH
D004867:Equipment Design; D006801:Humans; D020706:Laparoscopes; D012371:Robotics / Q000295:instrumentation; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods*