Vesicourethral anastomosis using a novel telesurgical system with haptic sensation, the Telelap Alf-X: a pilot study.
Vesicourethral anastomosis is a necessary part of radical prostatectomy and presents technical challenges when performed endoscopically. This study demonstrates the feasibility of the van Velthoven anastomosis method in swine model using a novel telesurgical system with haptic sensation: the Telelap Alf-X. Twenty vesicourethral anastomoses were performed using the system in female swine with two working ports and a camera. With two 2.0 Vicryl, a single knot vesicourethral anastomosis was performed as described by van Velthoven with Telelap Alf-X. The time of each operation was recorded, water tightness and tension were examined at the end of the procedure by irrigation through a 12 Fr catheter. The 1:1 haptic sensation, improved ergonomy, the open architecture of the robotic system, and articulated handles contributed to the easiness of performance and short learning curve, as the time of the procedure decreased by 50% after the first 5 cases. All the anastomoses were functional and proved to be successful and watertight. No leakage occurred. The novel features of the Telelap Alf-X contribute to its ease of use and make the telesurgical performance of vesicourethral anastomosis similar to open surgery, without the disadvantages of the latter.
Department of Surgical Science Università G.D'Annunzio Cheti-Pescara Chieti-Pescara, Italy.
Stefano
S
Gidaro
Department of Urology Campus Biomedico, University of Rome Rome, Italy.
Emanuela
E
Altobelli
Department of Urology University of Rome Rome, Italy.
Cristina
C
Falavolti
Department of Urology Campus Biomedico, University of Rome Rome, Italy.
Alfredo Maria
AM
Bove
ALF-X Robotic Department Sofar S.p.A. Trezzano Rosa, Italy.
Emilio Morales
EM
Ruiz
New European Surgical Academy Berlin, Germany.
Michael
M
Stark
Department of Veterinary Science and Public Health Milan, Italy.
Giuliano
G
Ravasio
Sara Simona
SS
Lazzaretti
Department of Urology Campus Biomedico, University of Rome Rome, Italy.
Buscarini
B
Maurizio
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D000818:Animals; D004867:Equipment Design; D005260:Female; D010865:Pilot Projects; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D013552:Swine; D017216:Telemedicine / Q000295:instrumentation* / Q000379:methods; D001743:Urinary Bladder / Q000601:surgery*