title: Robotic implantation of biodegradable regenerative urinary conduit: experimental study.
abstract: OBJECTIVE
  To determine the feasibility and develop a robotic technique for intracorporeal implantation of a biodegradable tubular scaffold seeded with adipose-sourced smooth muscle cells (Neo-Urinary-Conduit) that, when implanted as a conduit for urinary diversion, facilitates regeneration of native-like neourinary tissue.
  
  
  METHODS
  Robotic NUC implantation was performed in two fresh male cadavers. The greater omentum was widely detached from the greater curvature of the stomach, in preparation for final wrapping of the conduit. Bilateral ureters were mobilized for implantation. The NUC, with two precreated ureteral openings, was inserted into the abdomen. Bilateral, stented uretero-NUC anastomoses were created. The NUC was circumferentially wrapped with the predissected omentum, exteriorized through the abdominal wall, and maturated.
  
  
  RESULTS
  Both procedures were successfully completed intracorporeally. Operative time for NUC implantation was 90 and 100 minutes, respectively. Examination of gross anatomy showed no injury to other organs. There was no omental kinking, rotation, eversion, or stripping from the NUC. Bilateral stents were confirmed to be in situ with the proximal coil in the kidney. Uretero-NUC anastomoses and omentum were tension free. The entire NUC, including its distal edge and posterior aspect, was circumferentially wrapped 360 degrees.
  
  
  CONCLUSIONS
  We demonstrated the feasibility and developed a robotic technique for intracorporeal implantation of a biodegradable regenerative urinary conduit. This study serves as the foundation for the robotic surgical technique before the clinical application.
authors.affiliation: USC Institute of Urology, Catherine & Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Andre Luis
authors.initials: AL
authors.lastname: de Castro Abreu
authors.forename: Raed A
authors.initials: RA
authors.lastname: Azhar
authors.forename: Andre K
authors.initials: AK
authors.lastname: Berger
authors.forename: Sameer
authors.initials: S
authors.lastname: Chopra
authors.forename: Arnaud
authors.initials: A
authors.lastname: Marien
authors.forename: Michael
authors.initials: M
authors.lastname: Santomauro
authors.forename: Raj
authors.initials: R
authors.lastname: Satkunasivam
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.forename: Monish
authors.initials: M
authors.lastname: Aron
authors.forename: Osamu
authors.initials: O
authors.lastname: Ukimura
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Desai
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
mesh_terms: D020341:Absorbable Implants; D002102:Cadaver; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D061646:Operative Time; D019919:Prosthesis Implantation / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000379:methods*; D054457:Tissue Scaffolds; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*