title: Image-guided robot-assisted prostate ablation using water jet-hydrodissection: initial study of a novel technology for benign prostatic hyperplasia.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of a novel robotic tissue ablation system (PROCEPT Aquablation(™) System), in performing prostate ablation in a survival canine model.
  
  
  METHODS
  This novel technology uses a high-velocity saline stream that aims to selectively ablate prostatic glandular tissue while sparing collagenous structures such as blood vessels and capsule. Once the ablation is complete, a laser beam is captured by a low-pressure water jet to produce surface hemostasis. The extent and depth of ablation is predetermined by endoscopic and transrectal ultrasonography guidance. The procedure was performed in eight noncastrated male beagles aged 6 years or older (Acute 2, Chronic 6) through a previously created perineal urethrostomy.
  
  
  RESULTS
  Aquablation time ranged from 40 to 84 seconds (mean 60.5 sec). There was no active bleeding in any of the dogs during or after Aquablation. Water jet-guided laser coagulation was used for purposes of monitoring its safety and efficacy. Five of the six dogs reached the predetermined 6-week mark. Complications included two dogs with infection successfully treated with antibiotics, a false passage created during catheter placement, and two bladder neck perforations (from mechanical insertion), one leading to euthanasia. Histologic evaluation at 6 weeks revealed a normal cellular architecture and full reepithelialization of the treatment cavity.
  
  
  CONCLUSIONS
  We report the initial survival data in the animal model of a novel robotic device developed for managing symptomatic benign prostatic hyperplasia (BPH). Aquablation produces ablation of adenomatous elements while preserving collagenous structures and is a promising technology for surgical management of symptomatic BPH.
authors.affiliation: 1 Department of Urology, University of Southern California , Los Angeles, California.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Faber
authors.forename: Andre Luis Castro
authors.initials: AL
authors.lastname: de Abreu
authors.forename: Patrick
authors.initials: P
authors.lastname: Ramos
authors.forename: Nikolai
authors.initials: N
authors.lastname: Aljuri
authors.forename: Surag
authors.initials: S
authors.lastname: Mantri
authors.forename: Inderbir
authors.initials: I
authors.lastname: Gill
authors.forename: Osamu
authors.initials: O
authors.lastname: Ukimura
authors.forename: Mihir
authors.initials: M
authors.lastname: Desai
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000818:Animals; D004210:Dissection / Q000379:methods; D004285:Dogs; D004724:Endoscopy; D008297:Male; D023421:Models, Animal; D061646:Operative Time; D011470:Prostatic Hyperplasia / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D012965:Sodium Chloride; D025321:Surgery, Computer-Assisted / Q000379:methods*; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D012965:Sodium Chloride