title: Robotic-assisted laparoscopic implantation of artificial urinary sphincter in women with intrinsic sphincter deficiency incontinence: initial results.
abstract: OBJECTIVE
  To investigate the feasibility, safety, and functional results of robotic-assisted artificial urinary sphincter (R-AUS) laparoscopic implantation in women with stress urinary incontinence due to intrinsic sphincter deficiency.
  
  
  METHODS
  Six women underwent an R-AUS implantation between 2012 and 2013. The mean age was 65 ± 9.6 years. Five patients had previous surgery for incontinence. The mean duration of follow-up was 14.3 months. A transperitoneal approach with a lateral positioning of the robotic arms was performed. The cuff implantation, positioning of the reservoir, and the pump were carried out similarly to the laparoscopic technique. Operative time, intraoperative occurrence of injuries of the bladder or vagina, postoperative complications, and continence (pad per day) were assessed.
  
  
  RESULTS
  The R-AUS implantation was feasible in all cases without intraoperative injury and 1 grade 1 postoperative complication. Mean operative time, postoperative bladder catheterization, and hospitalization time were 210 ± 32 minutes, 7 days, and 6 days, respectively. At the end of the follow-up, 83% of cases were fully continent.
  
  
  CONCLUSIONS
  R-AUS implantation in incontinent women with intrinsic sphincter deficiency was feasible and safe with good functional results. More data are needed before concluding to the superiority of this new technique compared with open or laparoscopic approaches.
authors.affiliation: Department of Urology, Brest University Hospital, Brest, France. Electronic address: georges.fournier@chu-brest.fr.
authors.forename: Georges
authors.initials: G
authors.lastname: Fournier
authors.affiliation: Department of Urology, Brest University Hospital, Brest, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Callerot
authors.affiliation: Department of Urology, Brest University Hospital, Brest, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Thoulouzan
authors.affiliation: Department of Urology, Brest University Hospital, Brest, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Valeri
authors.affiliation: Department of Urology, Brest University Hospital, Brest, France.
authors.forename: Marie-Aimee
authors.initials: MA
authors.lastname: Perrouin-Verbe
mesh_terms: D000368:Aged; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D061646:Operative Time; D059035:Perioperative Period; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000379:methods*; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000293:injuries / Q000601:surgery; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D016741:Urinary Sphincter, Artificial; D014621:Vagina / Q000293:injuries