title: Laparoscopic Radical Prostatectomy with a Remote Controlled Robot.
abstract: Robotics in surgery is a recent innovation. This technology offers a number of attractive features in laparoscopy. It overcomes the difficulties with fixed port sites by restoring all 6 degrees of freedom at the instrument tips, provides new possibilities for miniaturization of surgical tasks and allows remote controlled surgery. We investigated the applicability of remote controlled robotic surgery to laparoscopic radical prostatectomy.
  
  
  
  Our previous experience with laparoscopic prostatectomy served as a basis for adapting robotic surgery to this procedure. A surgeon at a different location who activated the tele-manipulators of the da Vinci∗robotic system performed all steps of the intervention. A scrub nurse and second surgeon who stood at patient side had limited roles to port and instrument placement, exposure of the operative field, assistance in hemostasis and removal of the operative specimen. Our patient was a 63-year-old man presenting with a T1c tumor discovered on 1 positive sextant biopsy with a 3+3 Gleason score and 7 ng./ml. preoperative serum prostate specific antigen.
  
  
  
  The robot provided an ergonomic surgical environment and remarkable dexterity enhancement. Operating time was 420 minutes, and the hospital stay lasted 4 days. The bladder catheter was removed 3 days postoperatively, and 1 week later the patient was fully continent. Pathological examination showed a pT3a tumor with negative margins.
  
  
  
  Robotically assisted laparoscopic radical prostatectomy is feasible. This new technology enhances surgical dexterity. Further developments in this field may have new applications in laparoscopic tele-surgery.
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Clément-Claude
authors.initials: CC
authors.lastname: Abbou
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: András
authors.initials: A
authors.lastname: Hoznek
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Leif Eric
authors.initials: LE
authors.lastname: Olsson
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Adrian
authors.initials: A
authors.lastname: Lobontiu
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Saint
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Antony
authors.initials: A
authors.lastname: Cicco
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Antiphon
authors.affiliation: Service d'Urologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Chopin
mesh_terms: D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: feasibility studies; laparoscopy; prostatectomy; prostatic neoplasms; robotics