Analysis of performance factors in 240 consecutive cases of robot-assisted flexible ureteroscopic stone treatment

AbstractFlexible ureteroscopy is the keystone of modern kidney stone treatment. Although a simple surgical technique achieves good clinical results and a low complication rate, there are high demands on the surgeon ’s dexterity and ergonomic restrictions. Robotic-assisted flexible ureteroscopy (rfURS) could overcome these limitations. After 4 years of use of rfURS at a tertiary stone center, performance factors were analyzed to define the role of rfURS in kidney stone management. A rfURS system was installe d in August 2014 at the SLK Kliniken (Heilbronn, Germany). Treatment data ofN = 240 consecutive patients undergoing rfURS were prospectively collected and analyzed. The patient cohort represents typical stone formers.N = 240 renal units containing 443 stones with an average stone load of 1798 mm3 were treated. Surgical parameters as well as the peri- and postoperative complications were recorded, analyzed and compared to the current data in the literature. OR time 91  min, stone treatment time 55 min, stone treatment efficacy 33 mm3/min; perioperative complications 5.4%; robot times: preparation 5  min, docking 5 min, console time to stone contact 6 min, console time 75 min; postoperative complications 6.7%; postoperative length of stay 1.5 days; stone-free rate (residuals<  2 mm) 90% and re-treatment rate 8.75%. This consecutive series represents real-life data about the utilization of rfURS. The detailed analysis of performance factors revealed ...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research