Lithotripsy of Renal Stones With Avicenna Roboflex Robotic-Assisted Retrograde Intra-Renal Surgery (RA-RIRS)

Lithotripsy of Renal Stones With Avicenna Roboflex Robotic-Assisted Retrograde Intra-Renal Surgery (RA-RIRS)

Ahmet Sinan Kabakci (Hacettepe University, Turkey), Anup Patel (Spire Roding Hospital, UK), Aydan M. Erkmen (Middle East Technical University, Turkey), Ismet Erkmen (Middle East Technical University, Turkey), Özlem Gümüşkanat (Middle East Technical University, Turkey) and Mehmet Çetinkaya (Middle East Technical University, Turkey)
Copyright: © 2018 |Pages: 19
DOI: 10.4018/978-1-5225-2993-4.ch006

Abstract

The role of retrograde intra-renal surgery (RIRS) with flexible ureterorenoscopy (FURS) in the management of kidney stone formation has garnered a prevalent use among urologists thanks to new improvements in medical equipment; however, it still remains a challenging technique. The purpose of this chapter is to overview robotic assistance for RIRS and mainly focus on ELMED's robotic device by thoroughly describing it and investigating its effects on surgical performance based on the IDEAL (idea, development, evaluation, assessment, long-term study) framework. The robotic device, Avicenna Roboflex, is a teleoperated robot consisting of a surgeon's console (master control console – MCC) and manipulator arm (MA) to house and couple with the FURS. It provides a suitable and safe platform for robotic-assisted (RA) RIRS with significant improvements in ergonomics and potentially prolongs equipment durability which may lead to its general acceptance and preference of use by many surgeons in various countries including Turkey, Germany, France, the UAE, and Romania.
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Background

In this section, the authors provide the reader with an introduction to the field of Flexible Uretero-renoscopy (FURS), a technique, where a flexible endoscope is inserted through natural orifices into the ureter(s), allowing more versatility in diagnosis and treatment of ureteral and intra-renal collecting system disorders. The status quo of surgical telerobotics before the arrival of ELMED’s robotic telemanipulator system, namely the Roboflex Avicenna, are also discussed. The section is finalized with the description of IDEAL, a framework for evaluating surgical innovation in the relevant field.

Key Terms in this Chapter

Extracorporeal Shock Wave Lithotripsy: The least invasive surgical stone treatment using high frequency sound waves from an external source (outside the body) to break up kidney stones into smaller pieces and allow them to pass out through the urinary tract.

Percutaneous Nephrolithotomy: A minimally invasive procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through skin.

Lithotripsy: Medical procedure of destroying or fragmenting stones.

Renal: Related to or located within kidneys.

Retrograde Intra-Renal Surgery: Surgery within the kidneys where a viewing tube called a fiberoptic endoscope is used for visual guidance.

Uretero-Renoscopy: Procedure used to diagnose or treat problems in kidneys using a small scope (uretero-renoscope) inserted through ureters.

Endoscopic Lithotripsy: The visualization of a calculus in the urinary tract and the simultaneous application of energy to fragment the stone or stones into either extractable or passable pieces.

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