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Feasibility of Laser Lithotripsy for Midsize Stones Using Robotic Retrograde Intrarenal Surgery System easyUretero in a Porcine Model

Authors
 Hyunho Han  ;  Joonhwan Kim  ;  Young Joon Moon  ;  Hae Do Jung  ;  Byungsik Cheon  ;  Jungmin Han  ;  Sung Yong Cho  ;  Dong-Soo Kwon  ;  Joo Yong Lee 
Citation
 JOURNAL OF ENDOUROLOGY, Vol.36(12) : 1586-1592, 2022-12 
Journal Title
JOURNAL OF ENDOUROLOGY
ISSN
 0892-7790 
Issue Date
2022-12
MeSH
Animals ; Female ; Lithotripsy, Laser* ; Robotics* ; Swine
Keywords
endoscopes ; laser ; lithotripsy ; robotic surgical procedures ; urinary calculi
Abstract
Purpose: To test the safety and feasibility of laser lithotripsy for midsize renal stones using a newly developed robotic retrograde intrarenal surgery (RIRS) system (easyUretero) in a porcine model. Materials and Methods: Three urologic surgeons representing three different RIRS experience levels (beginner, intermediate, and expert) participated. Four female pigs (aged 6 months) underwent manual or robotic RIRS. Under general anesthesia, a nephrostomy tract was created ventrally, and calcium stones (diameter, 1.0-1.5 cm) were inserted at renal calices. For manual RIRS, surgeons operated a flexible ureteroscope. For robotic RIRS, the ureteroscope was attached to the robotic slave device. The Auriga XL™ Holmium laser was used for lithotripsy. Lasering and stone retrieval time were measured. Kidneys and ureters were inspected for injury at the end of each session. Results: For the expert, both lasering and stone retrieval by manual RIRS were quicker than by robotic RIRS (22.8 ± 11.0 s/stone vs 234.5 ± 102.5 s/stone, p = 0.02; 41.5 ± 0.5 s/stone vs 79.3 ± 8.1 s/stone, p = 0.02). For the intermediate and beginner, lasering and stone retrieval times were not significantly different between manual and robotic procedures (127.8 ± 93.2 s/stone vs 284.8 ± 112.3 s/stone, p = 0.08; 86.0 ± 30.5 s/stone vs 84.1 ± 21.4 s/stone, p = 0.92). All stones were removed. Grade 1 ureteral and renal injuries occurred in both manual RIRS and robotic RIRS. Conclusions: The laser lithotripsy using the easyUretero robotic system is safe and feasible in a porcine model, even for less-experienced surgeons.
Full Text
https://www.liebertpub.com/doi/10.1089/end.2022.0272
DOI
10.1089/end.2022.0272
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Moon, Young Joon(문영준)
Lee, Joo Yong(이주용) ORCID logo https://orcid.org/0000-0002-3470-1767
Han, Hyun Ho(한현호) ORCID logo https://orcid.org/0000-0002-6268-0860
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193062
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