TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: Subjective surgeon experience with a Remotely-Operated Suction/Irrigation system (ROSI) has been associated with improved surgical field visibility through autonomy and flexibility of suction/irrigation tasks. We report our first objective experience of 11 patients who all underwent robotic pyeloplasty during which the ROSI was utilized for suction/irrigation tasks.
Methods: 22 consecutive patients underwent robotic pyeloplasty – the first 11 surgeries utilized a human-assistant to perform suction/irrigation tasks with a traditional rigid suction/ irrigation device (control group) and the next 11 surgeries utilized a surgeon or assistant-controlled, flexible suction/irrigation device (ROSI group). Age, BMI, surgery time, estimated blood loss, as well as immediate post-operative and discharge hematocrit values were compared between the two groups.
Results: The ROSI and control groups were similar in terms of age (35.3 vs. 44.2 years, p = 0.183), BMI (25.7 vs. 24.6, p = 0.69), surgery time (140.9 vs. 149.2 minutes, p = 0.39), and estimated blood loss (45.5 vs. 45.9 cc, p = 0.971). Compared to the ROSI group, the control group had a greater but non-significant immediate post-operative drop in hematocrit (2.40 vs. 4.43 %, p = 0.13) and a statistically significant drop in hematocrit at the time of discharge (3.05 vs. 5.95 %, p = 0.034).
Conclusions: The use of a flexible, surgeon-controlled suction/irrigation system may lead to less post-operative blood loss after robotic pyeloplasty, although this is likely not of clinical significance. However, the ROSI system does have the ability to enhance the surgeon’s surgical field visibility, possibly enabling him/her to better detect and cauterize small bleeding vessels.
Source of Funding: None
|View an interview with Alon Y. Mass, one of the authors of this study.|
Presented by Alon Y. Mass, MD and Michael Stifelman, MD at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
New York University School of Medicine, New York, NY USA