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24th World Congress of Endourology 2006 - Session VP5 Robotics Highlights

World Congress of Endourology, Cleveland, OH.

This session was conducted in the virtual poster setting with plasma screens acting as the posters. The majority of posters had video running with procedural footage related to the poster information. The posters of note include work from Dr. Tewari from Cornell where a comparative study was performed between robot assisted radical prostatectomy (RARP) and open radical prostatectomy (ORP). The RARP procedures were performed at Cornell while the ORP cases were performed in Innsbruck. Surgical margin data revealed the odds ratio for experiencing a positive margin was 0.36 between RARP and ORP when Gleason score and pathological stage were matched.

Dr. Menon from Henry Ford Hospital presented data on 12 patients with partial staghorn calculi that underwent robot assisted extended pyelolithotomy. All procedures were completed robotically. Mean OR time was 158 minutes. Complete stone removal was accomplished in all but one patient who had a complete staghorn calculus. Complications were minimal.

Dr. Herrell and Dr. Smith from Vanderbilt reported on the effect of experience on margin rates during RARP. They examined 662 patients and found an overall positive margin rate for T2 disease of 14%. The positive margin rate in the first 100 cases however was 26% but decreased dramatically to 11% with the last 100 cases. Even further this positive margin rate is lower than what the high volume open surgeon experience for open radical prostatectomy with a T2 margin rate of 16%.

An invitro study performed by Dr. Clayman’s group at UCI examined the tactile ability of surgeons in a robotic platform versus laparoscopic platform. A series of foam models had metal balls randomly placed within. Surgeons were asked to manipulate the models with either laparoscopic or robotic instrumentation to detect the hidden nodule. There was actually a trend toward better detection with the robotic platform than with standard laparoscopic instrumentation.