AUA 2011 - Characterization of ureter, bladder, and bowel tissue injury after compression with robotic instruments - Session Highlights

WASHINGTON, DC USA ( - In the past decade, there has been an exponential increase in urological surgery utilizing the da Vinci robot platform. One of the main issues with this technology is the lack of haptic feedback or the ability to feel the tissue. In a novel and timely study by Pope and colleagues from Lackland AFB in Texas, the authors characterized the histopathological changes in porcine ureter, bladder, and bowel in the immediate and short term interval after robotic grasper compression.


Ureter, bladder, and bowel were examined for tissue injury after no compression, 1 sec, 10 sec, 30 sec, 1 min, and 5 min compression with a robotic grasper. Tissues were harvested either immediately after compression or after the animals were survived 10-14 days. A single pathologist graded the tissue crush injury in 4 categories (inflammation, nuclear smearing, necrosis, and hemorrhage) on a 0 – 5 point scale with 0 representing no change and 5 indicating severe change.

Results in the immediate period showed a trend towards increased injury to the bowel (p=0.07), but not in the ureter (p=0.16) or bladder (p=0.30). At the 14 day follow up, there were no differences in the injury scores between the tissue types or with the compression time with all categories of injury scoring 0.

The porcine model may be more difficult to prove injury to than in humans as evidenced by prior partial nephrectomy models, but this study demonstrates that short term grasping may not be as harmful as initially thought. Further studies that include grasping tissues for longer periods of time to induce ischemia are needed as well as the grasping of vascular structures.


Presented by Necia M. Pope, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA

Reported for UroToday by Michael Louie, MD, Department of Urology, University of California, Irvine.

The opinions expressed in this article are those of the Contributing Editor and do not necessarily reflect the viewpoints of the American Urological Association.



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