Robot-assisted transurethral holmium ureterolithotripsy
Introduction. Currently, transurethral laser ureterolithotripsy is the standard treatment for ureteral stones. It allows you to achieve complete stone fragmentation in one-stage. We were interested in the possibility of performing ureterolithotripsy using a robotic assistant. In fact, robotic system...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | Russian |
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Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education
2023-12-01
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| Series: | Вестник урологии |
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| Online Access: | https://www.urovest.ru/jour/article/view/789 |
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| author | S. N. Eremenko A. N. Eremenko A. G. Martov A. V. Simonovich V. P. Dolgopolov V. S. Chernega M. A. Aliyev |
| author_facet | S. N. Eremenko A. N. Eremenko A. G. Martov A. V. Simonovich V. P. Dolgopolov V. S. Chernega M. A. Aliyev |
| author_sort | S. N. Eremenko |
| collection | DOAJ |
| description | Introduction. Currently, transurethral laser ureterolithotripsy is the standard treatment for ureteral stones. It allows you to achieve complete stone fragmentation in one-stage. We were interested in the possibility of performing ureterolithotripsy using a robotic assistant. In fact, robotic systems in medicine and surgery are becoming more and more relevant every year.Objective. To evaluate the possibilities of robot-assisted transurethral laser ureterolithotripsy, to study its effectiveness and duration in comparison with holmium lithotripsy in standard surgery, as well as to conduct a study and expert evaluation of the symptoms of surgeon fatigue in standard lithotripsy and robot-assisted lithotripsy.Materials & methods. The study was conducted in 2022 and consisted of two stages. The first stage involved the development and testing of a robotic lithotripsy technique using simulators, including the author's fixation device for the ureteroscope. This device allowed to tightly fix the instrument in the "robotic arm", while maintaining the full range of necessary movements. During the second stage (clinical), the results of holmium ureterolithotripsy in standard and robotic surgeries were studied. Patients with ureterolithiasis were divided into two groups: 14 patients — standard lithotripsy and 13 patients — robotic assisted lithotripsy. The selection criteria were the presence of a single ureteral stone accessible to a semi-rigid ureteroscope.Results. According to the results of the study, robot-assisted transurethral holmium ureterolithotripsy has the greatest advantages in terms of the fatigue indicators of the surgeon during surgery. So, no significant difference was found in fragmentation time (1 gram of stone). In standard ureterolithotripsy this indicator was 63.8 min/g, and in robot-assisted ureterolithotripsy it was 57.8 min/g (p < 0.1). When comparing the surgeon's fatigue scores, a significant difference between the two groups was determined. Thus, during standard surgery, the surgeon rated the shoulder numbness score at 3.50 points, while during robot-assisted surgery at 0.17 points (p < 0.01).Conclusion. The study showed that transurethral contact laser ureterolithotripsy with the use of robotic assistant does not increase the surgery time, but the surgeon's fatigue factor is significantly reduced. This may indirectly contribute to reducing the risk of intra- and postoperative complications. |
| first_indexed | 2024-03-07T14:22:54Z |
| format | Article |
| id | doaj.art-03eefc99926c49f582919b4e46af7d5d |
| institution | Directory Open Access Journal |
| issn | 2308-6424 |
| language | Russian |
| last_indexed | 2025-03-14T10:35:57Z |
| publishDate | 2023-12-01 |
| publisher | Ministry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional Education |
| record_format | Article |
| series | Вестник урологии |
| spelling | doaj.art-03eefc99926c49f582919b4e46af7d5d2025-03-02T10:59:30ZrusMinistry of Health of Russian Federation, Rostov State Medical University, State Budget Educational Institute of Higher Professional EducationВестник урологии2308-64242023-12-01114273510.21886/2308-6424-2023-11-4-27-35481Robot-assisted transurethral holmium ureterolithotripsyS. N. Eremenko0A. N. Eremenko1A. G. Martov2A. V. Simonovich3V. P. Dolgopolov4V. S. Chernega5M. A. Aliyev6St. Luke Clinical Multidisciplinary Medical Centre (St. Luke CMC) — Vernadsky Crimean Federal UniversitySt. Luke Clinical Multidisciplinary Medical Centre (St. Luke CMC) — Vernadsky Crimean Federal UniversityBiomedical University of Innovations and Continuing Education — State Research Center Burnasyan Federal Medical Biophysical Center of Federal Medical Biological AgencySt. Luke Clinical Multidisciplinary Medical Centre (St. Luke CMC) — Vernadsky Crimean Federal UniversitySt. Luke Clinical Multidisciplinary Medical Centre (St. Luke CMC) — Vernadsky Crimean Federal UniversitySevastopol State UniversityGeorgievsky Medical Institute of the Order of the Labour Red Banner — Vernadsky Crimean Federal UniversityIntroduction. Currently, transurethral laser ureterolithotripsy is the standard treatment for ureteral stones. It allows you to achieve complete stone fragmentation in one-stage. We were interested in the possibility of performing ureterolithotripsy using a robotic assistant. In fact, robotic systems in medicine and surgery are becoming more and more relevant every year.Objective. To evaluate the possibilities of robot-assisted transurethral laser ureterolithotripsy, to study its effectiveness and duration in comparison with holmium lithotripsy in standard surgery, as well as to conduct a study and expert evaluation of the symptoms of surgeon fatigue in standard lithotripsy and robot-assisted lithotripsy.Materials & methods. The study was conducted in 2022 and consisted of two stages. The first stage involved the development and testing of a robotic lithotripsy technique using simulators, including the author's fixation device for the ureteroscope. This device allowed to tightly fix the instrument in the "robotic arm", while maintaining the full range of necessary movements. During the second stage (clinical), the results of holmium ureterolithotripsy in standard and robotic surgeries were studied. Patients with ureterolithiasis were divided into two groups: 14 patients — standard lithotripsy and 13 patients — robotic assisted lithotripsy. The selection criteria were the presence of a single ureteral stone accessible to a semi-rigid ureteroscope.Results. According to the results of the study, robot-assisted transurethral holmium ureterolithotripsy has the greatest advantages in terms of the fatigue indicators of the surgeon during surgery. So, no significant difference was found in fragmentation time (1 gram of stone). In standard ureterolithotripsy this indicator was 63.8 min/g, and in robot-assisted ureterolithotripsy it was 57.8 min/g (p < 0.1). When comparing the surgeon's fatigue scores, a significant difference between the two groups was determined. Thus, during standard surgery, the surgeon rated the shoulder numbness score at 3.50 points, while during robot-assisted surgery at 0.17 points (p < 0.01).Conclusion. The study showed that transurethral contact laser ureterolithotripsy with the use of robotic assistant does not increase the surgery time, but the surgeon's fatigue factor is significantly reduced. This may indirectly contribute to reducing the risk of intra- and postoperative complications.https://www.urovest.ru/jour/article/view/789urolithiasisureteral stonetransurethral surgeryrobot-assisted surgeryureterolithotripsy |
| spellingShingle | S. N. Eremenko A. N. Eremenko A. G. Martov A. V. Simonovich V. P. Dolgopolov V. S. Chernega M. A. Aliyev Robot-assisted transurethral holmium ureterolithotripsy Вестник урологии urolithiasis ureteral stone transurethral surgery robot-assisted surgery ureterolithotripsy |
| title | Robot-assisted transurethral holmium ureterolithotripsy |
| title_full | Robot-assisted transurethral holmium ureterolithotripsy |
| title_fullStr | Robot-assisted transurethral holmium ureterolithotripsy |
| title_full_unstemmed | Robot-assisted transurethral holmium ureterolithotripsy |
| title_short | Robot-assisted transurethral holmium ureterolithotripsy |
| title_sort | robot assisted transurethral holmium ureterolithotripsy |
| topic | urolithiasis ureteral stone transurethral surgery robot-assisted surgery ureterolithotripsy |
| url | https://www.urovest.ru/jour/article/view/789 |
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