Urologists have always led the race in the adoption of innovative surgical technology, with the extensive use of transurethral surgery, the use of flexible endoscopes and lasers, and the early inclusion of laparoscopic surgery in their surgical quiver.
A brilliant example is the application of robotic technology in urological operations.
The applications of robotic surgery in the genitourinary system are many, both in neoplastic diseases such as cancer of the prostate (radical prostatectomy), bladder (radical cystectomy), kidney (radical or partial nephrectomy), renal pelvis or ureter (nephroureterectomy) , as well as in non-neoplastic-benign diseases of organs such as the kidney (conjunctival stricture, pyeloplasty-urolithectomy, lithotomy, prolapsed or non-functioning kidney-simple nephrectomy), ureteral stenosis (ureteral transplantation-reflux), varicocele, benign prostatic hypertrophy, female urinary incontinence (vaginal suspension) or pelvic organ prolapse (sacral vagus).
Robotic Nephrectomy PN – Nephroureterectomy PN
Conventional laparoscopic surgery has been applied with great success for several years in benign and malignant surgical diseases of the kidney. The advantages of robotic nephrectomy in relation to laparoscopic nephrectomy are the reduction of the operation time, greater precision and stability in ligation of the portal vessels and better ergonomics. In specialized centers abroad, robotic nephrectomy has found great application in simple living donor nephrectomy for kidney transplantation.
The advantages of robotic nephrectomy over Open Nephrectomy (AN) are:
• less blood loss intraoperatively
• minor trauma
• less postoperative pain
• shorter hospital stay
• faster recovery
Robotic nephroureterectomy (RPN) is a safe method with all the advantages of a minimally invasive technique, and is the method of choice for the treatment of urothelial carcinoma of the upper urinary tract. Robotic assistance gives advantage to management (resection) of the bladder cuff near the vesicoureteral junction due to easier tissue preparation and suture placement.
Robotic partial Nephrectomy PMN
Open Partial Nephrectomy (APN) was the surgery of choice for small kidney tumors. Laparoscopic Partial Nephrectomy is technically one of the most difficult operations. Robotic partial nephrectomy (RPN) due to better ergonomics, 3D imaging and high technology tools comes to bridge this gap safely. Its advantages over AMN are those of the minimally invasive technique (less intraoperative blood loss, less trauma, less postoperative pain, shorter hospital stay, faster recovery).
The Second Urology Clinic of HYGEIA with extensive experience in robotic operations has performed a significantly large number of robotically assisted partial nephrectomies, i.e. successfully removing only the tumor while preserving the healthy renal parenchyma, adopting pioneering techniques such as the intraoperative use of laparoscopic (real time) of ultrasound, the technique without interrupting the blood circulation of the kidney (zero ischemia time), the intervention in a solitary kidney and the use of fluorescence mapping.
Written by:
Dr. Emmanuel Panagiotou
Urology surgeon
Director of 2nd Urological Clinic HYGEIA
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