This little piggie went to the market, this little piggie stayed home and this little piggie squealed NO NO not Zeus!
>>Urology
Volume 61, Issue 5 , May 2003, Pages 1063-1066
Robotically assisted laparoscopic dismembered pyeloplasty: a chronic porcine study*1
Bertrand Guillonneau, a, John B. W. Rietbergenb, G. aëlle Fromontc and Guy Vallancienc
a Department of Urology, Institut Mutualiste Montsouris, University Pierre & Marie Curie, Paris, France
b Department of Urology, Erasmus University and Academic Hospital Rotterdam, Rotterdam, The Netherlands
c Department of Pathology, Institut Mutualiste Montsouris, Paris, France
Received 2 October 2000; accepted 18 November 2002. ; Available online 29 April 2003.
Abstract
Objectives
To evaluate the feasibility and efficacy of robotically assisted laparoscopic dismembered pyeloplasty in an animal model. We also investigated whether the use of a device that lacks tactile feedback results in tissue damage and subsequent stenosis or leaking of the anastomosis.
Methods
Robotically assisted dismembered pyeloplasty was performed on 10 farm pigs. After 1 month, all pigs were anesthetized again for intravenous urography and to remove the kidney and ureter on the operated side. Histopathologic examination of all specimens was performed.
Results
All animals survived the initial procedure without complications. In the first five procedures, the time required for the performance of the anastomosis showed a decreasing trend. In the last five procedures, 30 to 40 minutes were required for the anastomosis. The results of urography showed mild hydronephrosis in 1 case (animal 7). The other animals showed no abnormalities. The histopathologic examination of the specimen showed a large foreign body granuloma in the ureteral wall of animal 7 that caused the before-mentioned obstruction. No significant abnormalities were seen in the other animals.
Conclusions
Robotically assisted laparoscopic dismembered pyeloplasty is a technically feasible procedure with an acceptable morbidity in an animal model. No significant histologic effects were seen of the possibly less-delicate tissue handling by the robotic device. The benefit of this technological progress has not yet been established. Therefore, the use of these techniques has to be thoroughly assessed before their clinical application. <<
>>Conclusions
The robotically assisted laparoscopic pyeloplasty is a feasible procedure with an acceptable morbidity in an animal model. In our study, no significant histologic effects were seen of the possibly less-delicate tissue handling by the robotic device. Even for an experienced laparoscopic surgeon, the robotically assisted procedure requires a learning curve. Additional research is needed to improve the current robotic devices such that they improve surgical procedures. At this time, we have to be concerned with not doing worse.<< |
