MP29-17: Feasibility of laser lithotripsy in robotic-assisted retrograde intrarenal surgery using Zamenix in an in-vitro model
Saturday, May 4, 2024 9:30 AM to 11:30 AM · 2 hr. (US/Central)
302B
Abstract
Information
Full Abstract and Figures
Author Block
Joonhwan Kim, Seoul, Korea, Republic of, Chinnakhet Ketsuwan, Bangkok, Thailand, Kyu-Seob Song, Jae-chul Kim, Joonyeong Kim, Hyeji Park, Seoul, Korea, Republic of, Dong-Soo Kwon, Daejeon, Korea, Republic of, Joo Yong Lee, Sung Yong Cho*, Seoul, Korea, Republic of
Introduction
This study aims to investigate the feasibility of laser lithotripsy in robotic-assisted retrograde intrarenal surgery (RIRS) using Zamenix (The second generation of the robotic flexible ureteroscopy system formerly known as easyUretero) that implements the compensation for the respiration-induced kidney motion during the lasering.
Methods
Laser lithotripsy was performed on a 5x5x5 mm size artificial stone placed into a calyx of kidney model that simulates the respiratory-induced motion. The experiment was performed with three groups: manual procedure (group M), robotic procedure without respiratory compensation (group RNR), and robotic procedure with respiratory compensation (group RR). Two urologists representing RIRS intermediate, and expert participated and performed the laser lithotripsy using fragmentation and popcorn techniques to reach the stone-free status. The study assessed fragmentation time, laser time, the number of mucosal contacts, and the total energy used.
Results
The fragmentation time decreased to 74.8% and 65.0% in group RNR and RR, respectively, compared to group M. RNR and RR groups showed a significant decrease compared to group M (P = 0.012 and P = 0.001, respectively). The laser time significantly decreased in group RR compared to group M (P = 0.003). The number of mucosal contacts decreased to 37.4% and 34.0% in group RNR and RR, respectively, compared to group M. RNR group showed a significant decrease compared to group M (P = 0.048). The total energy significantly decreased in RR group compared to group M (P = 0.011).
Conclusions
The robotic-assisted RIRS reduced the fragmentation time, the laser time, the mucosal contacts, and the total energy during the laser lithotripsy. The respiratory adjustment was able to improve the outcomes further. These results demonstrated the feasibility of robotic-assisted RIRS showing potential for improving procedural efficiency and safety in the laser lithotripsy.
Source Of Funding
This work was supported by the ROEN Surgical.
Author Block
Joonhwan Kim, Seoul, Korea, Republic of, Chinnakhet Ketsuwan, Bangkok, Thailand, Kyu-Seob Song, Jae-chul Kim, Joonyeong Kim, Hyeji Park, Seoul, Korea, Republic of, Dong-Soo Kwon, Daejeon, Korea, Republic of, Joo Yong Lee, Sung Yong Cho*, Seoul, Korea, Republic of
Introduction
This study aims to investigate the feasibility of laser lithotripsy in robotic-assisted retrograde intrarenal surgery (RIRS) using Zamenix (The second generation of the robotic flexible ureteroscopy system formerly known as easyUretero) that implements the compensation for the respiration-induced kidney motion during the lasering.
Methods
Laser lithotripsy was performed on a 5x5x5 mm size artificial stone placed into a calyx of kidney model that simulates the respiratory-induced motion. The experiment was performed with three groups: manual procedure (group M), robotic procedure without respiratory compensation (group RNR), and robotic procedure with respiratory compensation (group RR). Two urologists representing RIRS intermediate, and expert participated and performed the laser lithotripsy using fragmentation and popcorn techniques to reach the stone-free status. The study assessed fragmentation time, laser time, the number of mucosal contacts, and the total energy used.
Results
The fragmentation time decreased to 74.8% and 65.0% in group RNR and RR, respectively, compared to group M. RNR and RR groups showed a significant decrease compared to group M (P = 0.012 and P = 0.001, respectively). The laser time significantly decreased in group RR compared to group M (P = 0.003). The number of mucosal contacts decreased to 37.4% and 34.0% in group RNR and RR, respectively, compared to group M. RNR group showed a significant decrease compared to group M (P = 0.048). The total energy significantly decreased in RR group compared to group M (P = 0.011).
Conclusions
The robotic-assisted RIRS reduced the fragmentation time, the laser time, the mucosal contacts, and the total energy during the laser lithotripsy. The respiratory adjustment was able to improve the outcomes further. These results demonstrated the feasibility of robotic-assisted RIRS showing potential for improving procedural efficiency and safety in the laser lithotripsy.
Source Of Funding
This work was supported by the ROEN Surgical.