Category: Other, Miscellaneous

VS5-10 - Docking and Port Placement using a Purpose Built Single-Port robotic platform in Urologic Surgeries

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : Seeking to further reduce the invasiveness of robot-assisted approach, robotic technology is evolving with new platforms. Namely, the Single Port SP1098 (Intuitive Surgical, Sunnyvale, CA, USA) is a robotic platform purpose-built for robotic laparo-endoscopic single-site surgery (R-LESS). To standardize the port placement is key in R-LESS. The primary aim of the study was to describe step-by-step the port placement and the robot docking during different R-LESS approaches to urological procedures using the novel SP platform in cadaver models.

Methods : The da Vinci® SP1098 Surgical system was used to perform different urological procedures in different surgical lodges including retroperitoneum and pelvic fossa in cadaver models. A single-port mini device (GelPOINT, Rancho Margarita, California, USA) secured and accommodated the robotic platform that included and articulating camera, three double-jointed articulating robotic instruments, and an accessory laparoscopic instrument. Intraoperative complications were recorded.

Results : Port placement and docking are feasible and performed within 10-15 minutes after a short learning curve. Performed cases were completed without the need for conversion to standard robotic techniques. No instruments clashing was observed. Direct transvesical or trans-perineal access avoiding the abdominal cavity were achieved. In retroperitoneal access to the kidney, both posterior and anterior tumors were easily approached. Limitations include the preclinical model, the small sample size and the lack of a control group.

Conclusions : In this preclinical model, the port placement and robot docking using the SP1098 robotic platform is reproducible and feasible for renal, retroperitoneal, pelvic, transvesical, and perineal surgical procedures.

Juan Garisto

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Cleveland, Ohio

Juan Garisto, MD is an Advanced Laparoscopy & Robotics clinical fellow at Cleveland Clinic, Cleveland, OH, United States under the mentorship of Dr. Jihad Kaouk. He completed a Society of Urologic Oncology fellowship at the University of Toronto and did his urology residency training at Complejo Hospitalario Dr. A.A.Madrid in Panama City, Panama.

His current research interest in single port surgery and multidisciplinary management of urologic malignancies, in particular kidney and bladder cancer.

Riccardo Bertolo

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
Turin, Piemonte, Italy

Riccardo Bertolo, MD
Research Fellow, Robotic Urology,
Cleveland Clinic, Cleveland, OH, USA
PhD Candidate, Bioengineering in Medical/Surgical Sciences
Turin Politechnic, Italy

Jihad Kaouk

Professor and Director, Center for Robotic and Image Guided Surgery Vice Chair, Surgical Innovations
Glickman Urologic Institute, Cleveland Clinic
Cleveland, Ohio

Jihad Kaouk, MD FACS

Dr. Jihad Kaouk is an American Board certified Urologist and Director, Center of Robotic and Image Guided Surgery at the Cleveland Clinic Glickman Urological Institute. He also serves as Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Vice Chair for Surgical Innovations and chair holder for the Zegarac-Pollock Endowed Chair in laparoscopic and robotic surgery.
In Innovations, he has performed several first ever done surgical procedures, including the first Robotic single port surgery through the belly button in 2008, the first completely transvaginal kidney removal in 2009, and the first robotic perineal prostatectomy in 2014 Dr. Kaouk holds 2 USA patents for medical devices used during partial nephrectomy and in robotic surgery.

Since 2005, Dr. Kaouk has served on committees at the national and local levels. From 2005-2008, he served in the American Urological Association’s Urologic Diagnostic and Therapeutic Imaging Task Force, from 2006-2010 he was on the Guidelines for the Management of small Renal Masses committee. Currently Dr Kaouk serves as Chairman elect on the AUA New Technology and Imaging committee, and is President Elect of (SURS) Society of Urologic Robotic Surgery. Dr Kaouk is associate editor of Urology journal.

Dr Kaouk have lectured in 130 scientific meetings, chaired 24 urologic meeting and performed live surgery in 18 medical centers worldwide. He authored 460 peer reviewed scientific publication, 26 book chapters and hundreds of scientific abstracts and surgical movies. Dr Kaouk received 32 honors and awards including Cleveland clinic innovator award twice, Teacher of the Year award, and EndoUrology 2017 Best Fellowship Program Director Award.

Presently, Dr Kaouk holds membership with the American Urological Association, the Endourological Society, Society of Urologic Oncology, Society of Robotic Surgery, and the Lebanese Order of Physicians. He is a fellow of the American college of Surgeons.