Category: Robotic Surgery: New Techniques - Malignant
Introduction & Objective : Single-site robotic assisted laparoscopic nephrectomy yields excellent cosmetic outcomes; however, it introduces unique challenges to the surgeon and the bedside assistant due to its limited working space. Principle among these challenges are suction and irrigation, which are critical to robotic nephrectomy. The Remotely Operated Suction Irrigator (ROSI) is a novel device that allows the robotic surgeon at the console to have complete control over suction and irrigation.
Methods : We present a case of a 34-year-old female with a congenitally dysplastic left kidney with an enhancing renal mass concerning for malignancy. She elects for a single-site robotic assisted laparoscopic radical nephrectomy utilizing the ROSI (Vascular Technology, Inc.). We sought to illustrate it functional properties intra-operatively.
Results : The device operation was successful and is demonstrated in the video. It can be placed through the GelPoint single-site port without its own trocar. It is easily grasped and manipulated by the robotic instruments. The case was completed successfully with an estimated blood loss of 25 mLs. The device could be used completely by the robotic surgeon and was not hindered by limited working area.
Conclusions : The Robotically Controlled Suction Irrigator, or ROSI, is a novel device that can provide the robotic surgeon complete control of suction and irrigation. This removes the hindrance of the bedside assistant during single-site robotic assisted laparoscopic surgery. Further testing is required to evaluate whether device usage improves clinical outcomes.
Brett Johnson, is the current second-year Endourology fellow at University of Texas Southwestern with Drs. Jeffrey Cadeddu and Margret Pearle. He completed residecny in Urology at the University of Wisconson.
Ryan L. Steinberg MD is a fellow in Endourology and Minimally Invasive Surgery at the University of Texas Southwestern.