Robotic renal surgery: The future or a passing curiosity?

Authors

  • Jeff Warren Department of Surgery, Division of Urology, University of Western Ontario, Schulich School of Medicine, University of Western Ontario, London, ON
  • Vitor da Silva Schulich School of Medicine, University of Western Ontario, London, ON
  • Yves Caumartin Department of Surgery, Division of Urology, Laval University, Québec City, QC
  • Patrick P.W. Luke Department of Surgery, Division of Urology, University of Western Ontario, Schulich School of Medicine, University of Western Ontario, London, ON

DOI:

https://doi.org/10.5489/cuaj.1080

Abstract

The development, advancement and clinical integration of robotic
technology in surgery continue at a staggering pace. In no other
discipline has this rapid evolution occurred to a greater degree
than in urology. Although radical prostatectomy has grown to
become the prototypical application for the robot, the role of the
robot in renal surgery remains controversial. Herein we review
the literature on robotic renal surgery. A comprehensive PubMed
literature search was performed to identify all published reports
relating to robotic renal surgery. All clinically related articles
involving human participants were critically appraised in this
review. Fifty-one clinical articles were included, encompassing
robot-assisted pyeloplasty, nephrectomy, nephroureterectomy,
living-donor nephrectomy and partial nephrectomy. Feasibility
has been shown for each of these procedures. Robot-assisted techniques
have been described for almost all renal-related procedures.
However, the intersect between feasibility and necessity
as it pertains to robotic renal surgery has yet to be defined. Also,
the high cost of surgical robotic technology mandates critical
appraisal before adoption, especially in a publicly funded health
care system, such as the one present in Canada.

Le développement, le perfectionnement et l’intégration en milieu
clinique de la technologie robotique en contexte opératoire se
poursuit à un rythme stupéfiant. Aucune autre discipline n’a vu
cette évolution rapide à un niveau aussi élevé que l’urologie.
Alors que la prostatectomie radicale en est devenue l’application
prototype, le rôle de la robotique en chirurgie rénale demeure
controversé. Dans l’article qui suit, nous passons en revue la
littérature portant sur l’emploi de la robotique en chirurgie rénale.
Une recherche exhaustive dans la base de données PubMed a
été effectuée afin de cerner les rapports sur le sujet. Tous les rapports
cliniques portant sur des sujets humains ont été évalués.
Cinquante et un articles cliniques ont été inclus dans notre
analyse, incluant des cas, tous assistés par robot, de pyéloplastie,
de néphrectomie, de néphro-urétérectomie, de néphrectomie
chez des donneurs vivants et de néphrectomie partielle. Pour chacune
de ces interventions, la faisabilité a été démontrée. Des techniques
assistées par robot ont été décrites pour pratiquement tousles types d’interventions rénales. Néanmoins, le point d’intersection
entre faisabilité et nécessité concernant l’utilisation de la
robotique reste à définir. Par ailleurs, le coût élevé de la robotique
chirurgicale justifie une évaluation critique avant l’adoption
de cette technologie, en particulier dans un système de santé
public comme celui du Canada.

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Author Biographies

Jeff Warren, Department of Surgery, Division of Urology, University of Western Ontario, Schulich School of Medicine, University of Western Ontario, London, ON

Vitor da Silva, Schulich School of Medicine, University of Western Ontario, London, ON

Yves Caumartin, Department of Surgery, Division of Urology, Laval University, Québec City, QC

Patrick P.W. Luke, Department of Surgery, Division of Urology, University of Western Ontario, Schulich School of Medicine, University of Western Ontario, London, ON

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How to Cite

Warren, J., da Silva, V., Caumartin, Y., & Luke, P. P. (2013). Robotic renal surgery: The future or a passing curiosity?. Canadian Urological Association Journal, 3(3), 231–40. https://doi.org/10.5489/cuaj.1080

Issue

Vol. 3 No. 3 (2009): CUAJ June

Section

Review

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