Endourology/MISFlexible Robotic Retrograde Renoscopy: Description of Novel Robotic Device and Preliminary Laboratory Experience
Section snippets
Material and Methods
The procedure was performed bilaterally in 5 acute swine (weight 27 to 51 kg) after approval from the institutional animal care and use committee. The novel robotic catheter system (Fig. 1) comprises the following components: (a) surgeon console, including the LCD display and master input device, (b) steerable catheter system, (c) remote catheter manipulator, and (d) electronic rack.
Results
Balloon dilation of the intramural ureter was required in 2 of (20%) 10 kidneys to accommodate the robotic catheter system (Table 1). Of the 85 calices in the 10 kidneys, 83 (98%) could be adequately inspected with the flexible robotic system. Two lower pole minor calices, one in each kidney of animal 5 (weight 32 kg), could not be entered because of their small ostial size; however, a 3F basket could be passed into both these calices under direct endoscopic vision. The time required to inspect
Comment
The development and refinement of robotic technology has evolved into the recent development of a robotic flexible catheter manipulator (Sensei, Hansen Medical) that was initially and primarily developed for cardiac electrophysiologic application. This novel flexible robotic catheter system has the potential to further enhance the capabilities and efficiency of conventional flexible ureteroscopy. The Sensei remote robotic catheter system works on the principle of a master-slave robotic
Conclusions
We describe a novel robotic flexible catheter control system for remotely performing retrograde flexible ureterorenoscopy. Our initial experience in the acute porcine model was encouraging. Success was achieved in performing diagnostic ureteroscopy in all 10 kidneys tested and with the therapeutic maneuvers in the 6 kidneys tested. Additional refinement of this technology and planning of the initial clinical trial are currently underway.
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M. M. Desai is a consultant and stockholder in Hansen Medical; I. S. Gill is a consultant to, and stockholder in, Hansen Medical; and F. Moll, G. Stahler, C. Carlson, and C. Barbagli are employees of Hansen Medical, Mountain View, California.
This study was funded by Hansen Medical, Mountain View, California.