Turkish robot "Avicenna" for flexible ureterorenoscopic surgery
Friday, 21 October 2011- At the recent EAU 7th South Eastern European Meeting (SEEM) held in Skopje, Karl Storz awarded the third prize for best abstract to a study by Turkish researchers examining the benefits of a new robot, Avicenna, used in the treatment of kidney stones.
Below is the original abstract submitted by winners R. Saglam and colleagues:
Abstract S116: Turkish robot "Avicenna" for flexible ureterorenoscopic surgery
Authors: Saglam R.1, Tokatli Z.2, Kabakçi A.S.3, Koruk E.4
1Medicana International Ankara Hospital, Dept. of Urology, Ankara, Turkey,
2Yüzüncü Yil Hospital, Dept. of Urology, Ankara, Turkey, 3Hacettepe University,
Dept. of Bioengineering, Ankara, Turkey, 4Elmed Co., Dept. of Research and
Development, Ankara, Turkey
Introduction & Objectives: We presented Avicenna, the new robotic manipulator for standard 7,5F flexible ureterorenoscope at EAU 2011 in Vienna and at AUA 2011 in Washington.
In this presentation we aimed to show some advantages of this new robot in the treatment of kidney stones, such as precise positioning of a ureterorenoscope tip, and its stability within the caliceal system, the remote control movement of the laser fiber, to operate seated and away from the radiation.
Material & Methods: We evaluated the information of 12 patients, (5 female, 7 male) with intrarenal stones, treated with robotic use of Storz Flex2 Flexible Uretero Reno Scope (FURS). The mean stone size was 23mm, after insertion of access sheath we introduced the FURS into the upper ureter and connected the FURS to the robot. Using joysticks we remotely controlled the forward and backward movement of the FURS, rotation and deflection of the tip of the FURS and dusted the stone precisely, while seated, outside of the radiation zone.
We adjusted the flow rate of the irrigation fluid if necessary. We could controlled the length of the laser fiber from the tip of the FURS to reach the stone. We tested the FURS after each use for damages. We measured the time for link up, for complete fragmentation and checked the patient for residual fragments by ultrasound and X-ray, after one week and one month.
Results: We successfully controlled all functions of the robot and dusted/ fragmented all of the stones. After one month, stone free rate including the fragments lower than 4 mm was 75%, there were residual fragments larger than 4 mm in 3 patients, we will refragment them during the removal of DJ catheter.
We will evaluate later, the time for fragmentation according to the size and composition of the stone and to compare the time of the hand operated FURS. The connection time of FURS to the robot was shorter than 2 minutes. There were no damage of the FURS.
Conclusions: We found that robotic use of FURS is very suitable to perform it in sitting position, outside of the radiation zone, the position and stability of the tip was satisfied, connection to the robot takes a short time, adjustable fluid flow rate provides better vision.
Source: Poster Session 8, Urolithiasis, EAU 7th South Eastern European Meeting (SEEM), 14-15 October 2011, Skopje. European Urology Supplements, Vol. 10, Issue 9, October 2011.