Robotic Ultrasound Beneficial for Robotic Partial Nephrectomy

August 12, 2013
Leah Lawrence

Surgeons saw advantages in robotic, over laparoscopic, ultrasound probes during robotic partial nephrectomy, and similar perioperative outcomes and margin rates.

The use of robotic ultrasound probes to identify tumors during robotic partial nephrectomy provided advantages to the surgeon while also resulting in similar perioperative outcomes and surgical margin rates as those seen with laparoscopic ultrasound probe, a new study published in the Journal of Endourology indicated.

Currently, ultrasonography is used during partial nephrectomy to visualize the tumor and helps ensure complete tumor removal. However, according to background information in the study, “laparoscopic ultrasound probe renders the surgeon dependent on the assistant to control the probe.”

“Besides giving the surgeon autonomy, the robotic ultrasound probe is more easily manipulated than the laparoscopic probe when measuring the tumor from certain angles,” said Craig Rogers, MD, a urologist at Henry Ford Hospital’s Vattikuti Urology Institute and senior author of the study, in a press release. “This can reduce the need to move the kidney to gain better position.”

Rogers and colleagues conducted a retrospective study of perioperative outcomes taken from 75 partial nephrectomy procedures using laparoscopic ultrasound and 75 procedures with robotic ultrasound.

The researchers found no significant different in characteristics of the groups, perioperative outcomes, or surgical margins:

• Mean nephrectomy score was 6.6 for laparoscopic vs 6.8 for robotic.

• Mean operating room time was 234 minutes vs 218 minutes.

• Mean console time was 173 minutes vs 156 minutes.

• Mean blood loss was 171 mL vs 164 mL.

• Positive tumor margin rates as 1.2% vs 2.2%.

“While our study showed comparable results from both methods of mapping and measuring kidney cancers, the robotic ultrasound probe enables the precision of a robotic instrument as well as direct surgeon control,” Rogers said.

Specifically, the researchers reported that during the course of the study, “the robotic probe resulted in less probe slippage and eliminated the need of probe grabbing for readjustment.”

The researchers stated that more research will need to be conducted to determine if the use of a robotic ultrasound probe will result in a cost savings.

“However, the majority of cost for an intraoperative ultrasound is for the ultrasound machine, not the probe,” the researchers wrote. “If centers doing robotic partial nephrectomy have already made the purchase of an ultrasound machine for an intraoperative ultrasound that is compatible with a robotic ultrasound probe, then the additional cost for a robotic ultrasound probe could be justified given the increased surgeon independence.”