Kidney-cancer surgery more precise with robotic ultrasound

Using robotic ultrasound probes for identification of kidney tumors during robotic partial nephrectomy (RPN) offered the advantage of surgeon autonomy compared with the use of laparoscopic ultrasound probes, according to a retrospective analysis of such procedures. In RPN, a surgeon-controlled robot removes only the diseased part of a cancerous kidney.

The use of ultrasound to identify tumors during kidney-cancer surgery is gaining acceptance, according to a statement from the Henry Ford Health System in Detroit, Michigan. The recent analysis was conducted by Craig G. Rogers, MD, of the Henry Ford Vattikuti Urology Institute, and colleagues.

After evaluating 75 consecutive partial nephrectomies in which a laparoscopic ultrasound probe was used (72 patients) and 75 consecutive partial nephrectomies in which a robotic ultrasound probe was used (73 patients), the researchers concluded that perioperative outcomes and surgical margin rates for robotic ultrasound were comparable to that of laparoscopic ultrasound. As the team reported in  Journal of Endourology, characteristics were similar between groups, and tumors had a similar complexity. Mean operating-room time, blood loss, and positive tumor margin rates did not differ significantly between the two groups. All laparoscopic patients were free of cancer recurrence after a mean follow-up of 25.7 months, and all robotic patients were free of cancer recurrence after a mean follow-up of 10.2 months.

However, the robotic approach allowed the surgeon to take direct control over the procedure rather than rely on an assistant for part of the task, as is required by laparoscopic ultrasound.

“The robotically controlled ultrasound probe performed on par with traditional ultrasound,” affirmed Rogers in the Henry Ford statement, “but with the added benefit of direct surgeon control and precision.”

In addition, noted Rogers, the robotic ultrasound probe is more easily manipulated than the laparoscopic probe when measuring the tumor from certain angles, which in turn reduces the need to move the kidney to gain better position.

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