Robot assisted Partial Nephrectomy with the REVO I Robot Platform in Porcine Models.
After the introduction of the da Vinci system (Intuitive Surgical, Sunnyvale, CA, USA) the trend in minimally invasive surgery accelerated, including robot assisted partial nephrectomy (RPN) for treatment of localized renal tumors [1] Introduction of the robotic platform showed great advantages in terms of learning curve and feasibility in the field of minimally invasive surgery [2] However, the robotic platform had some specific limitations such as the absence of tactile feedback, and the costs and maintenance of the equipment remain high [3] Recently, the markets for robotic platforms have been varied, and new robotic platforms have been developed. In Korea, a new robotic platform has been developed, called REVO I (model MSR5000; Meerecompany Inc, Seongnam, Republic of Korea) and we performed a pilot study of the benefits of this platform in porcine models with RPN. The REVO I robot consists of a surgeon control console (MSRC 5000) a four arm robotic operation cart (MSRO5000) a high definition (HD) vision cart (MSRV 5000) and reusable endoscopic instruments (Fig. 1) After induction of general anesthesia, the pig was placed in a lateral flank position. The first and second procedureswere performed in lower pole kidney, and the third and fourth procedureswere performed in upper pole kidney. The surgeon was placed at the surgeon control console, and the first assistant was positioned at the robotic operation cart. RPN was performed through one supraumbilical 12.2mm port and three 9.3 mm robotic ports. A 12.2 mm camera port was inserted just superior to the umbilicus, a 9.3 mm port was placed just lateral to the midline between the umbilicus and xiphoid, and two 9.3 mm ports were caudal and lateral from the supraumbilical port. A 12 mm assistant port was placed caudal to the supraumbilical port. We used four robotic arms: one for the three dimensional HD 10 mm scope (Conmed, Utica, NY, USA) and three for the operative instruments. An additional lateral 12 mm port was placed for the assistant instruments. Instruments including a Maryland bipolar grasper, monopolar scissors,
European urology