Abstract: PD18-08
Sources of Funding: none

Introduction

Pre- and intraoperative data from all patients who underwent robotic retrograde intrarenal stone surgery (robRIRS) using the Avicenna Roboflex system (Elmed, Turkey) at the two european robotic stone centers located in Heilbronn (Germany) & Ankara (Turkey) was prospectively recorded and analyzed.

Methods

In 2013&2014 the Roboflex system was successfully introduced in two european stone centers. All data of patients (n=266) who underwent robRIRS with the system was prospectively recorded and analyzed

Results

General data: n=266 (?=90, ?=176), age: 55a, min 25a, max 76a, BMI: 29,1; min 20,6, max 43,3; ASA: 2,3, UTI preop: 14%, Stone localisation: right: 118x, left 148x, Number of stones/kidney: 1,8 min:1, max 6; stone load: 1620 mm³, min 98, max 10600; prestentet: 43%.
Intraop data: number of surgeons: 5, OR-time: 96min; min 58, max 193; access sheath used: 100%, Instrument: Digital flex scope incl. chip on the tip technology. Stonetreatment: Holmiumlaserdesintegration: 92%, fragment extraction using dormia basket: 42%, console time: 65 min, min 16, max 174, stoneclearance rate: 25 mm³/min, min: 9, max 101. postop: DJ 44%.
Complications intra-op: 0,7% technical system failure. Stone migration: 20%.
X-ray parameters: time 02:30min, 297 cGy*cm².
Robottimes: Preparation&Set up time preop: 04:30 min, min 3, max 8, docking time 4min, min1, max 29, console time to stonecontact: 4 min, min 1, max 12.

Conclusions

All technical surgical aspects of flexible URS (dusting & fragmentation of the stone, stone extraction with a stone basket aso) has been completely and successfully performed using the robot system. The robot provides a non exhausting environment for the surgeon especially in larger stone loads with a reduction of radiation exposure of the surgeon during the procedure. Stonetreatment using robRIRS can be safely performed. The set up of the system is not time-consuming. The clinical application of the system in an every day routine setting can be managed easily within a short learning curve.