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Robotic Surgery in Urology

Clay Mechlin M.D Urologist Urology Associates of Central Missouri. Robotic Surgery in Urology. Utilization of Robotic Platform in Urology. Radical Prostatectomy Partial Nephrectomy Pyeloplasty and Ureteral Reconstruction Microsurgery and Male Infertility. Advantages of Robotic Platform.

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Robotic Surgery in Urology

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  1. Clay Mechlin M.D Urologist Urology Associates of Central Missouri Robotic Surgery in Urology

  2. Utilization of Robotic Platform in Urology • Radical Prostatectomy • Partial Nephrectomy • Pyeloplasty and Ureteral Reconstruction • Microsurgery and Male Infertility

  3. Advantages of Robotic Platform • Suturing and wrist articulation • Stability of operative field • Ergonomics • Decrease “tremor”, increased accuracy/precision of suture placement • Ease of magnification • Stereo Vision • Increased surgeon autonomy

  4. Radical Prostatectomy • Robotic vs Open • Surgeon Experience is #1 • Decrease length of stay • D/C POD 1 • Decrease blood loss and transfusion • Shorter learning curve

  5. Radical Prostatectomy and Bleeding /Transfusion

  6. Urethral Anastomosis

  7. Kidney and Ureteral Surgery • Kidney Cancer • Morbidity with Open approaches for nephron sparing surgery

  8. Robotic Partial Nephrectomy • Decrease morbidity of incision with lap approach • Kidney Reconstruction • Warm ischemia times

  9. Robotic Pyeloplasty for UPJ Obstruction

  10. Robotic Pyeloplasty Pre Post

  11. Magnification and Visibility • Stereotactic Vision (depth perception) • No restriction of focal length Prevent Complication of Hydrocele Fluid around testicle) Seminiferous Tubule: 200-300 microns in diameter! (thickness of human hair = 100um, avg. sheet of paper = 90um)

  12. Microsurgery for Male Infertility

  13. Summary: Robotic Platform in Urologic Surgery • Advantages • Wrist Articulation with Laparoscopic approach • Decrease tremor, increased accuracy/precision of suture placement • Stereo Vision • Teaching and Education • Increased Surgeon Autonomy • Cons • Access • Cost • Lack of tactile feedback

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