Robotic Microsurgery in Male Infertility and Urology

Taking Robotics to the Next Level

Ahmet Gudeloglu; Jamin V. Brahmbhatt; Sijo J. Parekattil

Transl Androl Urol. 2014;3(1):102-112.

Conclusions

Robotic assistance for microsurgical procedures in male infertility and urology appears to be a possible adjunct to standard microsurgery. It has several advantages including elimination of tremor, multi-view magnification, additional instrument arms, and enhanced dexterity with articulating instrument arms. The current literature supports that these procedures appear to be safe and feasible. However, larger, prospective studies are needed to demonstrate the clinical benefits over standard microsurgery.

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Acknowledgements
Disclosure: The authors declare no conflict of interest.

Table 1. Demographics and outcomes of 180 robotic assisted microsurgical vasectomy reversals
	RAVV (n=106)	RAVE (n=74)
Median age [years]	41 [23–59]	43 [27–64]
Median duration of obstruction [years]	7 [1–23]	10 [1–49]
Median robotic OR time [minutes]	120 [40–180]	150 [60–210]
Median follow-up [months]	26 [1–73]	25 [1–51]
Patency rate (%)	97	55

RAVV, robotic assisted vasovasostomy; RAVE, robotic assisted vasoepididymostomy; OR, operating room.

Table 2. Classification of robotic microsurgical training models
Training models	Examples
Simulators	Mimic®, Ross®, dv-Trainer®
Non-living non-biological	Plastic rings, Lego®, Silicone, Syndaver®, microsuturing practice cards
Non-living biological	Vas deferens samples from radical cystectomy, earthworm, chicken wing artery, placenta
Living	Mouse, rat, rabbit