A randomized controlled trial of human versus robotic and telerobotic access to the kidney as the first step in percutaneous nephrolithotomy.
Comput Aided Surg
; 10(3): 165-71, 2005 May.
Article
em En
| MEDLINE
| ID: mdl-16321914
ABSTRACT
OBJECTIVE:
We present results from the first randomized controlled trial of human vs. telerobotic access to the kidney during percutaneous nephrolithotomy.METHODS:
To compare (a) human with robotic percutaneous needle access and (b) local robotic with trans-Atlantic robotic percutaneous needle access, we used a validated kidney model into which a needle was inserted 304 times. Half the insertions were performed by a robotic arm and the other half by urological surgeons. Order was decided randomly except for a sub-group of 30 trans-Atlantic robotic procedures that were controlled by a team at Johns Hopkins, Baltimore, via four ISDN lines.RESULTS:
All attempts were successful within three passes with a median time of 35 s for human attempts compared with a median of 57 s for robotic attempts. The robot was slower than the human to complete insertions (p < 0.001, Mann-Whitney U test), but was more accurate when compared with human operators as it made fewer attempts (88% robotic vs. 79% human first attempt success; p = 0.046, chi-squared test). Times for trans-Atlantic robotic needle insertion (median = 59 s) were comparable to times taken for local robotic needle insertion (median = 56 s) with no difference in accuracy.CONCLUSION:
Telerobotics is an accurate and feasible tool for future minimally invasive surgery.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Robótica
/
Nefrostomia Percutânea
/
Telemedicina
/
Agulhas
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Revista:
Comput Aided Surg
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Reino Unido