Zukunft der Laparoskopie und Robotik in der Urologie

Zusammenfassung

Die Robotik hat die klassische Laparoskopie in den letzen Jahren etwas an den Rand gedrängt. Dennoch hat sich auch die Laparoskopie und Retroperitoneoskopie in den letzten Jahren technologisch weiterentwickelt mit 4K-Ultra-HD-Videotechnologie, 3D-HD-Videosystemen, miniaturisierten Instrumenten, modernen Schneid- und Koagulationsverfahren, Instrumenten mit 7 Freiheitsgraden und ergnomischen Plattformen Ethos Chair^®. Aufgrund der auslaufendenden Patente von Intuitive Surgical wird ab 2019 eine Konkurrenzsituation mit neuen Herstellern von Operationsrobotern existieren. Diese müssen erst belegen, ob sie den hohen Qualitätsstandard der Da-Vinci-Serie (SI, X, XI) bieten können. Dies betrifft die Art der Konsole, Anordnung der Roboterarme, Technologie des 3D-Videosystems und Qualität und Freiheitsgrade der Endeffektoren. Robotersysteme für die Endourologie sind Avicenna Roboflex^® für die flexible Ureteroskopie und AquaBeam^®-System für die Roboter-assistierte Aquaablation der Prostata. Während Roboflex ähnlich dem Da-Vinci-System die Ergonomie des Eingriffes erleichtert, ersetzt die robotergestützte Aquaablation erstmals den Operateur.

Abstract

The introduction of robotics led to a decrease in the importance of classical laparoscopy. Nevertheless laparoscopy and retroperitoneoscopy underwent significant technological improvements during the last decade, including introduction of 4k Ultra HD video technology, 3D-HD-videosystems, minaturised instruments, advanced sealing devices, instruments with 7 degrees of freedom, and ergonomic platforms Ethos Chair^®. The monopoly of robotic surgical devices will end in 2019, because key patents of Intuitive Surgical will expire. This will lead to an interesing competition among new manufacturers of robotic surgical devices, which however have to prove that they meet the high quality standard of the current da Vinci series, such as type of console, arrangement of robotic arms, technology of 3D-videosystem, and quality and degrees of freedom of end effectors. There are also robotic systems used in endourology: Avicenna Roboflex^® and the AquaBeam^®-System for robot-assisted aquablation therapy of the prostate. While Roboflex improves the ergonomics of flexbile ureteroscopy, AquaBeam may for the first time eliminate the surgeon.

Schlüsselwörter

chirurgische Roboter - Laparoskopie - Endourologie - robotische flexible Ureteroskopie - robotische TURP

Keywords

surgical robots - laparoscopy - endourology - robotic flexible ureteroscopy - robotic TURP

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