V07-06: A novel technique using the articulating Flexdex(TM) laparoscopic instrument for partial nephrectomy
The FlexDexTM Surgical laparoscopic needle driver, an instrument designed to model the seven degrees of motion the robotic arms mimics while also maintaining traditional laparoscopic advantages may propose an improved solution to the treatment of partial nephrectomy. The following cases aim to demonstrate the implementation feasibility of this instrument in clinical practice.
Two patients were selected as candidates for partial nephrectomy at a center without a robot available. These patients underwent laparoscopic partial nephrectomy using the novel laparoscopic articulating needle driver.
Two patient underwent partial nephrectomy using the articulating instrument. The first patient underwent right sided partial nephrectomy of a 4.7cm mass, with an ischemia time of 44 minutes while the second patient underwent right sided partial nephrectomy of 4.8cm mass showing significantly improved ischemia time of 23 minutes. No complications occurred during these procedures. Preliminary cost analysis shows that variable costs are similar to robotic assisted partial nephrectomy without fixed costs associated with robotic surgery.
This first and second case experience with the FlexDex instrument shows the feasibility of partial nephrectomy, the improvement in increased usage of this novel instrument for the surgeon and the possible alternative to robotic assisted partial nephrectomy. Usage of this instrument or other similar in design would have large cost saving implications if implemented.