V6-01: ROBOT ASSISTED FLEXIBLE URETEROSCOPIC LASER LITHOTRIPSY, WITH AVICENNA ROBOFLEX

Video

Introductions and Objectives
As recently reported in European Urology, the new robot for flexible ureteroscopy “Avicenna Roboflex” produced by Elmed-Turkey is used now in three Urologic Departments (Ankara, Paris, Heilbronn). In this paper we were able to demonstrate the safety and effectivity of the new robotic device for flexible ureteroscopy. Thus, treatment of kidney stones by using Avicenna Roboflex, is no more experimental. Now, we are searching the additional advantages of the Roboflex.

Methods
Avicenna Roboflex consists of a console and manipulator. The hand piece of the scope is locked to the robotic arm. _x000D_ _x000D_ The surgeon at the console, to controls two joy-sticks to manipulate the rotation, deflection and in and out movement of the endoscope. It is possible to observe the deflection degree, and when necessary switch the European type to the United States type. A central wheel enables fine tuning of deflection inside the collection system. _x000D_ _x000D_ The surgeon can rotate robotically 440 degrees. This minimizes the torsion risk of the endoscope. Once the tip comes on the stone it is usually decreased to 2mm per second to provide an excellent precision of movement._x000D_ _x000D_ Laser fiber can be remotely moved in and out which is very helpful to provide suitable distance between stone and the tip of the laser fiber. Software prevents firing of the laser shot when the laser tip is very close to the endoscope to prevent the laser damages._x000D_ _x000D_ The integrated water pump can be also adjusted remotely. By this way, it is possible to treat the stone with minimal flow rate and to provide low pressure lithotripsy.

Results
Robotic flexible ureteroscopy, provides better ergonomics, prevents the user from radiation exposure, prevents damages of the device_x000D_ In the meantime more than 150 renal stones have been treated with the device at all three centers including a series of larger stones (n=42) with a mean volume of these stones of 1,6 cm3.

Conclusions
Avicenna Roboflex is a new and suitable platform for the flexible ureteroscopy, with free rotatable manipulator, fine movement steerable at console, adjustable to American and European endoscopes, versatile for endoscopes and lasers, the Avicenna Roboflex improves ergonomy by sitting at console with armrest and free control of all functions.

Funding: None