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Robotic Surgery

The NYU Urology Robotic Surgery Team

Advances in computer technology and miniaturization of surgical instruments have enabled the introduction of robotics into urologic surgery. At NYU Urology Associates, we use robotic surgery to manage kidney cancer, prostate cancer and adrenal tumors; to perform reconstructive urologic surgery and to repair obstructions in the urinary tract. Our surgeons have performed hundreds of robotic surgeries since 2003 with a highly experienced surgical team and have co-authored some of the largest clinical research studies describing the efficacy of robotic surgery. In addition, with the addition of Dr. Mani Menon to the robotic surgical team in 2008, NYU Urology Associates has gained a world-renowned expert in robotic-assisted prostate surgery, who has performed over 2,500 of these complex surgical procedures since 2001. Robotic surgery provides all the advantages of traditional minimally invasive laparoscopic surgery while adding some distinct advantages.

About the da Vinci surgical system

The da Vinci robotic surgical system in use at NYU consists of a surgical tower and a console. The tower has three robotic arms: one with a pair of small video cameras attached to a fiber optic cable, and two with specialized adaptors for the attachment of quarter-inch-wide surgical instruments. The surgical console, where the surgeon sits, has a stereoscopic 3-D monitor that projects images from the camera in real time, and two joysticks controlled by the surgeon, allowing the movement of the surgeon's hands and fingers to be precisely translated into movements of the robotic surgical instruments. It is analogous to miniaturizing the surgeon’s hands and eyes and placing them inside the body.

About robotic surgery

During robotic surgery, three small incisions are made in the patient’s abdomen. The three arms of the tower are inserted into the patient's body through the incisions and controlled by the surgeon seated at the console. The operation then proceeds similarly to standard laparoscopic surgery, but with several advantages over the traditional technique. First, it gives the surgeon a three-dimensional stereoscopic view of the surgical field, as opposed to the two-dimensional view in traditional laparoscopic surgery. Second, it allows a greater range of motion of the surgical tools: any motion that can be done by a surgeon’s hand or wrist can be translated into a movement of the robotic surgical instruments. It also provides scaled-down movement, meaning that a relatively large movement of the surgeon’s hand at the console translates into a very fine movement of the robotic tool. These factors allow for more precision within a smaller operative field and are particularly useful in procedures that involve extensive suturing and reconstruction.

Videos

Watch videos of robotic procedures:

Related publications by NYU urologists

  • Mufarrij PW, Woods M, Shah OD, Palese MA, Berger AD, Thomas R, Stifelman MD. Robotic Dismembered Pyeloplasty: A 6-Year, Multi-Institutional Experience. J Urol. 2008 Aug 14.
  • Mufarrij, PW, Shah OD, Berger AD, Stifelman MD. Robotic reconstruction of the upper urinary tract. J Urol.178(5): 2002-5, 2007
  • Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 2007 Nov 1;110(9):1951-8.
  • Korets R, Hyams ES, Shah OD, Stifelman MD. Robotic-assisted laparoscopic uterocalicostomy. Urology. 70(2): 366-9, 2007.
  • Breda A, Stepanian SV, Lam JS, Liao JC, Gill IS, Colombo JR, Guazzoni G, Stifelman MD, Perry KT, Celia A, Breda G, Fornara P, Jackman SV, Rosales A, Palo J, Grasso M, Pansadoro V, Disanto V, Porpiglia F, Milani C, Abbou CC, Gaston R, Janetschek G, Soomro NA, De la Rosette JJ, Laguna PM, Schulam PG. Use of Haemostatic Agents and Glues during Laparoscopic Partial Nephrectomy: A Multi-Institutional Survey from the United States and Europe of 1347 Cases. Eur Urol. 2007.
  • Breda A, Stepanian SV, Liao J, Lam JS, Guazzoni G, Stifelman MD, Perry K, Celia A, Breda G, Fornara P, Jackman S, Rosales A, Palou J, Grasso M, Pansadoro V, Disanto V, Porpiglia F, Milani C, Abbou C, Gaston R, Janetschek G, Soomro NA, de la Rosette J, Laguna MP, Schulam PG. Positive margins in laparoscopic partial nephrectomy in 855 cases: a multi-institutional survey from the United States and Europe. J Urol.178 (1):47-50, 2007.
  • Menon M, Shrivastava A, Kaul S, Badani KK, Fumo M, Bhandari M, Peabody JO. Vattikuti Institute prostatectomy: contemporary technique and analysis of results. Eur Urol. 2007 Mar;51(3):648-57
  • O'Malley RL, Berger AD, Kanofsky JA, Phillips CK, Stifelman MD, Taneja SS. A matched-cohort comparison of laparoscopic cryoablation and laparoscopic partial nephrectomy for treating renal masses. BJU Int. 99(2):395-8, 2007.
  • Caruso RP, Phillips CK, Kau E , Taneja SS, Stifelman MD. Robot assisted laparoscopic partial nephrectomy: initial experience. J Urol. 176(1):36-9, 2006.
  • Menon M, Kaul S, Bhandari A, Shrivastava A, Tewari A, Hemal A. Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia-sparing techniques. J Urol. 2005 Dec;174(6):2291-6.
  • Palese MA, Muver R, Phillips CK, Dinlenc C, Stifelman MD, DelPizzo, JJ. Robot-assisted laparoscopic dismembered pyeloplasty. JSLS. 9(3):252-7, 2005.
  • Phillips CK, Taneja SS, Stifelman MD. Robot-assisted laparascopic partial nephrectomy: the NYU technique. J Endourology. 19(4):441-5; discussion 445, 2005.
  • Palese MA, Stifelman MD, Munver R, Sosa RE, Philipps CK, Dinlenc C, Del Pizzo JJ. Robot-assisted laparascopic dismembered pyeloplasty: a combined experience. J Endourology. 19(3):382-6, 2005.
  • Stifelman MD, Caruso RP, Nieder AM, Taneja SS. Robot-assisted laparoscopic partial nephrectomy. JSLS. 9(1):83-6, 2005.