Robotics in urology.

PURPOSE OF REVIEW: Robotic urologic surgery, an exciting and new emerging frontier in the field of urology, has tremendous potential to progress in the future. It is important, therefore, that urologists keep abreast of the new technologies, their limitations, and the possibility of incorporating them in day-to-day surgery. There are a substantial number of reports on performing complex urological procedures with robotic assistance in humans that document their safety, efficacy and feasibility.

RECENT FINDINGS: Most of the recent reports pertaining to robotic surgery have been in the domain of localized cancer of the prostate (radical prostatectomy), bladder cancer (radical cystectomy and urinary diversion for muscle invasive bladder cancer), kidney surgery (nephrectomy, donor nephrectomy and pyeloplasty), and adrenal surgery. There are also a few anecdotal reports.

SUMMARY: With the potential advantages and latent qualities of robotic assistance in minimally invasive surgery over conventional surgery, robot-assisted surgeries may be developed to the next level and lead to a future revolution of the way surgery is performed. Robot-assisted radical prostatectomy in the management of localized cancer of the prostate is one such example. The impact of robotics is therefore very promising. However, controlled clinical trials and comparisons from various centers are needed. Other important concerns are the cost and training implications. Future application may also allow integration of pre- and intraoperative imaging in the management of urological diseases. In the not too distant future, newer robotic instruments will be added to the armamentarium for performing different urological procedures.