Zamenix™r,机器人辅助逆行肾内手术系统去除肾结石及其疗效和安全性评价

Dong-Ho Lee, Joonhwan Kim, Jung-Gil Han, Hyeon Seo, J. Lee, Sung Yong Cho, H. K. Park, D. Kwon
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摘要

我们介绍了Zamenix™R,一种新型机器人逆行肾内手术(RIRS)系统,可以远程控制输尿管镜,激光和石筐。通过猪模型和多中心、前瞻性、单臂、关键的人体临床试验,对该系统的有效性和安全性进行了体内比较初步研究。在体内试验中,将10头猪随机分为两组,分别为常规RIRS组和机器人RIRS组。3名不同RIRS熟练程度的外科医生参与其中,他们完成了2项任务:1)结石取出测试,然后是2)结石碎裂和取出测试。在临床研究中,招募了47名患有一个或多个最大尺寸为5- 30mm的结石的成年患者。无石率为93.5%。术后并发症发生率为6.5%,2级尿路感染3例(Clavien-Dindo分类)。实验结果证明了该方法的可行性和与常规RIRS相当的安全性,并改善了操作人员的疲劳和辐射暴露。
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ZAMENIX™ R, ROBOTIC-ASSISTED RETROGRADE INTRARENAL SURGERY SYSTEM FOR RENAL STONE REMOVAL AND ITS EFFICACY AND SAFETY EVALUATION
We introduce Zamenix™ R, a novel robotic retrograde intrarenal surgery (RIRS) system that can remotely control a ureteroscope, laser, and stone basket. The efficacy and safety of the system were explored in an in vivo comparative pilot study using a porcine model and a multicenter, prospective, single-arm, pivotal human clinical trial. In the in-vivo test, 10 pigs were randomly divided into two groups: conventional RIRS and robotic RIRS. Three surgeons with different RIRS proficiency participated and they performed two tasks: 1) Stone retrieval test, then followed by 2) Stone fragmentation and retrieval test. In the clinical study, forty-seven adult patients who have one or more stones with a maximum size of 5-30 mm were recruited. The stone-free rate was 93.5%. The postoperative complication rate was 6.5% with three cases of Grade II urinary tract infection (Clavien-Dindo Classification). The experimental results demonstrated the feasibility and comparable safety to conventional RIRS with improved operator’s fatigue and radiation exposure.
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