1993 SAFETY AND EFFICACY OF ROBOTIC AQUABLATIONTM RESECTION OF PROSTATE FOR TREATMENT OF BENIGN PROSTATIC HYPERTROPHY (2013)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (II)1 Apr 20131993 SAFETY AND EFFICACY OF ROBOTIC AQUABLATIONTM RESECTION OF PROSTATE FOR TREATMENT OF BENIGN PROSTATIC HYPERTROPHY Kenneth Faber, Andre Abreu, Patrick Ramos, Osamu Ukimura, Nikolai Aljuri, Surag Mantri, and Mihir Desai Kenneth FaberKenneth Faber Los Angeles, CA More articles by this author , Andre AbreuAndre Abreu Los Angeles, CA More articles by this author , Patrick RamosPatrick Ramos Los Angeles, CA More articles by this author , Osamu UkimuraOsamu Ukimura Los Angeles, CA More articles by this author , Nikolai AljuriNikolai Aljuri Redwood Shores, CA More articles by this author , Surag MantriSurag Mantri Redwood Shores, CA More articles by this author , and Mihir DesaiMihir Desai Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2412AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the safety and efficacy of a novel robotic tissue ablation system (AquablatorTM, PROCEPT BioRobotics, Redwood Shores, CA) in performing prostate ablation in a canine model. METHODS The Aquablator is an integrated system with two central mechanisms. First, a high-velocity saline stream is delivered under precise motion control that selectively ablates prostatic glandular tissue while sparing collagenous structures like blood vessels and capsule. Second, a laser beam is captured by a low-power waterjet to produce effective surface hemostasis with a very low laser power (2-4W). The extent and depth of ablation is pre-determined by endoscopic and transrectal ultrasound (TRUS) guidance and is monitored using real-time TRUS. The postulated advantage of the Aquablator is a rapid ablation of adenomatous elements with minimal bleeding that may result in an effective and rapid treatment option for patients with symptomatic BPH. The procedure was performed in 8 non-castrated male beagles aged 6 years or older (Acute 2, Chronic 6) through a perineal urethrostomy. RESULTS The length of the prostatic urethra for all 8 dogs, measured from verumontanum to bladder neck ranged from 10 to 20 mm (mean 14.6 mm). Aquablation time ranged from 40 to 84 secs (mean 60.5 secs). There was no active bleeding in any of the dogs after Aquablation, but waterjet-guided laser coagulation was used for purposes of monitoring its safety and efficacy. Coagulation time ranged from 180 to 500 secs (mean 372 secs). 5 of the 6 dogs who underwent chronic study survived to the pre-determined 6 week mark. Complications included 2 dogs with infection successfully treated with antibiotics, a false passage created during catheter placement, and 2 bladder neck perforations (from mechanical insertion), one leading to euthanasia on POD 2 and the other treated successfully with exploratory laparotomy and repair. Most complications were a result of the peculiar anatomy or need for a perineal urethrostomy specific to the animal model. 6-week histological evaluation revealed a normal cellular architecture and full re-epithelialization of the treatment cavity whereas a 0.4-0.5 mm zone of acute inflammation was visible in the acute cases. CONCLUSIONS We report the initial survival data in the animal model of a novel robotic device developed for treating symptomatic BPH. The Aquablator produces rapid ablation of adenomatous elements while preserving collagenous structures. Phase I clinical trials of this promising technology are awaited. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e818 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenneth Faber Los Angeles, CA More articles by this author Andre Abreu Los Angeles, CA More articles by this author Patrick Ramos Los Angeles, CA More articles by this author Osamu Ukimura Los Angeles, CA More articles by this author Nikolai Aljuri Redwood Shores, CA More articles by this author Surag Mantri Redwood Shores, CA More articles by this author Mihir Desai Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...