Advantages and Disadvantages of Robotic Technology in Urology – Dr. Shaw Zhou

Shaw Zhou, MD of St Petersburg, FL

My name is Shaw Zhou, I am with Advanced Urology Institute.

Robotic surgery is truly precise, for example, the magnify [goes] up to ten times so the doctor can see better and if your doctor has a hand tremor [it’s still] very steady. You got four arms instead of two arms, so you have two arms to grab for you and so on and so forth. And you have three dimensional [view], you can see much better. The traditional labs got surgical screens which are two dimensional so you don’t have that sense of depth. However the drawback is first of all, the doctor sits 10 feet away, so God forbid if something happened, your doctor will have to go in, wash your hands and you are not by your patient

Also you lose the tactile sensation, cause you don’t feel it no more. When you tie a knot or whatever you know, the tactile sensor feed gives how much force you use now, [before] it’s purely by experience. Although the new robot that we’re talking about that has tactile sensationin other words you can visually see it. They see how much force [is needed] if its red or green. So it’s getting better and better, eventually new robots keep on coming out but in the future I think we can overcome all these shortcomings for robot surgery.

How Percutaneous Nephrolithotomy Works?

Percutaneous Nephrolithotomy (PCNL) is a minimally invasive surgical procedure for removing upper ureteral stones and kidney stones larger than 2 centimeters in diameter. Historically, larger stones were removed in open surgery, which required a larger flank incision. Percutaneous nephrolithotomy (nephrolithotripsy) is a more refined alternative to open surgery, using a 1-centimeter skin incision. The procedure reduces blood loss, pain and hospital stay and has an increased success rate.

During PCNL, the patient is given general anesthesia before a needle is inserted through the skin to puncture the kidney and create a channel through which a nephroscope is passed into the kidney to break the stone into fragments for easy extraction. The entire procedure takes 3-4 hours.

During percutaneous nephrolithotomy:

  • The patient receives general anesthesia to make the procedure less painful. The patient then lies face down on the abdomen.
  • The surgeon performs cystoscopy (telescopic exam of the bladder) and instills X-ray dye or carbon dioxide into the kidney using a small catheter through the ureter of the affected kidney. This helps the surgeon to locate the stone more precisely.
  • After locating the stone, the urologist makes a small incision on the back and passes a tiny needle through the skin (under X-ray guidance) into the kidney to directly access the stone.
  • The needle tract is dilated to about 1-centimeter to enable placement of a plastic sheath and telescope for visualizing the stone.
  • Using a laser or mechanical lithotripsy device, the surgeon breaks the stone into smaller fragments and extracts the pieces through the sheath.
  • At the end of the operation, temporary catheters, a nephrostomy tube for the kidney and a stent tube for the bladder, are used to drain urine. The catheters are removed before discharge from hospital, usually after 2-4 days.

Percutaneous nephrolithotomy is recommended when:

  • Urine flow is blocked.
  • Kidney stones obstruct several branches of the collecting system of the kidney (also called staghorn kidney stones).
  • Kidney stones are bigger than 2 centimeters (0.8 inch) in diameter.
  • Urine leakage is occurring inside the body.
  • There is severe pain even after treatment for a kidney stone.
  • Kidney stone is causing damage to the kidney.
  • Other treatment options have failed.
  • The urologist will request several tests before the operation. Blood and urine tests check for infection and other problems, while a computerized tomography (CT) scan helps to determine the location of the stones.

Advantages of PCNL:

  • Minimally-invasive procedure, with less pain, quick recovery, shorter hospital stay (2-4 days) and quick return to work (7-10 days).
  • No surgical scar or complications associated with large incision operations.
  • Less risk of postoperative infections compared to open surgery.
  • Minimal harm to kidney function.
  • Limits residual stones, as the surgeon has the opportunity to look inside the renal calyx and ureter.
  • Percutaneous nephrolithotomy is effective for most people with stones in the ureter or kidney. Its stone free rate is greater than 90 percent and is the highest of all procedures.

For more information on treatment of kidney stones, visit Advanced Urology Institute.

Who uses the Davinci Robotic System for kidney cancer treatment? – Dr. Evan Fynes


  • Dr. Evan Fynes, a urologist in Port Orange, FL, uses the DaVinci Robotic System for kidney cancer treatment, performing both total and partial nephrectomies.
  • The DaVinci Robotic System provides enhanced visualization and precision during surgery, allowing for more accurate tumor removal and preservation of healthy kidney tissue.
  • Robotic-assisted kidney cancer surgery results in reduced pain and faster recovery times for patients compared to traditional open procedures.

The DaVinci Robotic System has revolutionized various fields of surgery, including urology. Dr. Evan Fynes, a urologist in Port Orange, FL, specializes in using this advanced technology for kidney cancer treatment. In this article, we will discuss how Dr. Fynes employs the DaVinci Robotic System for kidney cancer procedures, such as nephrectomies, and the benefits it offers patients.

Robotic Surgery for Kidney Cancer

In the past, kidney cancer surgeries required large incisions and lengthy hospital stays. However, with the introduction of the DaVinci Robotic System, patients can now experience quicker recovery times and reduced pain. Dr. Fynes uses the robotic system to perform both total and partial nephrectomies. Total nephrectomies involve the removal of the entire kidney, while partial nephrectomies allow for the removal of only the tumor, preserving the healthy kidney tissue.

Enhanced Visualization and Precision

One of the key benefits of the DaVinci Robotic System is the improved visualization it provides during surgery. The system magnifies the surgical field, allowing Dr. Fynes to perform precise dissections and remove tumors with greater accuracy. This enhanced visualization is particularly beneficial for partial nephrectomies, where it is crucial to separate the tumor from the healthy kidney tissue without causing damage.

Reduced Pain and Faster Recovery

Robotic-assisted surgery with the DaVinci Robotic System is significantly less painful for patients compared to traditional open procedures. The smaller incisions used in robotic surgery result in less blood loss, reduced pain, and faster healing. As a result, patients can return home and resume their normal activities much sooner. According to Dr. Fynes, patients who undergo robotic-assisted kidney cancer surgery are typically discharged from the hospital in just two or three days, compared to five to seven days for traditional open procedures.

Advanced Urology Institute

Dr. Evan Fynes is a part of the Advanced Urology Institute, the largest urology practice in Florida. This institute is committed to providing the highest quality of care for their patients through the use of cutting-edge technology, such as the DaVinci Robotic System. By choosing the Advanced Urology Institute for your kidney cancer treatment, you can trust that you are receiving the best possible care from highly skilled and experienced professionals.


Back in olden days, so to speak, we used to make a bigger incision, and the patient would
be in the hospital five to seven days, and now with the robot, a lot of people are home
in two or three days after removing a kidney.
Hello, Dr. Evan Fynes, I’m a urologist with Advanced UrologyInstitute.
So the robot is also being used extensively for kidney type, kidney surgery, whether it’s
removing the whole kidney for somebody with a presumed kidney cancer, or a lot of times
these days we’re doing something called partial nephrectomies with the robot, where you’re
able just to remove the tumor and leave the kidney behind.
In regards to robotic surgery with the kidney, it just magnifies everything.
You’re able to get fine movements to dissect the tumor off, remove the tumor, and close
the kidney back up.
It’s also a lot less painful for patients.


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