Background and objectives: A new method of mounting the AESOP (Automated Endoscopic System for Optimal Positioning-Computer Motion Inc., Goleta, CA) robotic arm for use in laparoscopic flank procedures is described, Methods: The AESOP robotic arm was mounted on a specially developed bracket to allow under-table positioning of the device on a specially-designed radiolucent laparoscopic urology table (Orthopedic Systems Inc., Union City, CA). With the AESOP device controlling the laparoscope, laparoscopic right total nephrectomy was performed in a patient with renal failure and a lower pole renal mass. Results: The operative time was 315 min, The robotic arm was able to control the camera with the patient in the flank position, providing a stable, clear view during the procedure. Conclusions: The use of a robotic arm to manipulate the laparoscope can significantly assist laparoscopic surgery. The AESOP device, intended for attachment to a standard operating table to provide for robotic control of the laparoscope with the patient in the supine position, can be used for renal and/or ureteral laparoscopic surgery with the patient in the flank position using a new under-table mounting adapter.
