Initial Experience with da Vinci Single-port Robot-assisted Radical Prostatectomies

Deepak K. Agarwal, Vidit Sharma, Amir Toussi, Boyd R. Viers, Matthew K. Tollefson, Matthew T. Gettman, Igor Frank

Research output: Contribution to journalArticlepeer-review

88 Scopus citations

Abstract

Background: Single-port robotic surgery is being adopted for various surgical procedures. There have been interest in and clinical use of single-port robot-assisted radical prostatectomy (spRARP), but little reported data on feasibility and early outcomes. Objective: To describe our institution's initial experience with spRARP utilizing the da Vinci single-port (SP) robotic system. Design, setting, and participants: A retrospective review of the initial experience of three high-volume robotic prostate surgeons performing an spRARP utilizing the da Vinci SP robotic system was carried out. Surgical procedure: An spRARP using the da Vinci SP robotic system was performed following the traditional retropubic or Retzius-sparing approach. Measurements: Patient demographics, operative time, blood loss, postoperative hospital stay, complications, and catheter duration were obtained and analyzed. Results and limitations: In a cohort of 49 patients undergoing spRARP, median age was 62 yr and prostate-specific antigen 6.4. Of the patients, 35 (71%) had cT1c disease on presentation, 92% had Gleason grade group ≥2 disease, and 85% were pT2 on final pathology. Median operative time was 161 min. Median blood loss was 200 ml. Seven Retzius-sparing cases were performed. Four Clavien 2 complications occurred (complication rate 8.1%). Median hospital stay was 1 d and median catheter duration 7 d. Operative time was <200 min for all three surgeons by their third case. Conclusions: The da Vinci SP system spRARP is safe and feasible, with acceptable operative time and blood loss. Further research is needed to establish noninferiority to the da Vinci Xi and Si systems, and impact of spRARP on patient-assessed cosmesis and pain. Patient summary: Robotic prostatectomy using a purpose-built da Vinci single-port robotic system is safe and feasible, and warrants further study to determine whether it can improve patient outcomes. Single-port robot-assisted radical prostatectomy utilizing the da Vinci SP system is safe and feasible, and has an acceptable learning curve. Retropubic and Retzius-sparing approaches can be undertaken with acceptable immediate postoperative outcomes.

Original languageEnglish (US)
Pages (from-to)373-379
Number of pages7
JournalEuropean Urology
Volume77
Issue number3
DOIs
StatePublished - Mar 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2019 European Association of Urology

Keywords

  • Laparoendoscopic single site
  • Prostate cancer
  • Prostatectomy
  • Robotic surgery
  • Single port

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