Aimed to balance the maximization of oncological results with the minimization of the surgery related impact on patient's quality of life and cosmetic, in 2018, the da Vinci Single-Port (SP) system was approved by the FDA for use in urology patients. Since the beginning, the robotic radical prostatectomy (RARP) is one of the most diffused procedure with this novel platform. The aim of this systematic review is to summarize the clinical experiences with SP-RARP and to present the evidences of perioperative and short terms outcomes.
A systematic review of the Literature was performed in December 2019 using Medline (via PubMed), Embase (via Ovid), Cochrane databases, Scopus and Web of Science (PROSPERO registry number 164129). All the studies that reported intra- and peri- operative data of SP-RARP were included. Cadaveric series and perineal or partial prostatectomy were excluded.
Pooled mean operative time, EBL, hospitalization time, catheterization time were 190.55 min, 198.4 ml, 1.86 days, 8.21 days, respectively. Pooled mean number of lymphnode removed was 8.33, and pooled rate of PSM was 33%. Pooled minor complication rate was 15%. Only one urinary leakage and one major complication (transient ischemic attack) was recorded. Regarding functional outcomes, continence and potency pooled rates at 12 weeks were 55% and 42%, respectively.
The present analysis confirms that SP-RARP is safe and feasible. This novel robotic platform allowed similar intraoperative and perioperative outcomes to standard multiport da Vinci system. The advantages of single incision can be translated in a preservation of patient's body image, self-esteem and cosmetic, that nowadays have a great impact on patient's quality of life.
BJU international. 2020 Apr 04 [Epub ahead of print]
Enrico Checcucci, Sabrina De Cillis, Angela Pecoraro, Dario Peretti, Gabriele Volpi, Daniele Amparore, Federico Piramide, Alberto Piana, Matteo Manfredi, Cristian Fiori, Riccardo Autorino, Prokar Dasgupta, Francesco Porpiglia, Uro-technology SoMe Working Group of the Young Academic Urologists Working Party of the European Association of Urology
Department of Urology, San Luigi Gonzaga" Hospital, Orbassano, Italy., Division of Urology, VCU Health, Richmond, VA, USA., King's College London, Guy's Hospital, London, UK.