To assess the feasibility and validity of the establishment of a modified channel for extraperitoneal robot-assisted laparoscopic radical prostatectomy (RARP) through single incision.
From November 2020 to January 2021, 35 cases of localized PCa were treated by extraperitoneal RARP through single incision in our center. All the operations were performed by the same surgeon, none via the multichannel port for the establishment of the channel. We recorded and analyzed the intra- and postoperative parameters, operation cost, complications, pathological findings and follow-up data.
All the operations were successfully completed, without conversion to open surgery or additional channels, or serious postoperative complications, the time for establishing the extraperitoneal space averaging 25.4 (20.0－45.0) min, the operation time 67.3 (35.0－125.0) min, intraoperative blood loss 75.5 (60.0－150.0) ml, time to first postoperative anal exhaust 26 (8－48) h, and postoperative hospital stay 7.89 (7－10) d. Postoperative pathology showed adenocarcinoma in all the cases, with Gleason score (GS) 3+3 in 9 (25.7%), GS 3+4 in 9 (25.7%), GS 4+3 in 8 (22.9%), and GS ≥ 8 in 9 (25.7%) of the cases, 23 (65.7%) in the <pT3aand 12 (34.3%) in the ≥pT3a stage, with a total positive margin rate of 20% (7/35), 13.0% (3/23) in the <pT3a group and 33.3% (4/12) in the ≥pT3a group. The time of drainage tube indwelling averaged 2.68 (2－7) d and urinary catheterization 6.78 (6－9) d. Urinary continence was achieved in 11 cases (31.4%) immediately after catheter removal and in 29 cases (82.8%) at 1 month after surgery. The mean incision length was 4.97 (4.6－5.8) cm and the average follow-up time was 1.88 (1－3) months. The total cost was about ¥6 000 less than that of the robotic surgery via a multichannel port.
The establishment of the modified channel for extraperitoneal RARP through single incision is a safe and feasible procedure, with the advantages of good cosmesis, fast recovery, effective tumor control and continence, no serious postoperative complications, and less cost.、.
Zhonghua nan ke xue = National journal of andrology. 2021 Oct 20 [Epub]
Fang Zhou, Shang-Qing Ren, Shi-da Fan, Qian L, Zheng-Jun Chen, Yong Ou, Yu Nie, Jing-Zhi Tian, Jiao-Jiao Huang, Dong Wang
Center of Robot Minimally Invasive Surgery, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, Sichuan 61000, China.