In 2018, the USFDA approved the da Vinci single-port (SP) system, in which four instruments are still utilized, but enter via a single-site access trocar. Herein, we report the largest case series for SP robot-assisted radical prostatectomy (RARP) to date.
Our primary aim is to analyze the peri-operative and short-term outcomes of this procedure. Our secondary aim is an assessment of the learning curve with this new platform.
A total of 157 patients underwent SP RARP by two surgeons who have completed over 3000 multiport robotic surgeries collectively. IRB approved prospectively collected data was used. Basic demographic pre-operative variables and peri-operative outcomes were analyzed.
Median patient age and PSA was 63 years and 6.3 ng/mL prior to treatment (IQR 4.7 - 8.2 ng/mL). Average prostate weight was 47 g. The median operating time was 195 min (IQR 165 - 221.25 min) with a median EBL of 100 mL (IQR 100 - 200 mL). Surgeon 1's operating time stabilized around case #56, and Surgeon 2 around case #26. Surgeon 2 used the transperitoneal approach for the first seven cases. There were no intraoperative complications. There were six total post-operative complications (3.8%) and four (2.5%) were Clavien-Dindo scale greater than or equal to IIIa. 110 patients went home same day, 45 stayed one night at the hospital, with only two patients requiring stay in the hospital for more than one night (70%, 29% and 1% respectively). With the median follow-up period of nine months, rates of biochemical recurrence, pad-free, and potency preservation were 8.3%, 82.5%, and 64.4%, respectively.
This case series confirms the safety and efficacy of SP RARP with acceptable short-term outcomes. There is a significant learning curve for this new modality. Shorter hospital stay appears to be an early benefit of the SP platform.
Journal of endourology. 2022 Jul 29 [Epub ahead of print]
Juliana Kim, Alain Kaldany, Benjamin Lichtbroun, Eric Singer, Thomas L Jang, Saum Ghodoussipour, Moses Kim, Isaac Yi Kim
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States; ., New Brunswick, United States; ., New Brunswick, United States; ., Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School, New Brunswick, United States; ., New Brunswick, United States; ., Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, United States; ., Orange County Urology Associates, Irvine, United States; ., The Cancer Institute of New Jersey, Surgery/Urologic Oncology, 195 Little Albany Street, #4560, New Brunswick, New Jersey, United States, 08903; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/35906798