Investig Clin Urol.  2020 Mar;61(2):173-179. 10.4111/icu.2020.61.2.173.

Single-port robot-assisted radical prostatectomy with the da Vinci SP system: A single surgeon's experience

Affiliations
  • 1Department of Urology, Ewha Womans University Seoul Hospital, Seoul, Korea. khkim.uro@gmail.com
  • 2Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Abstract

PURPOSE
To report an initial single-surgeon experience with single-port robot-assisted radical prostatectomy (SP-RARP) using the da Vinci SP surgical system (Intuitive Surgical, USA).
MATERIALS AND METHODS
Between December 2018 and October 2019, a single surgeon performed SP-RARP in 20 patients with prostate cancer. SP-RARP was performed using the conventional approach through an umbilical port with a GelPOINT access system (Applied Medical, USA) and an additional assist port. During surgery, the camera was placed in the 6- or 12-o'clock position, and a traction arm was placed in the counterpart position for upward or downward traction. Clinicopathologic data, perioperative data, and short-term surgical outcomes were analyzed.
RESULTS
Of 20 patients, 45% of patients had pT3 or greater disease and 45% had Gleason grade 4 to 5, respectively. In 11 patients that underwent lymph node dissection, the median number of lymph nodes removed was 19 (interquartile range [IQR], 14-22). Median operative time was 245 minutes (IQR, 200-255), and median console time was 190 minutes (IQR, 165-210). Median blood loss was 200 mL (IQR, 150-300 mL), and there were no intraoperative complications or open conversion. In 10 patients with a follow-up period longer than 3 months, one patient experienced biochemical recurrence, and all patients required 0 to 1 pads per day. Of seven patients that were potent before surgery, four recovered erectile function sufficient for intercourse.
CONCLUSIONS
Our report shows the safety and feasibility of SP-RARP, and that the associated surgical outcomes with short-term follow-up are satisfactory.

Keyword

Prostatectomy; Prostatic neoplasms; Robotics

MeSH Terms

Arm
Follow-Up Studies
Humans
Intraoperative Complications
Lymph Node Excision
Lymph Nodes
Operative Time
Prostatectomy*
Prostatic Neoplasms
Recurrence
Robotics
Traction
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