Feasibility and safety of a novel single-port robotic surgical system in radical prostatectomy: initial experiences

doi:10.3877/cma.j.issn.1674-3253.2022.04.002

Abstract

Abstract:

Objective

To investigate the feasibility and safety of a novel single-port robotic surgical system in radical prostatectomy.

Methods

From October 2021 to April 2022, 17 cases of radical prostatectomy were carried out in the First Affiliated Hospital of Naval Military Medical University, the Second Affiliated Hospital of Nanjing Medical University and the First Affiliated Hospital of Zhejiang University with a novel single-port robotic surgical system. The perioperative information was recorded, such as oncological profiles, surgical approach, operating time, console time, estimated blood loss, number of auxiliary ports, perioperative complications, pathological results, PSA and continence 1 month after operation.

Results

The average age of the patients was (70±7) years old, the average BMI was (24.8±2.7) kg/m², the average PSA before operation was 11.9(6.6) ng/ml, and the Gleason score was 6 in 7 cases and 7 in 10 cases. All operations were successfully completed, including 10 transperitoneal cases and 7 extraperitoneal cases. Five cases were received pure single-port operation, and in 12 cases, a 12 mm auxiliary port was added. The average operation time was (210±63) minutes, the console time was (172±52) minutes, and estimated blood loss was (115±92) ml. There were no complications observed, such as blood transfusion, colon injury, urinary leakage, fever, poor wound healing and so on. Postoperative pathology showed that Gleason score was 6 in 4 cases, 7 in 12 cases, and 9 in 1 case. Fourteen cases were in T₂ stage and 3 cases were T₃. There were 4 cases (23.5%) with positive margin. One month after operation, the average PSA was 0.01(0.074) ng/ml, and continence was achieved in 12 cases (71%).

Conclusions

The novel single-port robotic surgical system can be safely and effectively applied in transperitoneal and extraperitoneal radical prostatectomy.

Key words: Robot, Single-port, Laparoscopy, Radical prostatectomy, Deformable surgicalinstruments

Chao Zhang, Yong Wei, Taile Jing, Zheng Wang, Chengwu Xiao, Luming Shen, Jian Yang, Ding Peng, Bo Yang, Shuo Wang, Dan Xia, Qingyi Zhu, Linhui Wang. Feasibility and safety of a novel single-port robotic surgical system in radical prostatectomy: initial experiences[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(04): 293-297.

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URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2022.04.002

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References 32

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组别	发表年份	设备型号	例数	平均/中位手术时间(min)	平均/中位术中出血(ml)	Ⅱ级或以上并发症(%)	切缘阳性率(%)
本组	2022	SP	17	210±63	115±92	0	23.5
Kaouk等^[29]	2019	SP	3	200(180~210)	70(50~750)	0	66.7
Dobbs等^[21]	2019	SP	10	234(191~258)	65(20~150)	0	20
Ng等^[30]	2019	SP	20	209±35	296±221	15	55
Steinberg等^[31]	2019	SP	15	224±43	198±115	6.7	13
Saidian等^[24]	2020	SP	47	256±44	169±114	11	10
Saidian等^[24]	2020	Xi/Si	48	275±50	157±125	11	13
Agarwal等^[22]	2020	SP	49	161(134~194)	200(75~300)	8	28
Moshovas等^[23]	2021	SP	71	114(104~125)	78%^a<100	0	12
Moshovas等^[23]	2021	Xi	71	103(88~111)	51%^a<100	0	11
Lenfant等^[25]	2021	SP	100	195(174~217)	190(100~250)	12	24
Lenfant等^[25]	2021	Xi/Si	110	190(171~210)	200(150~300)	5.5	37

组别	发表年份	设备型号	例数	平均/中位手术时间(min)	平均/中位术中出血(ml)	Ⅱ级或以上并发症(%)	切缘阳性率(%)
本组	2022	SP	17	210±63	115±92	0	23.5
Kaouk等^[29]	2019	SP	3	200(180~210)	70(50~750)	0	66.7
Dobbs等^[21]	2019	SP	10	234(191~258)	65(20~150)	0	20
Ng等^[30]	2019	SP	20	209±35	296±221	15	55
Steinberg等^[31]	2019	SP	15	224±43	198±115	6.7	13
Saidian等^[24]	2020	SP	47	256±44	169±114	11	10
Saidian等^[24]	2020	Xi/Si	48	275±50	157±125	11	13
Agarwal等^[22]	2020	SP	49	161(134~194)	200(75~300)	8	28
Moshovas等^[23]	2021	SP	71	114(104~125)	78%^a<100	0	12
Moshovas等^[23]	2021	Xi	71	103(88~111)	51%^a<100	0	11
Lenfant等^[25]	2021	SP	100	195(174~217)	190(100~250)	12	24
Lenfant等^[25]	2021	Xi/Si	110	190(171~210)	200(150~300)	5.5	37

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