Faster both in operative time and functional recovery by the extraperitoneal daVinci SP-based robot-assisted radical prostatectomy: a propensity score matching analysis compared to transperitoneal multiport counterpart

• Published in: Journal of robotic surgery 2024-05, Vol.18 (1), p.205, Article 205
• Main Authors: Ko, Young Hwii, Jang, Jae Youn, Kim, Yeong Uk, Kim, Sang Won
• Format: Article
• Language: English
• Subjects: Abdomen; Aged; Criteria; Dissection; Humans; Learning curves; Lymph Node Excision - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Operative Time; Patients; Peritoneum - surgery; Propensity Score; Prostate cancer; Prostatectomy - methods; Prostatic Neoplasms - surgery; Recovery of Function; Robotic Surgical Procedures - methods; Robotics; Robots; Surgeons; Surgery; Surgical techniques; Treatment Outcome; Urology
• ISSN: 1863-2491; 1863-2483; 1863-2491
• DOI: 10.1007/s11701-024-01950-6

We aim to investigate the peri-operative outcomes after extraperitoneal single-port based robot-assisted radical prostatectomy (eSP-RARP) utilizing the da Vinci SP system compared to conventional transperitoneal multi-port counterparts (tMP-RARP), in an era when pelvic lymph node dissection (PNLD) was omitted for the node-negative case. With exclusion criteria of volume  + 50 g, suspicious rectal invasion, and node-positive disease given relatively weak grasping power and limited range of motion from the current SP system, 50 consecutive patients (Since December 2021) with localized prostate cancer underwent eSP-RARP by a single urologist maintaining identical surgical technique for 100 consecutive tMP-RARP cases (Since December 2020). Given initial selection criteria, each group was matched to a 1:1 ratio based on the risk-stratification parameters and the prostate volume. The operative time, which was maintained in each group during the study period, was significantly faster in eSP-RARP groups than in tMP-RARP (149.2 vs. 163.2 min, p  = 0.025), while the weight of the removed specimen (27.1 vs. 29.0 g, p  = 0.420) and margin positivity (14.7% vs. 11.7% in pT2, p  = 0.812) were similar. The gas-out (1.5 vs. 1.88 days, p  = 0.003) and solid diet dates (2.26 vs. 3.22 days, p