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Luo C, Yang B, Ou Y, Wei Y, Wang Y, Yuan J, Li X, Wang K, Wang D, Ren S. Experience with an innovative surgical approach: 321 cases modified extraperitoneal single-incision robot-assisted laparoscopic radical prostatectomy without dedicated PORT based on Da Vinci SI system. J Robot Surg 2023:10.1007/s11701-023-01576-0. [PMID: 36947295 DOI: 10.1007/s11701-023-01576-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
To summarize surgical experiences with a new modified technique involving extraperitoneal single-incision robot-assisted laparoscopic radical prostatectomy based on Da Vinci SI system by reviewing case data, including follow ups, and to evaluate the safety and clinical efficacy of the surgical procedure. The case data from December 2020 to September 2022 of 321 patients undergoing modified single incision (without dedicated PORT) robotic-assisted laparoscopic radical prostatectomy via an extraperitoneal approach were reviewed. All procedures were performed by the same surgeon at our center. Perioperative data and postoperative urinary control, tumor control, and erectile function recovery were assessed. The immediate, 3-months, 6-months, 12-months, 18-months and 24-months complete urinary control rates were 34.3%, 56.6%, 79.7%, 85.7%, 89.6% and 90.7%, respectively; the 3-months, 6-months, 12-months, 18-months and 24-months biochemical recurrence rates were 3.4%, 5.2%, 9.1%, 21.7% and 30.2%, respectively; and for those with normal preoperative erectile function, the 3-months, 6-months, 12-months, 18-months and 24-months postoperative erectile function recovery rates were 52.2%, 60.0%, 70.7%, 72.2% and 73.9%, respectively. The new modified technique involving extraperitoneal single-incision robotic-assisted laparoscopic radical prostatectomy is safe and feasible. This technique has satisfactory surgical results, and this new method results in satisfactory urinary control, tumor control and recovery of erectile function. In addition, this new method is not limited to specific dedicated access devices, which facilitates its application.
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Affiliation(s)
- Cheng Luo
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
- Sichuan Electric Power Hospital, Chengdu, 610065, China
| | - Bo Yang
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Yong Ou
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Yi Wei
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Yaoqian Wang
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Jiazheng Yuan
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Xinglan Li
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
- Department of Pathology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Kai Wang
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China
- Department of Acute Care Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Dong Wang
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China.
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
| | - Shangqing Ren
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China.
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, 610072, China.
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Hou W, Wang B, Zhou L, Li L, Li C, Yuan P, Ouyang W, Yao H, Huang J, Yao K, Wang L. Single-site multiport vs. conventional multiport robot-assisted radical prostatectomy: A propensity score matching comparative study. Front Surg 2022; 9:960605. [PMID: 36248365 PMCID: PMC9554244 DOI: 10.3389/fsurg.2022.960605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveRobot-assisted radical prostatectomy (RARP) is a dynamically evolving technique with its new evolution of single-site RARP. Here we sought to describe our extraperitoneal technique, named the single-site multiport RARP (ssmpRARP) using the da Vinci Si® platform and compare it with the transperitoneal conventional multiport RARP (cmpRARP).Materials and MethodsData were retrospectively collected for patients who underwent RARP for localized prostate cancer from June 2020 to January 2022 in a single center. Propensity score matching was performed based on age, prostate size, body mass index, neoadjuvant hormonal therapy usage, prostate-specific antigen levels, and clinical T stage. The differences between the matched two groups were investigated.ResultsOf the patients, 20 underwent ssmpRARP and 42 underwent cmpRARP during the period. After matching, 18 patients from each group were selected. Median follow-up was 7.8 months (2–12 months) for the ssmpRARP group, and 15.0 months (3–26 months) for cmpRARP. The demographic features between the two groups were comparable. The median total operative time, estimated blood loss, pathologic data, early follow-up outcomes, and hospitalization stays and costs were similar between the two groups. The ssmpRARP group tended to return to their bowel activities earlier (44.78 ± 10.83 h vs. 54.89 ± 12.97 h, p = 0.016). There were no significant differences in complication rates.ConclusionsWe demonstrated the feasibility and safety of performing extraperitoneal ssmpRARP using the da Vinci Si® robotic platform. Our technique showed comparable short-term outcomes with the transperitoneal cmpRARP. Prospective trials and long-term follow-up are necessary to confirm these results.
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Affiliation(s)
- Weibin Hou
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Bingzhi Wang
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Lei Zhou
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Lan Li
- Department of Urology, Ningxiang Hospital Affiliated to Hunan University of Traditional Chinese Medicine, Changsha, China
| | - Chao Li
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Peng Yuan
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei Ouyang
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Hanyu Yao
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Jin Huang
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Kun Yao
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
- Correspondence: Long Wang Kun Yao
| | - Long Wang
- Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China
- Correspondence: Long Wang Kun Yao
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