Robot-assisted Radical Prostatectomy Using Single-port Perineal Approach: Technique and Single-surgeon Matched-paired Comparative Outcomes

Lenfant, Louis; Garisto, Juan; Sawczyn, Guilherme; Wilson, Clark A.; Aminsharifi, Alireza; Kim, Soo Dong; Schwen, Zeyad; Bertolo, Riccardo

doi:10.1016/j.eururo.2020.12.013

Cited by 41 publications

(46 citation statements)

References 28 publications

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“…The baseline characteristics of the prostate volume were not relatively equal in one study (the mean volume for the SP-RARP group and the MP-RARP group was 30 and 48 mL, respectively). 24 However, the preoperative demographics were comparable in other studies, with similar age, BMI, baseline PSA, prostate volume, ISUP grade group, and pathologic stage observed in each of the included studies. The median follow-up time of the studies ranged between 3 and 13 months.…”

Section: Study Characteristicssupporting

confidence: 60%

“…1). [18][19][20][21][22][23][24] All the multiport platforms are da Vinci Si or Xi systems. SP-RARP was used as single-port da Vinci SP robotic platform.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…[18][19][20][21][22][23] In four studies, patients underwent SP-RARP performed with the SP console by one surgeon. 18,20,23,24 Besides, the patients in the other two studies underwent SP-RARP performed by two and three experienced robotic surgeons using the SP console, respectively. 21,22 Patients enrolled in one of the studies treated with the SP platform; patients underwent perineal radical prostatectomy.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…21,22 Patients enrolled in one of the studies treated with the SP platform; patients underwent perineal radical prostatectomy. 24 Notably, most patients that managed with the perineal approach underwent complex abdominal surgery. Furthermore, we often encountered the complex anatomy and narrow and deep surgical field with perineal radical prostatectomy.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…[18][19][20][21][22][23] Similarly, there is no statistical significance in the blood loss between SP-RARP and MP-RARP (four studies; p = 0.32). [19][20][21][22] When we pooled the results from three studies, the SP-RARP group demonstrated less catheterization time compared to MP-RARP (WMD -1.51 days, 95% CI -2.60 to Vigneswaran et al 19 Lenfant et al 20 Huang et al 21 Saidian et al 22 Lenfant et al 23 Lenfant et al 24…”

Section: Outcome Analysismentioning

confidence: 99%

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Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis

Yang

et al. 2022

Journal of Endourology

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Purpose: Although single-port robot-assisted radical prostatectomy (SP-RARP) is considered a safe and feasible approach for radical prostatectomy, the comparative performance of the SP robot with earlier models, including da Vinci Xi or Si, is elusive. This systematic review summarizes the current evidence on SP-RARP and compares its perioperative, functional, and oncologic outcomes to multiport robot-assisted radical prostatectomy (MP-RARP). Methods: We performed a systematic search in PubMed, Embase, Web of Science, and Cochrane Library database for randomized control trials (RCTs) and non-RCTs that compare SP-RARP to MP-RARP. The primary outcomes included perioperative, functional, oncologic, and painful outcomes. The odds ratio (OR) and weighted mean difference (WMD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CIs). Results: Seven studies, including 1239 patients, were enrolled in the meta-analysis. We reported similar results for SP-RARP and MP-RARP in terms of the operative time, blood loss, continence and potency rates, complication rate, positive surgical margin, and biochemical recurrence. However, hospital stay (WMD -17.86 hours, 95% CI -27.80 to -7.92; p = 0.0004), catheterization time (WMD -1.51 days, 95% CI -2.60 to -0.41; p = 0.007), and the rate of opioid use (OR 0.26, 95% CI 0.13 to 0.53; p = 0.0002) were less with SP-RARP. In addition, more patients did not require any pain medication during the hospital stay with SP-RARP (OR 14.41, 95% CI 5.22 to 39.76; p < 0.00001). Conclusions: SP-RARP is associated with a shorter hospital stay and catheterization time, and the need for postoperative pain medication is lower compared to MP-RARP, with comparable perioperative, functional, and oncologic outcomes.

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Section: Study Characteristicssupporting

confidence: 60%

“…1). [18][19][20][21][22][23][24] All the multiport platforms are da Vinci Si or Xi systems. SP-RARP was used as single-port da Vinci SP robotic platform.…”

Section: Study Characteristicsmentioning

confidence: 99%