Robot‐assisted transvesical partial prostatectomy using a purpose‐built single‐port robotic system

Kaouk, Jihad; Sagalovich, Daniel

doi:10.1111/bju.14194

Cited by 39 publications

(6 citation statements)

References 9 publications

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“…The da Vinci single port (SP) robotic platform (Intuitive Surgical) is a novel technology which uses a single robotic trocar and flexible multi‐articulating instruments (Figure 1) as compared to previous da Vinci models which utilized multiple trocars and rigid laparoscopic instrumentation with articulating wrists (Figure 2). The SP platform received FDA approval for urologic use in 2018, and multiple case series have published on its utility in major urologic procedures, including prostatectomy, ureteral reimplantation and transvesical operations 6–12 . However, little is known about the challenges facing surgeons and the operating room staff as they adapt to this new platform.…”

Section: Introductionmentioning

confidence: 99%

Single port robotic radical prostatectomy versus multi‐port robotic radical prostatectomy: A human factor analysis during the initial learning curve

Talamini

Halgrimson

Dobbs

et al. 2020

Robotics Computer Surgery

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Background Studies have thus far neglected to evaluate the impact of the da Vinci single port (SP) robotic platform on surgeon experience and operating room efficiency. We sought to assess the effect of the SP platform on surgeon cognitive load measures during robotic assisted laparoscopic prostatectomy (RALP). Methods We prospectively compared the first 20 SP‐RALPs performed at our institution to 20 multi‐port (MP)‐RALPs performed by a single experienced robotic surgeon. Three multi‐dimensional assessment tools were used to evaluate mental and surgical workload, teamwork and workflow disruptions. Results No statistically significant differences were found between the MP‐RALP and SP‐RALP cohorts when evaluated by NASA Task Load Index, Surgery Task Load Index and Observational Teamwork Assessments. Conclusions The SP robotic platform did not adversely affect human factor performance of the surgeon during RALP. Multi‐institutional validation will be necessary to confirm these initial findings.

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Section: Introductionmentioning

confidence: 99%

Single port robotic radical prostatectomy versus multi‐port robotic radical prostatectomy: A human factor analysis during the initial learning curve

Talamini

Halgrimson

Dobbs

et al. 2020

Robotics Computer Surgery

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“…The continuous update of the da Vinci robotic surgery-assisted system provides more opportunities for technological innovation in single-incision laparoscopy. Although special PORT equipment is often used to help solve space constraints, it will add an additional economic burden 6 , 7 . To eliminate the dependence on special PORT equipment, our centre has continually explored innovative extraperitoneal space techniques since November 2020 to implement the single-incision extraperitoneal nonspecial PORT modified RARP approach 8 .…”

Section: Introductionmentioning

confidence: 99%

Preliminary comparison of the modified extraperitoneal free-PORT single incision technique and transabdominal multi-incision robot-assisted laparoscopic radical prostatectomy

Ren

Wang

et al. 2023

Sci Rep

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To compare the clinical efficacy of an innovative modified single-incision technique without special extraperitoneal PORT with that of transperitoneal multi-incision robot-assisted laparoscopic radical prostatectomy and to explore the feasibility and safety of the former. A retrospective analysis was performed on 259 patients who received robot-assisted laparoscopic radical prostatectomy in the Robot Minimally Invasive Center of Sichuan Provincial People's Hospital between September 2018 and August 2021. Among them were 147 cases involving extraperitoneal single incision with no special PORT (Group A) and 112 cases involving multiple incisions by the transperitoneal method (Group B). Differences in age, PSA level, Gleason score, prostate volume, body mass index, clinical stage, lower abdominal operation history, and lymph node dissection ratio between the two groups were not statistically significant (P > 0.05). All operations were performed by the same operator. In this study, all 259 operations were completed successfully, and there was no conversion. There was no significant difference in transperitoneal blood loss, postoperative hospital stay, positive rate of incision margin, indwelling time of urinary catheter, satisfaction rate of immediate urine control, satisfaction rate of urine control 3 months after operation, positive rate of postoperative lymph node pathology or postoperative pathological stage between the two groups (P > 0.05). There were significant differences in operation time, postoperative exhaust time and incision length (P < 0.05). The modified extraperitoneal nonspecial PORT single-incision technique is safe and feasible for robot-assisted laparoscopic radical prostatectomy, and its curative effect is similar to that of transperitoneal multi-incision RARP. It has the advantages of a short operation time, less impact on the gastrointestinal tract and a more beautiful incision. The long-term effect of treatment needs to be further confirmed by prospective studies.

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“…[5] Although the gold-standard treatment for ureteral reconstructive operation is open surgery, [6] endourological procedures are often used as a rst-line treatment. [7] The advantageous technique is considered a safe alternative to ureteral stricture. It postpones or even potentially shuns the needs of open or laparoscopic ureteral reimplantation.…”

Section: Introductionmentioning

confidence: 99%

A Nomogram to Predict Stricture-free Survival in Patients with Ureteral Stricture after Balloon Dilation

Lai

Gao

et al. 2021

Preprint

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Background Balloon dilation is a commonly used minimally invasive endourological treatment of ureteral stricture, but the postoperative recurrence rate is relatively high. And factors contributing to recurrence after treatment are poorly understood. Herein, we sought to develop a novel clinical nomogram to predict ureteral stricture-free survival in patients suffering from ureter stricture and performed balloon dilation. Methods The nomogram was established based on a retrospective analysis of 321 patients diagnosed with ureter strictures from January 2016 to January 2020 in Sun Yat-sen Memorial Hospital using the Cox regression model. Perioperative clinical data and disease outcomes were analyzed. Discrimination of the nomogram was assessed by the concordance index (C-index) and the calibration curve. The results were internally validated using bootstrap resampling. Results Overall, 321 patients with a median follow-up of 590 days were enrolled in the study, among which 97 patients (30.2%) developed recurrence of ureteral stricture during follow-up. Five variables remained significant predictors of ureteral re-stricture after multivariable analyses: stricture nature (P < 0.001), urinary nitrite (P = 0.041), CKD (P = 0.005), stent retention time (P < 0.001), and balloon size (P = 0.029). The calibration craves for the probability of 1-, 3-, and 5-years stricture-free survival (SFS) presented satisfied with the consistency of nomogram prediction and actual observation. The C-index of the model was 0.74 (95% CI 0.70–0.79). Conclusions Our study developed the first nomogram to effectively predict stricture-free survival in patients suffering from ureter stricture after balloon dilation. It is helpful to identify the optimal patients with ureter stricture for balloon dilation and improve treatment outcomes. However, further external validation of the nomogram is warranted.

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Robot‐assisted transvesical partial prostatectomy using a purpose‐built single‐port robotic system

Cited by 39 publications

References 9 publications

Single port robotic radical prostatectomy versus multi‐port robotic radical prostatectomy: A human factor analysis during the initial learning curve

Single port robotic radical prostatectomy versus multi‐port robotic radical prostatectomy: A human factor analysis during the initial learning curve

Preliminary comparison of the modified extraperitoneal free-PORT single incision technique and transabdominal multi-incision robot-assisted laparoscopic radical prostatectomy

A Nomogram to Predict Stricture-free Survival in Patients with Ureteral Stricture after Balloon Dilation

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