Single-port and multiport robot-assisted radical prostatectomy: A meta-analysis

Dobbs, Ryan W.; Vuong, Huy Gia; Quy, Khoa; Ngo, Hanh Thi Tuyet; Tuan, Anh; Tuyet, Mai Tran Thi; Thái, Minh Sâm; Tiong, Ho Yee; Choi, Se Young; Shahait, Mohammed; Lee, David I.

doi:10.1016/j.prnil.2023.04.002

Cited by 3 publications

(1 citation statement)

References 45 publications

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“…One notable benefit of the use of SP system is the ease of extraperitoneal access through a subumblical incision. It is well known that the extraperitoneal approach results in less intestinal irritation than the transperitoneal approach, facilitating early postoperative diet, and the less steep Trendelenburg position leads to fewer anesthetic complications ( 20 , 21 ). In line with these advantages, our study found that passing gas occurred faster in the spRARP group both before and after PSM, with no difference in the occurrence of complications.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of extraperitoneal singe-port robot-assisted radical prostatectomy and transperitoneal multiport robot-assisted radical prostatectomy using propensity score matching

Yoon,

Kwon,

Kim

et al. 2024

Transl Androl Urol

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Background With the introduction of the da Vinci single-port (SP) robot platform, surgery in a narrow space has become easier, and using this, extraperitoneal radical prostatectomy has been frequently performed recently. However, studies comparing it with existing methods are still lacking. Therefore, in this study, we compared the initial extraperitoneal single-port robot-assisted radical prostatectomy (spRARP) with intraperitoneal multiport robot-assisted radical prostatectomy (mpRARP) and tried to investigate the feasibility of extraperitoneal spRARP. Methods We retrospectively analyzed patients who underwent RARP performed between January 2019 and April 2023. A total of 184 consecutive patients were enrolled in this study: 64 underwent spRARP and 120 underwent mpRARP. Patient characteristics before and after surgery were investigated, and period of passing gas, foley maintenance period, length of hospital stay, and pain changes were compared and analyzed to estimate post-surgery recovery. To address inherent biases stemming from differing patient characteristics at baseline, we performed an additional analysis after propensity score matching (PSM) (ratio, 1:1). Results After PSM, both the spRARP and mpRARP groups consisted of 64 patients each. On preoperative examination, there were no significant differences in prostate-specific antigen level, Gleason score (GS), prostate volume, magnetic resonance imaging T stage, or Prostate Imaging-Reporting and Data System score between the two groups. Following surgery, there were no significant differences in operative and console time between the two groups. Notably, the estimated blood loss was considerably lesser in the spRARP group than in the mpRARP group (P=0.049). When comparing pathologic outcomes, the GS, T stage, positive surgical margin, extracapsular extension, and seminal vesicle invasion rates showed no significant differences between the two groups. Four patients who underwent spRARP and six who underwent mpRARP suffered Clavien-Dindo classification grade 3 and 4 complications. After 3 months, there were no significant differences in incontinence or potency between the two groups. However, even after PSM, the period of passing gas was earlier in the spRARP group than in the mpRARP group. Conclusions In this study, both the extraperitoneal spRARP and transperitoneal mpRARP groups exhibited similar complication rates and surgical outcomes. Furthermore, the spRARP group had a short surgical time and demonstrated early recovery. Therefore, extraperitoneal spRARP is a feasible procedure that is expected to become increasingly popular in the future.

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Section: Discussionmentioning

confidence: 99%