"Single-Surgeon" versus "Dual-Surgeon" Robot-Assisted Radical Prostatectomy and Pelvic Lymph-nodes Dissection: Comparative Analysis of Perioperative Outcomes

Abstract

Purpose: To compare the perioperative outcomes of robot-assisted radical prostatectomy (RARP) with pelvic lymph-nodes dissection (PLND) when the same surgeon performs RARP and PLND versus one surgeon performs RARP and another surgeon performs PLND. Materials and Methods: From January 2022 to March 2023, data of consecutive patients who underwent RARP with PLND were prospectively collected. The surgeries were performed by two "young" surgeons with detailed profi le. Specifi cally for the study purpose, one surgeon performed RARP, and the other surgeon performed PLND. A set of surgeries performed according to the standard setup (i.e., the same surgeon performing both RARP and PLND) was retrieved from the institutional database and used as comparator arm. To test the study hypothesis, patients were divided into two groups: "dual-surgeon" versus "single-surgeon". Results: Fifty patients underwent RARP and PLND performed according to dual-surgeon setup and were compared to the last 50 procedures performed according to the standard single-surgeon setup. Patients in the groups had comparable baseline characteristics. Dual-surgeon interventions had signifi cantly shorter median total operative versus 174 ] minutes, p<0.001) and console time versus 154 [IQR 129-170] minutes, p<0.001). No signifi cant differences were found in terms of blood loss, intraoperative complications, postoperative outcomes, and fi nal pathology results. Conclusions: The present analysis found that when RARP and PLND are split onto two surgeons, the operative time is shorter by 20 minutes compared to when a single surgeon performs RARP and PLND. This is an interesting fi nding that could sponsor further studies.

New perspectives of robotic surgery are the topic highligheted in International Brazilian Journal of Urology

“…Dr. Bertolo and collegues from Italy performed on page 732 ( 6 ) a nice comparative analysis of perioperative outcomes about "Single-Surgeon" versus "Dual-Surgeon" in Robot-Assisted Radical Prostatectomy (RARP) and Pelvic Lymph-nodes Dissection (PLND) and concluded that when RARP and PLND are split onto two surgeons, the operative time is shorter by 20 minutes compared to when a single surgeon performs RARP and PLND.…”