Single-Port Robot-Assisted Simple Prostatectomy: A Multi-Institutional Cohort From the SPARC
Recommended Citation
Ramos-Carpinteyro R, Soputro N, Pedraza A, Calvo RS, Raver M, Manfredi C, Wang Y, Chavali JS, Okhawere K, Mikesell CD, Ferguson E, Stifelman M, Badani KK, Autorino R, Rogers C, Ahmed M, Schwen ZR, Crivellaro S, Kaouk J. Single-Port Robot-Assisted Simple Prostatectomy: A Multi-Institutional Cohort From the SPARC. J Endourol 2024; 38(S1):A372.
Document Type
Conference Proceeding
Publication Date
8-1-2024
Publication Title
J Endourol
Abstract
Introduction: The single-port (SP) robot-assisted simple prostatectomy (RASP) is a viable minimally invasive technique for patients with symptomatic benign prostatic hyperplasia and adenomas > 80 cc. Early SP RASP reports have shown a fast recovery and >90% outpatient cases. This study aims to present updated data from the largest multi-institutional SP cohort. Methods: Retrospective analysis of all consecutive SP RASP cases done by 11 experienced surgeons from 6 centers from February 2019 to January 2024. In general, a suprapubic incision was performed, and the da Vinci SP access was established through a transvesical, transperitoneal, or extraperitoneal (retropubic) approach. The prostate was excised, and subsequent intraprostatic mucosal reconstruction was performed. Continuous variables were summarized using measures of central tendency based on their distribution, while percentages were employed to depict frequencies. Results: A total of 240 entries were analyzed. All cases were completed successfully, without extra ports or conversion. Three types of approaches were identified: 164 transvesical (68.3%), 51 transperitoneal (21.3%), and 25 extraperitoneal (10.4%). Median age was 70 years. Eighteen percent of patients had previous prostate interventions. Median preoperative International Prostate Symptom Score (IPSS) and prostate volume were 22 and 137 ml, respectively. The most common indication for surgery was urinary retention (43.3%). Median estimated blood loss during surgery and console time were 100 ml and 142 minutes, respectively. One patient required a blood transfusion. There were 5 intraoperative complications, 4 air emboli (during early experience) and 1 accidental posterior cystotomy. The median percentage of tissue removed was 55.5%. Upon discharge, 87.9% of patients did not require narcotics for pain control. Median length of stay was 16 hours and hospitalization was needed for 15.8% of planned outpatient cases. Readmission rate was 0%. Median urinary catheter duration was 6 days. Figure 1 shows the long-term functional outcomes. Conclusions: SP robotic surgery is a feasible technique for transvesical, transperitoneal and extraperitoneal approaches to RASP. Its main advantages are minimal postoperative pain and fast recovery, and long-term functional outcomes show promising results in a multi-institutional setting.
Volume
38
Issue
S1
First Page
A372
