Using the Single-port Robot to Solve Clinical Challenges in Prostate Cancer

Document Type

Conference Proceeding

Publication Date

9-1-2022

Publication Title

J Endourol

Keywords

abdominal surgery, adult, cancer patient, cancer surgery, clinical article, complication, conference abstract, hernioplasty, human, incision, intestine, male, peritoneal dialysis catheter, peroperative complication, postoperative complication, prospective study, prostate adenocarcinoma, prostate cancer, prostatectomy, robot, surgery, tertiary health care

Abstract

Introduction &Objective: Patients with prostate cancer who are poor candidates for multi-port robotic surgery, but desire or require surgical management, can present a clinical challenge. Use of single port (SP) robotic technology may help overcome some of these challenges. We present our initial experience with robotic-assisted radical prostatectomy (RARP) using the da Vinci SP robot for prostate cancer in patients who would otherwise not be good surgical candidates for conventional multi-port transabdominal robotic surgery. Methods: Fourteen of 41 patients who underwent SP-RARP for biopsy confirmed, organ-confined prostate adenocarcinoma at a single tertiary care institution qualified for inclusion in our study. Patient characteristics were collected prospectively and are highlighted in table 1. Results: Nearly all patients had prior abdominal surgery (13/14, 93%) including aborted multi-port RARP (2), hernia repair (5), bowel diversion (3), or peritoneal dialysis catheters (2) among others. Patients underwent extraperitoneal (9/14, 64%) or transvesical (5/14, 36%) approach. All patients underwent successful procedures without need to convert to multi-port robotic or open approach. There were no intraoperative complications and one Clavien III post-operative complication. Positive margin rate was 29%, most of which were microscopic (=3mm, 3/4, 75%). Eighty-five percent of patients had undetectable nadir PSA. Conclusions: The SP robot can facilitate surgery for prostate cancer in some patients who might otherwise not be considered surgical candidates. In our experience, operative outcomes are not compromised despite a smaller incision and working space. We have found the SP system to be a valuable tool for carefully selected patients.

Volume

36

Issue

Supplement 1

First Page

A234

Last Page

A235

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