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

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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