Single-port transvesical robot-assisted simple prostatectomy a multi-institutional series from the SPARC

Document Type

Conference Proceeding

Publication Date

9-1-2023

Publication Title

Eur Urol Open Sci

Keywords

endogenous compound, narcotic agent, osteonectin, abdominal surgery, adenocarcinoma, advanced cancer, aged, air embolism, bladder, bleeding, body mass, body weight, cancer surgery, catheter, Charlson Comorbidity Index, complication, conference abstract, controlled study, excision, hemostasis, human, incision, major clinical study, male, multicenter study, operation duration, outpatient, pain, peroperative complication, prospective study, prostate adenoma, robot, simple prostatectomy, surgery, urine retention

Abstract

Introduction & Objectives: Our aim is to report the results of the novel single-port (SP) transvesical (TV) robot-assisted simple prostatectomy (RASP) by presenting a multi-institutional series from the Single-Port Advanced Research Consortium (SPARC). Materials & Methods: Data from four institutions were collected prospectively and analyzed. SP TV RASP was performed in patients with severely symptomatic BPH. A 3 cm suprapubic incision was made to access the bladder directly with the SP access port. The procedure included two steps: 1) Excision of the prostatic adenoma 2) 360° reconstruction with a mucosal flap (Figure 1). Results: A total of 117 cases were analyzed. All cases were completed successfully without the need for conversion. Mean age and body mass index were 67 years and 28 kg/m2, respectively. Median Charlson comorbidity index was 3, up to 42% and 28% of the patients had a history of abdominal surgery and prostatic procedures, respectively. The median preoperative volume was 149.5 cc (IQR: 109-196). The most common indication for surgery was urinary retention (59%). Median operative time and estimated blood loss were 162 minutes and 100 ml, respectively. There were 3 intraoperative complications during the initial experience, all of them were air emboli due to high pneumovesicum pressure (>12 mmHg). Median specimen weight was 81 g (IQR: 59-123) and incidental adenocarcinoma was found in 5 cases (4.3%). The median pain score at discharge was 2/10, 92% did not require narcotics at discharge. Planned outpatient cases were discharged within 24 hours 85% of the time. Median catheter duration was 6 days. Biochemical and functional results are shown in Figure 2. Conclusions: SP TV RASP is a feasible outpatient technique for patients with severe BPH. The 360° mucosal flap reconstruction step provides hemostasis and fast recovery. [Figure presented]

Volume

55

First Page

S254

Last Page

S255

Find It @ Sladen

Share

COinS