Comparison Between Three Contemporary Approaches of Single-Port Robotic Radical Prostatectomy: A Report From the Single-Port Advanced Research Consortium Involving 1800 Patients

Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: The improved maneuver-ability of the purpose-built Single-Port (SP) robotic platform has allowed for expanded armamentarium of robotic radical prostatectomy (RARP) approaches. The aim of this study was to evaluate for differences between three commonly used techniques of SP-RARP, namely Transperitoneal (TP), Extraperitoneal (EP), and Transvesical (TV),based on a large multi-institutional series .METHODS: A retrospective review was performed on the prospectively maintained, IRB-approved database of the Single-Port Advanced Research Consortium (SPARC) to identify all patients who underwent SP-RARP between 2018 to 2023. Baseline clinicodemographic, perioperative, and postoperative data were evaluated and categorized based on the three different approaches of SP-RARP. RESULTS: A total of 1802 patients were included, which comprised 563, 978, and 260 cases of TP, EP, and TV SP-RARP, respectively. Despite the similarities in age and BMI, history of previous abdominal surgery was more prevalent in the TV cohort(p<0.05). Higher-grade diseases were more commonly referred for TP or EP techniques. Intraoperatively, the TV approach was associated with the least amount of intraoperative blood loss and the need for additional ports. All procedures were completed successfully without the need for conversion. Intraoperative complications were identified in 1.4%, 0.5%, and 0.4% of the TP, EP, and TV cases, respectively. TV SP-RARP was associated with earlier, opioid-sparing discharge (p<0.05) and a significantly reduced Foley catheter duration (p<0.05). The shorter length of stay did not translate to increased risks of postoperative complication (p[0.144) and readmission (p[0.127). At a median follow-up duration of 12 months, earlier return of continence was achieved following TV SP-RARP and oncological outcomes remained favorable across the three groups. CONCLUSIONS: Herein, we reported the outcomes of three contemporary approaches of SP-RARP, with added values towards enhancing patient comfort and postoperative recovery. Compared with the other techniques, the TV approach was associated with a significantly shorter length of stay, Foley catheter duration, and earlier return of urinary continence

Volume

211

Issue

5S

First Page

e1283

Comments

American Urological Association Annual Meeting, May 3-6, 2024, San Antonio, TX

DOI

10.1097/01.JU.0001009352.31737.3d.09

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