Comparing the Approach to Radical Prostatectomy Using the Multiport da Vinci Xi and da Vinci SP Robots: A Propensity Score Analysis of Perioperative Outcomes

Moschovas, Marcio Covas; Bhat, Seetharam; Sandri, Marco; Rogers, Travis; Önol, Fikret Fatih; Mazzone, Elio; Roof, Shannon; Mottrie, Alexandre; Patel, Vipul

doi:10.1016/j.eururo.2020.11.042

Cited by 47 publications

(63 citation statements)

References 23 publications

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“…We performed a retrospective study comparing the operative satisfaction and perspectives of two groups of patients who underwent RARP with the Xi and SP robot platforms. After a propensity score match (PS), the groups were compared, and the operative outcomes were described previously by our group [ 5 ]. In this study, the same patients were interviewed with a questionnaire regarding their postoperative experience in our center.…”

Section: Methodsmentioning

confidence: 99%

“…Comparison between these two robotic approaches (SP vs. multiport) on their intraoperative performances, early functional and oncological outcomes has been published [ 5 ]. These studies have found SP RALP to be technically feasible and safe with similar perioperative outcomes compared to the Xi, but the instrument limitations and increased cost of this novel technology must be considered [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…These studies have found SP RALP to be technically feasible and safe with similar perioperative outcomes compared to the Xi, but the instrument limitations and increased cost of this novel technology must be considered [ 6 ]. Some groups have described decreased postoperative pain with increased opportunities for outpatient procedures, while other authors have reported no difference between the SP and multiport postoperative pain [ 5 , 7 ]. Future reports of long-term outcomes with higher volume of patients will give additional insight regarding the best applications of the SP platform.…”

Section: Introductionmentioning

confidence: 99%

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Patient surgical satisfaction after da Vinci® single-port and multi-port robotic-assisted radical prostatectomy: propensity score-matched analysis

et al. 2021

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The da Vinci ® single-port (SP) and multiport (Xi) approaches to robotic-assisted radical prostatectomy (RARP) are described by different authors in the literature, primarily comparing short-term outcomes of both modalities. To our knowledge, this is the first article comparing the surgical perspective and satisfaction of patients who underwent RARP with the SP and Xi platforms. To determine the patient surgical perspective and satisfaction in terms of pain control, return to normal activity, and overall results of surgery for two groups who underwent SP and Xi radical prostatectomy. The data from 71 consecutive patients who underwent SP RARP in a single center from June 2019 to April 2020 was compared to 875 patients who underwent Xi RARP in the same period. A single surgeon performed all procedures with a transperitoneal technique. After a propensity score match, two groups of 71 patients (SP and Xi) were selected and compared in the study. Patients were contacted by phone by two interviewers and a questionnaire was administered in English or Spanish. Patients were instructed not to disclose the type of robotic surgery they underwent, as interviewers were blinded to that information. A validated Surgical Satisfaction Questionnaire (SSQ-8) was used, along with an additional question from our institution asking about the satisfaction with the number of incision sites (GRI-1). Data were analyzed as continuous and discrete variables to compare the differences between the Xi and SP cohorts. A response rate of 85.9% ( n = 61) in the Xi group and 73.2% ( n = 52) in the SP group was captured. Overall satisfaction with surgical results was 80% and 88% in the Xi and SP cohorts, respectively. No statistical difference in responses was found between the Xi and SP cohorts for SSQ-8. However, GRI-1 demonstrated a statistically significant difference ( P < 0.001) in terms of number of scars that favors the SP approach. Limitations of this study are the small sample size and recall bias. We found no statistical difference between the groups regarding the answers for SSQ-8 questionnaire; both groups were very satisfied. When assessing the number of incision sites with the GRI-1 question, patients who underwent MP had lower satisfaction rates compared to SP. These patients perceived the number of scars and their appearance as reason for lower satisfaction. We believe that future studies should consider patient’s postoperative perspective when adopting new platforms in order to combine adequate treatment with patient expectations. We performed a study assessing the postoperative satisfaction and perspectives of two groups of patients who underwent radical prostatectomy with two different robots (SP and Xi). There was no difference in patient satisfaction with the results of either the da Vinci ® SP or Xi RARP except for the patients’ perception on their number of scars, which favored the SP group.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient surgical satisfaction after da Vinci® single-port and multi-port robotic-assisted radical prostatectomy: propensity score-matched analysis

et al. 2021

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“…1). [18][19][20][21][22][23][24] All the multiport platforms are da Vinci Si or Xi systems. SP-RARP was used as single-port da Vinci SP robotic platform.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six studies used SP-RARP through the transperitoneal or extraperitoneal approach. [18][19][20][21][22][23] In four studies, patients underwent SP-RARP performed with the SP console by one surgeon. 18,20,23,24 Besides, the patients in the other two studies underwent SP-RARP performed by two and three experienced robotic surgeons using the SP console, respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis

Yang

et al. 2022

Journal of Endourology

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Purpose: Although single-port robot-assisted radical prostatectomy (SP-RARP) is considered a safe and feasible approach for radical prostatectomy, the comparative performance of the SP robot with earlier models, including da Vinci Xi or Si, is elusive. This systematic review summarizes the current evidence on SP-RARP and compares its perioperative, functional, and oncologic outcomes to multiport robot-assisted radical prostatectomy (MP-RARP). Methods: We performed a systematic search in PubMed, Embase, Web of Science, and Cochrane Library database for randomized control trials (RCTs) and non-RCTs that compare SP-RARP to MP-RARP. The primary outcomes included perioperative, functional, oncologic, and painful outcomes. The odds ratio (OR) and weighted mean difference (WMD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CIs). Results: Seven studies, including 1239 patients, were enrolled in the meta-analysis. We reported similar results for SP-RARP and MP-RARP in terms of the operative time, blood loss, continence and potency rates, complication rate, positive surgical margin, and biochemical recurrence. However, hospital stay (WMD -17.86 hours, 95% CI -27.80 to -7.92; p = 0.0004), catheterization time (WMD -1.51 days, 95% CI -2.60 to -0.41; p = 0.007), and the rate of opioid use (OR 0.26, 95% CI 0.13 to 0.53; p = 0.0002) were less with SP-RARP. In addition, more patients did not require any pain medication during the hospital stay with SP-RARP (OR 14.41, 95% CI 5.22 to 39.76; p < 0.00001). Conclusions: SP-RARP is associated with a shorter hospital stay and catheterization time, and the need for postoperative pain medication is lower compared to MP-RARP, with comparable perioperative, functional, and oncologic outcomes.

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Pure single‐port retzius‐sparing robot‐assisted radical prostatectomy with the da Vinci SP: Initial experience and technique description

et al. 2022

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Objective: To assess the feasibility and safety of pure single-port (SP) retzius-sparing robot-assisted radical prostatectomy (RARP) using the da Vinci SP and describe the technique.Materials and Methods: From August 2020 to November 2020, data of 10 consecutive patients with localized prostate cancer, who underwent SP retzius-sparing RARP, were prospectively collected. Patients demographics, intraoperative variables, postoperative complications, early oncological, and functional outcomes were assessed. Results:The patients were aged 46-73 years with a body mass index between 20.3 and 27.4 kg/m 2 . Prostate volumes ranged from 15 to 47.2 ml, with a median (interquartile range, IQR) PSA level of 7.4 (6.2-9.1) ng/ml. All surgeries were successfully completed without conversion. The median (IQR) operative and console time were 106 (101-109) min and 65 (63-68) min, respectively. The median (IQR) blood loss was 125 (50-150) ml, and one Clavien-Dindo grade I complication occurred. At 3 months, nine patients had undetectable PSA levels and all patients were continent.Conclusions: Pure SP retzius-sparing RARP could be safely performed using the da Vinci SP system, with acceptable surgical times and minimal complications. Future research will evaluate the advantages of this technique over the standard multiport robotic surgery.

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Comparing the Approach to Radical Prostatectomy Using the Multiport da Vinci Xi and da Vinci SP Robots: A Propensity Score Analysis of Perioperative Outcomes

Cited by 47 publications

References 23 publications

Patient surgical satisfaction after da Vinci® single-port and multi-port robotic-assisted radical prostatectomy: propensity score-matched analysis

Patient surgical satisfaction after da Vinci® single-port and multi-port robotic-assisted radical prostatectomy: propensity score-matched analysis

Perioperative and Oncologic Outcomes of Single-Port vs Multiport Robot-Assisted Radical Prostatectomy: A Meta-Analysis

Pure single‐port retzius‐sparing robot‐assisted radical prostatectomy with the da Vinci SP: Initial experience and technique description

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