Contemporary techniques of da Vinci SP radical prostatectomy: multicentric collaboration and expert opinion

Abstract

Background: The da Vinci SP robot consists of an innovative single port trocar that houses a flexible camera and three biarticulated arms, which minimizes the number of incisions to assess the surgical site, allowing a less invasive procedure. However, due to its recent release in the market, the current literature reporting SP-RARP is still restricted to a few centers. In this scenario, after performing a literature search with all available techniques of SP-RARP, our objective is to report a multicentric opinion of referral centers on different techniques to approach SP-RARP. Results: The SP literature is provided by only a few centers due to the limited number of this new console in the market. Five different approaches are available: transperitoneal, extraperitoneal, Retzius-Sparing, transperineal and transvesical. None of the current studies describe long-term functional or oncological outcomes. However, all approaches had satisfactory operative performance with minimum complication rates. Conclusions: Several techniques of SP-RARP have been reported in the literature. We performed a multicentric collaboration describing and illustrating the most challenging steps of this surgery. We believe that the details provided in this article are useful teaching material for new centers willing to adopt the SP technology.

Predictors of urinary function recovery after laparoscopic and robot-assisted radical prostatectomy

“…However, previous studies have suggested selective suture ligation of the DVC to preserve the rhabdosphincter and underlying neurovascular components, which may improve the recovery of urinary continence ( 17 ). Other studies revealed that Retzius-sparing RALP contributed to postoperative urinary continence ( 19 , 20 ). These findings indicate the importance of reducing the complications of postoperative urinary incontinence by selecting the optimal surgical procedure.…”

Comparison between intra and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

“…Since the acquisition of the da Vinci SP by our center, we have described in previous studies our experience and results with this platform in patients undergoing robotic radical prostatectomy. 17,19,21 Although minimally invasive techniques such as robotic surgery decrease perioperative impacts, surgical outcomes depend on several different factors, such as preoperative patient characteristics, age, SHIM score, cancer stage, and comorbidities. 10,13,22,23 In addition, surgical technique and nerve-sparing degree also play an important role along with postoperative management and patient follow-up protocols.…”

Comparison between intra- and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

“…Since the acquisition of the da Vinci SP by our center, we have described in previous studies our experience and results with this platform in patients undergoing robotic radical prostatectomy. 17,19,21 Although minimally invasive techniques such as robotic surgery decrease perioperative impacts, surgical outcomes depend on several different factors, such as preoperative patient characteristics, age, SHIM score, cancer stage, and comorbidities. 10,13,22,23 In addition, surgical technique and nerve-sparing degree also play an important role along with postoperative management and patient follow-up protocols.…”

“…We also used transperitoneal access with an anterior approach, as described by previous studies performed at our institution. 3,[15][16][17][18][19][20][21] None of the groups had abdominal drains placed after the procedure.…”