R-LESS-RP versus C-LESS-RP: a single-institution retrospective comparative study

Abstract

This study aimed to compare the peri- and postoperative outcomes of patients treated with conventional versus robot-assisted laparoendoscopic single-site radical prostatectomy (C-LESS-RP vs. R-LESS-RP). Data of patients with prostate cancer (106 who underwent C-LESS-RP, 124 underwent R-LESS-RP) were retrospectively collected and analyzed. All operations were performed by the same surgeon from January 8, 2018, to January 6, 2021, in the same institution. Information on clinical characteristics and perioperative outcomes was obtained from records at the medical institution. Postoperative outcomes were acquired from follow-up. Intergroup differences were retrospectively analyzed and compared. All patients had similar clinical characteristics in meaningful aspects. The perioperative outcomes were better with R-LESS-RP than with C-LESS-RP in terms of operation time (120 min vs. 150 min, p < 0.05), estimated blood loss (17.68 ml vs. 33.68 ml, p < 0.05), and analgesic duration (0 days vs. 1 days, p < 0.05). The drainage tube duration and postoperative stay did not differ significantly between groups. However, R-LESS-RP was more expensive than C-LESS-RP (56559.510 CNY vs. 44818.27 CNY, p < 0.05). The patients who underwent R-LESS-RP had better urinary incontinence recovery and higher European quality of life visual analog scale scores than those who underwent C-LESS-RP. However, no significant intergroup difference was noted in biochemical recurrence. In conclusion, R-LESS-RP could achieve better perioperative outcomes, especially for those skilled surgeons who have mastered C-LESS-RP. Additionally, R-LESS-RP accelerated the recovery from urinary incontinence effectively and presented some benefits in health-related quality of life with additional costs.

Clinical status and future prospects of single-incision robotic-assisted surgery: a review

“…It provided versatility with an independent instrument clutch and pivot controls that allow positioning of instruments around the robot’s remote center. No significant differences between SIRAS and laparoscopy were reported in terms of oncologic outcomes such as positive surgical margin rates (24% vs. 37.3%; P =0.08) and biochemical recurrence rates ( P =0.472) in RP 145 , 151 , and trifecta achievement (11/14, 79%) and disease recurrence (0/14, 0%) in partial nephrecto 152 . Safety and feasibility of SIRAS urologic surgeries based on the Da Vinci SP system underwent further evaluation and were verified across various types of urologic surgeries 141 , 145 , 146 , 148 , 150 , 154 .…”