Robot-assisted versus open radical prostatectomy: a systematic review and meta-analysis of prospective studies

Wang, Junji; Hu, Ke; Wang, Yu; Wu, Yinyu; Bao, Erhao; Wang, Jiahao; Tan, Chunlin; Tang, Tielong

doi:10.1007/s11701-023-01714-8

Cited by 11 publications

(7 citation statements)

References 77 publications

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“…Regarding post-RARP complications, our pooled estimate appears to be consistent with those reported in recent meta-analyses: Bertolo et al [36] reported a CD ≥ 2 complication rate of 7.6%, and Wang et al [1] reported a major complication (CD > 3) rate of 2.5% with an overall complication rate of 13.7%.…”

Section: Main Findings and Interpretation Of The Resultssupporting

confidence: 90%

“…Since the Food and Drug Administration (FDA) approved the first robotic platform for surgical procedures in 2000, robotic-assisted surgery has witnessed the worldwide adoption of the daVinci robotic systems (Intuitive Surgical Inc., Sunnyvale, CA, USA), with their well-established efficacy and safety [1,2]. With the expiration of Intuitive's patent in 2019, a surge of new robotic systems entered the global market, aiming to enhance surgical capabilities and address the cost-efficiency challenges in healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Marino,

Moretto,

Rossi

et al. 2024

JCM

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Background/Objectives: to assess surgical, oncological, and functional outcomes of robot-assisted radical prostatectomy (RARP) performed using the novel Hugo™ RAS system. Methods: A systematic review was conducted following the PRISMA guidelines, using PubMed, Web of Science, Scopus, and Embase databases. Eligible papers included studies involving adult males undergoing RARP with the Hugo™ RAS platform, with at least ten patients analyzed. The pooled analysis was performed using a random-effect model. Results: Quantitative analysis was conducted on 12 studies including 579 patients. The pooled median docking time, console time, and operative time were 11 min (95% CI 7.95–14.50; I2 = 98.4%, ten studies), 142 min (95% CI 119.74–164.68; I2 = 96.5%, seven studies), and 176 min (95% CI 148.33–203.76; I2 = 96.3%, seven studies), respectively. The pooled median estimated blood loss was 223 mL (95% CI 166.75–280.17; I2 = 96.5%, eleven studies). The pooled median length of hospital stay and time to catheter removal were 2.8 days (95% CI 1.67–3.89; I2 = 100%, ten studies) and 8.3 days (95% CI 5.53–11.09; I2 = 100%, eight studies), respectively. The pooled rate of postoperative CD ≥ 2 complications was 4.1% (95% CI 1–8.5; I2 = 63.6%, eleven studies). The pooled rate of positive surgical margins and undetectable postoperative PSA were 20% (95% CI 12.6–28.5; I2 = 71.5%, nine studies) and 94.2% (95% CI 87.7–98.6; I2 = 48.9%, three studies), respectively. At three months, a pooled rate of social continence of 81.9% (95% CI 73.8–88.9; I2 = 66.7%, seven studies) was found. Erectile function at six months was 31% in one study. Conclusions: despite the preliminary nature of the evidence, this systematic review and pooled analysis underscores the feasibility, safety, and reproducibility of the Hugo™ RAS system in the context of RARP.

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Section: Main Findings and Interpretation Of The Resultssupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Marino,

Moretto,

Rossi

et al. 2024

JCM

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“…With the inception of minimally invasive surgical procedures, many remarkable advancements have been achieved in the realm of radical prostatectomy, including laparoscopic radical prostatectomy and robot-assisted radical prostatectomy (RARP). RARP, compared with open radical surgery, could greatly decrease the postoperative complications and estimated blood loss [ 3 ]. Applying robotic systems in radical prostatectomy could benefit patients by decreasing operative time, blood loss, transfusion rates, hospital stays, and complication rates [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…RARP, compared with open radical surgery, could greatly decrease the postoperative complications and estimated blood loss [ 3 ]. Applying robotic systems in radical prostatectomy could benefit patients by decreasing operative time, blood loss, transfusion rates, hospital stays, and complication rates [ 3 ]. In the abovementioned parameters, the advantage of decreasing the transfusion rate has been particularly consistent among the published studies (I 2 = 0).…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms

Ou,

Marian,

et al. 2024

Cancers

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Objective: In a previous study, we proved that an experienced urologist is more likely to adapt to the Hugo RAS system. Based on this, we further examine various parameters in this study. Parameters included in this study consisted of console time, functional outcomes, and oncological outcomes. Materials and Methods: A total of 60 patients who underwent robot-assisted radical prostatectomy (RARP) performed by a single surgeon using the da Vinci (DV) system (n = 30) or the Hugo RAS system (n = 30) between March 2023 and August 2023 were included in the analysis. The intraoperative operative time was categorized into vesicourethral anastomosis time and overall console time. Functional and oncological outcomes were documented at the 1st and 3rd postoperative months. Parametric and non-parametric methods were adopted after checking skewness and kurtosis, and an α value of 5% was used to determine the significance. Results: The vesicourethral anastomosis time was significantly lengthened (Hedge’s g: 0.87; 95% confidence interval (CI): 0.34–1.39; J factor = 0.987). However, the overall console time was not affected. The functional (postoperative 3rd month: p = 0.130) and oncological outcomes (postoperative 3rd month: p = 0.103) were not significantly different. We also found that the adverse effect on surgical specimens and positive surgical margins was not affected (p = 0.552). Conclusion: During the process of adaptation, although intricate motions (such as the vesicourethral anastomosis time) would be lengthened, the overall console time would not change remarkably. In this process, the functional and oncological outcomes would not be compromised. This encourages urologists to adopt the Hugo RAS system in RARP if they have previous experiences of using the DV system, since their trifecta advantage would not be compromised.

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Complications Experienced by Prostate Cancer Patients in the Era of Robot-Assisted Radical Prostatectomy

Masuda

2024

Interdisciplinary Cancer Research

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Robot-assisted versus open radical prostatectomy: a systematic review and meta-analysis of prospective studies

Cited by 11 publications

References 77 publications

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Robot-Assisted Radical Prostatectomy Performed with the Novel Hugo™ RAS System: A Systematic Review and Pooled Analysis of Surgical, Oncological, and Functional Outcomes

Robot-Assisted Radical Prostatectomy by the Hugo Robotic-Assisted Surgery (RAS) System and the da Vinci System: A Comparison between the Two Platforms

Complications Experienced by Prostate Cancer Patients in the Era of Robot-Assisted Radical Prostatectomy

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