Single-port Extraperitoneal and Transperitoneal Radical Prostatectomy: A Multi-Institutional Propensity-Score Matched Study

Zeinab, Mahmoud Abou; Beksaç, Alp Tuna; Ferguson, Ethan; Kaviani, Aaron; Moschovas, Marcio Covas; Joseph, Jean; Kim, Moses; Crivellaro, Simone; Nix, Jeffrey; Patel, Vipul; Kaouk, Jihad

doi:10.1016/j.urology.2022.10.001

Cited by 13 publications

(35 citation statements)

References 26 publications

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“…The first experience was described by Kaouk et al [ 16 ], demonstrating a significantly shorter postoperative hospital stay and decreased need for postoperative narcotics, as well as shorter operative time for the extraperitoneal cohort. Later, the first and largest multi-institutional propensity score-matched study comparing the two approaches was reported [ 17 ] ( Table 2 ). Results largely echoed findings from the previous study, with exception of the operative time, which was longer in the extraperitoneal group (median 206 vs. 155 min, p < 0.001).…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Results largely echoed findings from the previous study, with exception of the operative time, which was longer in the extraperitoneal group (median 206 vs. 155 min, p < 0.001). The authors justified this finding by the different surgeon experience, additional operative time required for creating the extraperitoneal space, and more frequent lymph node dissection cases in the extraperitoneal cohort [ 17 ].…”

Section: Evidence Synthesismentioning

confidence: 99%

“…However, the lower cost of shorter hospitalization may counterbalance the higher cost of surgical consumables, hence the costs for SP-RALP and MP RALP prostatectomy may be comparable [ 45 ]. Several studies suggest a major role of SP-RALP in an outpatient setting [ 15 , 16 , 17 ]. Certainly, a lower administration of analgesics and opioids will positively also affect hospital stay and facilitate outpatient procedures.…”

Section: Oncological and Functional Outcomesmentioning

confidence: 99%

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Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand?

et al. 2023

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In 2018, the da Vinci Single Port (SP) robotic system was approved by the US Food and Drug Administration for urologic procedures. Available studies for the application of SP to prostate cancer surgery are limited. The aim of our study is to summarize the current evidence on the techniques and outcomes of SP robot-assisted radical prostatectomy (SP-RARLP) procedures. A narrative review of the literature was performed in January 2023. Preliminary results suggest that SP-RALP is safe and feasible, and it can offer comparable outcomes to the standard multiport RALP. Extraperitoneal and transvesical SP-RALP appear to be the two most promising approaches, as they offer decreased invasiveness, potentially shorter length of stay, and better pain control. Long-term, high-quality data are missing and further validation with prospective studies across different sites is required.

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Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Oncological and Functional Outcomesmentioning

confidence: 99%

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Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand?

et al. 2023

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“…Since the introduction in 2018 of the da Vinci Single Port (SP) robotic platform, several studies have investigated the safety and initial perioperative outcomes of SP procedures. Indeed, studies have been published regarding radical and simple prostatectomy, 1,2 partial nephrectomy, 3 pyeloplasty and ureteric reimplantation to name a few. 4 Most of these studies showed no difference in terms of blood loss, operative time and complications when compared to multiport (MP) surgery; however, there have been consistent findings pointing toward less pain, less narcotic use and a shorter hospital stay when compared to MP surgery.…”

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confidence: 99%

Outpatient vs Inpatient Single-Port Robotic Urologic Surgery: Perioperative Outcomes and Complications

Pellegrino,

Calvo,

Pellegrino

et al. 2024

Urology Practice

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Introduction:The da Vinci Single Port (SP) robotic surgical system has minimized the impact of surgery on patients. Hence, outpatient robotic procedures are being explored to reduce costs and improve patient experience. Here, we evaluate the perioperative outcomes and safety of same-day discharge (SDD) after surgery compared to inpatient procedures using the SP.Methods: A total of 374 patients underwent surgery with the da Vinci SP system between January 2019 and February 2023. Surgeries were performed in a single high-volume center. Patients were either managed with a standardized outpatient or inpatient protocol. SDD clinical pathway was implemented in June 2021. Patients were assessed for discharge eligibility based on specific guidelines. Detailed instructions were provided at discharge, and patients were followed postoperatively. Baseline characteristics, perioperative data, complications, time to complication, and readmissions were assessed.Results: Two hundred eight patients underwent outpatient surgery and 166 underwent inpatient surgery (total ¼ 374). Outpatient surgery was not associated with increased postoperative complications and readmission compared to inpatient surgery. Ninety percent and 74.6% of patients experienced no complications in the outpatient and inpatient populations, respectively (P ¼< .001). Time to first complication was also comparable between the 2 groups (3 days [IQR 1-8] vs 10 days for outpatient vs inpatient; P ¼ .3). The proportion of successful SDDs increased over time, reaching 88% in October 2022.Conclusions: Outpatient surgery using the da Vinci SP is safe and feasible, without increasing postoperative complications compared to standard inpatient surgery.

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“…This evolution involved different surgical fields, including general surgery, urology, gynaecology and many other specialities ( 1 – 3 ). Further evolution of minimally invasive surgery was represented by ultra-minimally invasive surgery, which is currently running through two different philosophies: the port size decreasing (3mm vs 5-10mm) ( 4 ) and the reduction of the incision numbers, represented by the single port approach ( 5 ). The latest innovations are represented by robotics.…”

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confidence: 99%

Editorial: Challenges, techniques and pitfalls in surgery: How far can we push the boundaries?

et al. 2022

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Editorial on the Research TopicChallenges, techniques and pitfalls in surgery: How far can we push the boundaries?In the last decade, surgery to relevant was subjected to relevant improvement thanks technological innovations and consequent novel surgical techniques. The actual surgical panorama gained by the progress of minimally invasive surgery that has become the gold standard for several procedures historically performed with open access. This evolution involved different surgical fields, including general surgery, urology, gynaecology and many other specialities (1-3). Further evolution of minimally invasive surgery was represented by ultra-minimally invasive surgery, which is currently running through two different philosophies: the port size decreasing (3mm vs 5-10mm) (4) and the reduction of the incision numbers, represented by the single port approach (5). The latest innovations are represented by robotics. This technology allows for overcoming many limits of traditional endoscopy, even reducing the invasiveness.Moreover, the different available platforms can actually allow for reduced costs (6). Furthermore, adjuvant therapies and new softwares can become fundamental in surgery. Therefore, these technologies could be useful even in different specialties as general surgery, surgical oncology, gynaecology, urology, etc. (7-12).It was an very pleasure to serve as Guest Editors of the Research Topic of Frontiers entitled "Challenges, Techniques and Pitfalls in Surgery: How Far Can We Push the Boundaries?". This Research Topic provides an overview of the last innovation in surgery and contributes to the field's growth. All authors on the Research Topic contribute significantly to clinical and basic research advancements. Therefore, we present a collection of articles reported by authors from different specialities as general surgery to more specialistic surgical subspecialties. The article treated in this Research Topic could be useful for students, researchers and clinicians.

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Single-port Extraperitoneal and Transperitoneal Radical Prostatectomy: A Multi-Institutional Propensity-Score Matched Study

Cited by 13 publications

References 26 publications

Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand?

Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand?

Outpatient vs Inpatient Single-Port Robotic Urologic Surgery: Perioperative Outcomes and Complications

Editorial: Challenges, techniques and pitfalls in surgery: How far can we push the boundaries?

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