Presentation Authors: Riccardo Bertolo*, Juan Garisto, Jose Agudelo, Mohamed Eltemamy, Jihad Kaouk, Cleveland, OH
Introduction: The Da Vinci SPÂ® robotic surgical platform (Intuitive Surgical, Sunnyvale, CA, USA) has been FDA approved and launched on the market. We aimed to report our initial experience with robotic urological interventions.
Methods: Data of patients undergoing urologic surgeries performed by the Da Vinci SPÂ® surgical platform were prospectively collected in the institutional review-board approved dataset (IRB 13-780) from September 28th to October 31th, 2018. All the surgeries were completed via a single-incision through which a GelPOINT advanced access platform (Applied Medical, Rancho Santa Margarita, CA, USA) and a dedicated 25-mm multi-channel port accommodating a 12 x 10-mm articulating robotic camera, three 6-mm double-jointed articulating robotic instruments and a 6-mm accessory laparoscopic instrument were placed. When needed, additional ports for the bed-side assistant were placed.
Results: A total of 15 patients were treated (5 robot-assisted radical prostatectomies, 3 transperitoneal robot-assisted partial nephrectomies, 3 cystectomies with intracorporeal ileal conduit urinary diversion, 3 ureteral reimplantations and 1 pyeloplasty). No intraoperative complications occurred. In 6 cases the surgeries were performed according to a pure single-site approach. The mean operative time was slightly longer than the one reported for the respective multi-arm robotic procedures in the published experiences, which can be easily explained by the expected learning curve. One patient required angioembolization after partial nephrectomy.
Conclusions: Major urological interventions were performed by using the Da Vinci SPÂ® robotic surgical platform. The surgery is feasible, and the platform could sponsor the achievement of a pure single-site approach. On the other hand, a learning curve exists when embarking with this surgery and further investigations are awaited.