Presentation Authors: Deepak K. Agarwal*, Vidit Sharma, Boyd R. Viers, Igor Frank, Matthew K. Tollefson, Matthew T. Gettman, Rochester, MN
Introduction: We present our initial experience with the da Vinci Single Port (SP) robotic system for robot-assisted radical prostatectomies (RARP). We describe our technique, modifications to standard RARP and initial outcomes.
Methods: A retrospective review of our experience with RARP utilizing the da Vinci SP was performed. All procedures were performed by one of three surgeons. Patient age, pathologic features, operative time, blood loss and complications were presented from this cohort.
Results: 18 patients were included in our cohort. Median age is 59 years (IQR 55-64). Median preoperative PSA was 6.3 ng/ml (5.2-9.2) and 11 were cT1c. 77% were pT2 on final pathology. 77% were Gleason grade group 2 or 3 on final pathology. Median node count was 8 and one patient had N1 disease._x000D_
Median operative time was 155 minutes (IQR 127-198) and estimated blood loss was 200 mL (100-338). Median length of stay 1 day (IQR 1-1) and catheter 7 days (7-8). One patient required a blood transfusion postoperatively from delayed pelvic bleeding._x000D_
An intraoperative frozen section of a whole prostate was obtained by undocking and redocking the robot._x000D_
Case time decreased with experience and began to plateau around the third case.
Conclusions: RARP is feasible on the da Vinci SP robotic system. Some modifications to the technique are required. Intraoperative frozen section is also feasible without significant interruption to the case. Morbidity is comparable to prior robotic systems. Further work is needed to establish non-inferiority, patient assessed cosmesis, and postoperative pain scores.