Standard Multiport vs Single-Port Robot-Assisted Simple Prostatectomy: A Single-Center Initial Experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robot-assisted simple prostatectomy (RASP) is a viable treatment for benign prostatic hyperplasia (BPH) with large prostates (>80 mL).
• The multiport (MP) da Vinci system is established for RASP, but data on the newer single-port (SP) da Vinci SP platform are limited.

Purpose of the Study:

• To compare intraoperative and short-term postoperative outcomes of RASP performed with the da Vinci MP and SP robotic systems.
• To evaluate the safety and efficacy of the SP da Vinci system for RASP in a referral center setting.

Main Methods:

• Retrospective review of 75 patients undergoing RASP between September 2016 and March 2021.
• Comparison of operative time, estimated blood loss, length of stay, 30-day complications (Clavien-Dindo), and 90-day readmission/reoperation rates between MP and SP groups.

Main Results:

• No significant differences were observed in mean operative time (216.6 vs 232.4 min), estimated blood loss (195.7 vs 227.1 mL), or length of stay (2 vs 2.5 days) between MP and SP groups.
• A trend towards a higher overall complication rate was noted in the SP group (42.86%) compared to the MP group (21.28%), though this was not statistically significant (p=0.09).
• Readmission (17.02% vs 10.71%) and reoperation (2.1% vs 7.14%) rates were comparable between the two groups.

Conclusions:

• The single-port (SP) da Vinci robotic system is a safe alternative for robot-assisted simple prostatectomy (RASP).
• Perioperative outcomes for SP-RASP are equivalent to those of the multiport (MP) system.
• While a trend for increased complications was seen with SP, it did not reach statistical significance, suggesting comparable safety profiles.