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Updated: May 30, 2025
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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
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Optimizing Prostate Cancer Surgery for Seniors: Single-Port Robotic-Assisted Platform
Hakan Bahadir Haberal1,2, Luca Lambertini1,3, Giulio Avesani1,4
1Department of Urology, University of Illinois at Chicago, Chicago, Illinois, USA.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|January 29, 2025
Summary
Robotic-assisted radical prostatectomy using the Da Vinci single-port platform is safe for elderly patients, showing similar complication and oncological outcomes compared to younger groups. This approach offers feasible treatment with acceptable results for older individuals.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Oncology
Background:
- The Da Vinci single-port (SP) robotic platform is increasingly adopted for radical prostatectomy (RP).
- Comparative data on its use in elderly versus younger patients undergoing robotic-assisted radical prostatectomy (SP-RARP) is limited.
- Understanding age-related differences in outcomes is crucial for surgical decision-making.
Purpose of the Study:
- To compare complications and oncological outcomes of SP-RARP between elderly and young patient groups.
- To further analyze differences within the elderly cohort, specifically between 'young-old' and 'old-old' subgroups.
- To evaluate the feasibility and safety of SP-RARP in an elderly population.
Main Methods:
- Retrospective analysis of 193 patients who underwent SP-RARP from December 2018 to June 2024.
- Patients were stratified into young (18-64 years) and elderly (65+ years) groups.
- The elderly group was further divided into young-old (65-69 years) and old-old (70+ years) subgroups. Variables included patient characteristics, intraoperative and postoperative outcomes, and oncological results.
Main Results:
- Overall intraoperative complication rate was 1.6%, with no conversions to open surgery. Postoperative adverse events occurred in 24.4% and 30-day readmission in 11.4%.
- Intraoperative complications and 30-day readmission rates were similar between age groups. However, postoperative complications were significantly higher in the younger group (P=.012).
- Biochemical recurrence-free survival rates at 3 and 5 years were 80.5% and 75.1%, respectively, with no significant differences between age groups.
Conclusions:
- SP-RARP demonstrates feasibility and acceptable oncological outcomes in elderly patients.
- The incidence of postoperative complications was notably higher in the younger patient cohort.
- The Da Vinci SP platform is a viable surgical option for radical prostatectomy across different age groups, including the elderly.
