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Comparing Perioperative Outcomes Using Single and Multiple Robot Systems During the Learning Period for
Yuto Matsushita1, Yoshihiro Tsuchiya1, Gaku Ishikawa1
1Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Asian Journal of Endoscopic Surgery
|June 4, 2025
Summary
Surgeons learning robot-assisted radical prostatectomy (RARP) with both the hinotori and da Vinci systems showed similar outcomes to those trained solely on da Vinci. This suggests multi-system training is effective for RARP learning.
Area of Science:
- Urology
- Surgical Technology
- Robotics
Background:
- Robot-assisted radical prostatectomy (RARP) is a complex procedure requiring specialized training.
- Evaluating the learning curve for new robotic systems is crucial for surgical education.
- Comparing outcomes between single-system and multi-system robotic training is essential for optimizing surgical training programs.
Purpose of the Study:
- To assess and compare perioperative outcomes during the learning period of RARP using multiple surgical robot systems (hinotori and da Vinci) versus single-system (da Vinci) training.
- To evaluate the impact of multi-system robotic training on surgeon proficiency and patient outcomes.
Main Methods:
- Retrospective analysis of the initial 25 RARP cases for surgeons trained on multiple systems (hinotori and da Vinci Xi [H&D] group) and those trained only on da Vinci (D group).
- Comparison of perioperative outcomes including robotic system time, PSA recurrence, and urinary continence at 3 months post-surgery.
- Multivariate analysis to identify factors influencing outcomes.
Main Results:
- No significant differences in patient characteristics between the H&D and D groups.
- Despite less prior experience in urology and laparoscopy, H&D group surgeons had extensive RARP assistant experience at institutions with greater RARP experience.
- Perioperative outcomes, including robotic system time, PSA recurrence rate, and 3-month pad-free rate, were not significantly different between the groups.
Conclusions:
- Multi-system RARP training (hinotori and da Vinci) yields comparable perioperative outcomes to single-system (da Vinci) training during the learning phase.
- Younger surgeons in the multi-system group benefited from prior RARP assistant experience and training at experienced institutions.
- The findings support the efficacy of multi-system robotic platforms in surgical education for RARP.
