Comparison of single-port and multi-port Retzius-sparing robot-assisted laparoscopic prostatectomy
Dissemination of robotic surgical technology for robot-assisted laparoscopic prostatectomy (RALP) has yielded advancements including the Retzius-sparing (RS) approach and the single-port (SP) platform. The safety and feasibility of each individual advancement have been evaluated, yet there is a lack...
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| Veröffentlicht in: | Journal of robotic surgery 2023-06, Vol.17 (3), p.835-840 |
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| creator | Shiang, Alexander L. Palka, Joshua K. Balasubramanian, Shiva Figenshau, R. Sherburne Smith, Zachary L. Kim, Eric H. |
| description | Dissemination of robotic surgical technology for robot-assisted laparoscopic prostatectomy (RALP) has yielded advancements including the Retzius-sparing (RS) approach and the single-port (SP) platform. The safety and feasibility of each individual advancement have been evaluated, yet there is a lack of literature comparing SP RS-RALP to conventional multi-port (MP) RS-RALP. All patients who underwent RS-RALP at our institution between January 2019 and February 2021 were retrospectively reviewed. Data regarding baseline patient and tumor characteristics, operative characteristics, and surgical outcomes were collected and analyzed using the Fisher’s exact test and two-tailed unpaired
t
tests. 62 patients were evaluated: 31 received SP RS-RALP and 31 received MP RS-RALP. Differences in patient age, BMI, and initial PSA were not observed. Lower median lymph node yield (SP: 4 vs MP: 12,
p
|
| doi_str_mv | 10.1007/s11701-022-01464-z |
| format | Article |
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t
tests. 62 patients were evaluated: 31 received SP RS-RALP and 31 received MP RS-RALP. Differences in patient age, BMI, and initial PSA were not observed. Lower median lymph node yield (SP: 4 vs MP: 12,
p
< 0.01), lower estimated blood loss (SP: 111.2 vs. MP 157.8 mL,
p
< 0.01), shorter operative time (SP: 207.7 vs. MP: 255.9 min,
p
< 0.01) and decreased length of stay (SP: 0.39 vs. MP: 1.23 days,
p
< 0.01) were observed in the SP RS-RALP cohort. No differences in positive surgical margins, complications, or biochemical recurrence rates were observed. SP RS-RALP is non-inferior to MP RS-RALP in terms of both perioperative and early oncologic outcomes. Despite the small sample size, the SP platform is a safe and feasible option for RS-RALP and confers potential benefits in the form of shorter operative time and reduced length of stay.</description><identifier>ISSN: 1863-2491</identifier><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-022-01464-z</identifier><identifier>PMID: 36316538</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Bladder ; Catheters ; Demographics ; Dissection ; Feasibility ; Humans ; Laparoscopy ; Laparoscopy - adverse effects ; Learning curves ; Length of stay ; Lymphatic system ; Male ; Medicine ; Medicine & Public Health ; Minimally Invasive Surgery ; Original ; Original Article ; Patients ; Postoperative Complications - etiology ; Prostate cancer ; Prostatectomy - adverse effects ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - methods ; Robotics ; Surgeons ; Surgery ; Surgical outcomes ; Treatment Outcome ; Urological surgery ; Urology</subject><ispartof>Journal of robotic surgery, 2023-06, Vol.17 (3), p.835-840</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-b7ecf5c18de83361378a28989e025a799ca38e83fe31f78993ffe3d99105bf073</citedby><cites>FETCH-LOGICAL-c474t-b7ecf5c18de83361378a28989e025a799ca38e83fe31f78993ffe3d99105bf073</cites><orcidid>0000-0002-7957-5418</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11701-022-01464-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918717694?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36316538$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shiang, Alexander L.</creatorcontrib><creatorcontrib>Palka, Joshua K.</creatorcontrib><creatorcontrib>Balasubramanian, Shiva</creatorcontrib><creatorcontrib>Figenshau, R. Sherburne</creatorcontrib><creatorcontrib>Smith, Zachary L.</creatorcontrib><creatorcontrib>Kim, Eric H.</creatorcontrib><title>Comparison of single-port and multi-port Retzius-sparing robot-assisted laparoscopic prostatectomy</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><addtitle>J Robot Surg</addtitle><description>Dissemination of robotic surgical technology for robot-assisted laparoscopic prostatectomy (RALP) has yielded advancements including the Retzius-sparing (RS) approach and the single-port (SP) platform. The safety and feasibility of each individual advancement have been evaluated, yet there is a lack of literature comparing SP RS-RALP to conventional multi-port (MP) RS-RALP. All patients who underwent RS-RALP at our institution between January 2019 and February 2021 were retrospectively reviewed. Data regarding baseline patient and tumor characteristics, operative characteristics, and surgical outcomes were collected and analyzed using the Fisher’s exact test and two-tailed unpaired
t
tests. 62 patients were evaluated: 31 received SP RS-RALP and 31 received MP RS-RALP. Differences in patient age, BMI, and initial PSA were not observed. Lower median lymph node yield (SP: 4 vs MP: 12,
p
< 0.01), lower estimated blood loss (SP: 111.2 vs. MP 157.8 mL,
p
< 0.01), shorter operative time (SP: 207.7 vs. MP: 255.9 min,
p
< 0.01) and decreased length of stay (SP: 0.39 vs. MP: 1.23 days,
p
< 0.01) were observed in the SP RS-RALP cohort. No differences in positive surgical margins, complications, or biochemical recurrence rates were observed. SP RS-RALP is non-inferior to MP RS-RALP in terms of both perioperative and early oncologic outcomes. Despite the small sample size, the SP platform is a safe and feasible option for RS-RALP and confers potential benefits in the form of shorter operative time and reduced length of stay.</description><subject>Bladder</subject><subject>Catheters</subject><subject>Demographics</subject><subject>Dissection</subject><subject>Feasibility</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Learning curves</subject><subject>Length of stay</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Minimally Invasive Surgery</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative Complications - etiology</subject><subject>Prostate cancer</subject><subject>Prostatectomy - adverse effects</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Urological surgery</subject><subject>Urology</subject><issn>1863-2491</issn><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kc1u1TAQhS3UipbCC7BAkbrpxq3HTvyzqYSuKFSqhIRgbTmOc3GVxKntIPU-fX1JKS0LVh7PfHPG44PQeyDnQIi4SACCACaUYgI1r_HuFToGyRmmtYKDZ_ERepPSLSGNaBi8RkeMM-ANk8eo3YRxNtGnMFWhr5KftoPDc4i5MlNXjcuQ_Xr95vLOLwmnPT5tqxjakLFJyafsumowJR-SDbO31VyibLKzOYz3b9Fhb4bk3j2eJ-jH1afvmy_45uvn683HG2xrUWfcCmf7xoLsnGSMAxPSUKmkcoQ2RihlDZOl1DsGvZBKsb6EnVJAmrYngp2gy1V3XtrRddZNOZpBz9GPJt7rYLx-WZn8T70Nv7TiVDLCi8DZo0AMd4tLWY8-WTcMZnJhSZoKVmZxaGRBT_9Bb8MSp7KepgqkAMFVXSi6Urb8R4quf3oMEL23UK8W6mKh_m2h3pWmD8_XeGr541kB2AqkeW-Ei39n_0f2AcWQqkc</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Shiang, Alexander L.</creator><creator>Palka, Joshua K.</creator><creator>Balasubramanian, Shiva</creator><creator>Figenshau, R. 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Sherburne</au><au>Smith, Zachary L.</au><au>Kim, Eric H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of single-port and multi-port Retzius-sparing robot-assisted laparoscopic prostatectomy</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><addtitle>J Robot Surg</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>17</volume><issue>3</issue><spage>835</spage><epage>840</epage><pages>835-840</pages><issn>1863-2491</issn><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>Dissemination of robotic surgical technology for robot-assisted laparoscopic prostatectomy (RALP) has yielded advancements including the Retzius-sparing (RS) approach and the single-port (SP) platform. The safety and feasibility of each individual advancement have been evaluated, yet there is a lack of literature comparing SP RS-RALP to conventional multi-port (MP) RS-RALP. All patients who underwent RS-RALP at our institution between January 2019 and February 2021 were retrospectively reviewed. Data regarding baseline patient and tumor characteristics, operative characteristics, and surgical outcomes were collected and analyzed using the Fisher’s exact test and two-tailed unpaired
t
tests. 62 patients were evaluated: 31 received SP RS-RALP and 31 received MP RS-RALP. Differences in patient age, BMI, and initial PSA were not observed. Lower median lymph node yield (SP: 4 vs MP: 12,
p
< 0.01), lower estimated blood loss (SP: 111.2 vs. MP 157.8 mL,
p
< 0.01), shorter operative time (SP: 207.7 vs. MP: 255.9 min,
p
< 0.01) and decreased length of stay (SP: 0.39 vs. MP: 1.23 days,
p
< 0.01) were observed in the SP RS-RALP cohort. No differences in positive surgical margins, complications, or biochemical recurrence rates were observed. SP RS-RALP is non-inferior to MP RS-RALP in terms of both perioperative and early oncologic outcomes. Despite the small sample size, the SP platform is a safe and feasible option for RS-RALP and confers potential benefits in the form of shorter operative time and reduced length of stay.</abstract><cop>London</cop><pub>Springer London</pub><pmid>36316538</pmid><doi>10.1007/s11701-022-01464-z</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7957-5418</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bladder Catheters Demographics Dissection Feasibility Humans Laparoscopy Laparoscopy - adverse effects Learning curves Length of stay Lymphatic system Male Medicine Medicine & Public Health Minimally Invasive Surgery Original Original Article Patients Postoperative Complications - etiology Prostate cancer Prostatectomy - adverse effects Retrospective Studies Robotic surgery Robotic Surgical Procedures - methods Robotics Surgeons Surgery Surgical outcomes Treatment Outcome Urological surgery Urology |
| title | Comparison of single-port and multi-port Retzius-sparing robot-assisted laparoscopic prostatectomy |
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