The modified single incision robot-assisted laparoscopic radical prostatectomy: initial experience and clinical efficiency
10.3760/cma.j.cn112330-20210303-00113
- VernacularTitle:改良单切口机器人辅助根治性前列腺切除术的初步疗效
- Author:
Qian LYU
1
;
Yi WEI
;
Yaoqian WANG
;
Yong OU
;
Qiang WANG
;
Hualin FENG
;
Cheng LUO
;
Yu NIE
;
Shangqing REN
;
Fang ZHOU
;
Shida FAN
;
Zhengjun CHEN
;
Keyang JIA
;
Yang LI
;
Dong WANG
Author Information
1. 四川省医学科学院 四川省人民医院机器人微创中心，成都 610072
- Keywords:
Prostatic neoplasms;
Robotic surgery;
Single incision;
Efficacy
- From:
Chinese Journal of Urology
2021;42(11):830-833
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility and clinical efficiency of robot-assisted laparoscopic radical prostatectomy (RARP) via extraperitoneal PORT-free single incision approach.Methods:The data of 33 patients with prostate cancer underwent the extraperitoneal PORT-free single incision RARP from November 2020 to January 2021 in Sichuan Provincial People's Hospital was retrospectively reviewed. The average age was 66.7 (58-78) years, the median PSA was 20.77 (2.89, 56.44) ng/m, and the mean Gleason score was 7.0 (6.0-9.0). The mean prostate volume was 48.4 (25.0-220.0) ml. Clinical stage: 32 cases was in cT 2a-2cN 0M 0, 1 case in cT 3aN 0M 0. 16 cases had a history of operation. All 33 operations were performed by the same operator. All operations were performed by extraperitoneal PORT-free single-incision approach. The surgical condition, postoperative complication, pathology, and follow-up results were observed. Results:In this study, 33 operations were successfully completed without conversion to open or additional single hole channel instruments. The average operation time was 61.3 (38.0-120.0) min, with the mean intraoperative bleeding volume of 72.2 (45.0-220.0) ml and the mean bladder neck urethral anastomosis time of 11.7 (8.5-15.7) min. The mean postoperative hospital stay was 7.9 (6.0-15.0) d, the mean postoperative indwelling time of urinary catheter was 6.8 (6.0-14.0) d, and the mean postoperative evacuation time was 1.0 (0.5-3.0) d. The average incision length was 5.2 (4.6-5.8) cm. There was no obvious complications. The postoperative pathological stage: 21 cases were in < pT 3a, 12 cases were in ≥ pT 3a, and 6 cases (18.8%) had positive resection margin. 29 cases (88.9%) acquired satisfactory urinary continence after operation, and the frequency of urinary pad use was ≤ 1 tablet/day. Conclusions:The extraperitoneal single-incision RARP surgical channel without PORT is safe and feasible with a satisfying cosmetic effect, which saves costs and requires less specific channel device. Simultaneously, the new approach has strong replicability, short-term tumor control and urinary control effect with rapid postoperative recovery. However, the sample size of this study is relatively small, which needs further research and demonstration
