A comparison of perioperative outcomes between extraperitoneal robotic single-port and multiport radical prostatectomy with the da Vinci Si Surgical System

AbstractTo describe perioperative outcomes following robot-assisted prostatectomy performed by a single surgeon during transitions between da Vinci standard/Si/Xi and the single port. Perioperative data were retrospectively evaluated of the first 40 consecutive robot-assisted radical prostatectomies performed by a single surgeon using the da Vinci standard, Si, Xi and single port. A total of 160 patients were included. We matched standard vs Si (Match 1), Si vs Xi (Match 2) and Xi vs single port (Match 3) cohort. Mann–Whitney and Fisher’s tests were used to test the difference among the groups. Univariate and multivariate logistic regression analyses were adopted to evaluate the predictors of overall and major complications. Single-port procedures in Match 3 showed significant shorter median operative time than Xi. Both Si and single-port groups showed significantly less median blood loss, a shorter median length of stay, respectively, than standard group in Match 1 and than Xi group in Match 3. 1 standard group patient required conversion to open surgery for an unsolvable conflict of the robotic arms. No other intraoperative complications were noted. On univariate and multivariate analyses, the da Vinci platform model was not a predicting factor of major complications (Clavien–Dindo ≥ 3). We described how technological progress impacted peri and postoperative outcomes during transitions between robotic surgical platforms for radical prostatectomy. In particular, the technological improvements associated to the increased surgeon’s expertise made the transition to the single port safe and effective when compared with previous platforms.

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Re: Comparing the Approach to Radical Prostatectomy Using the Multiport da Vinci Xi and Single-port da Vinci SP Robots: A Propensity Score Analysis of Perioperative Outcomes

European Urology ◽

10.1016/j.eururo.2021.04.008 ◽

2021 ◽

Author(s):

Alexander Haese ◽

Markus Graefen

Keyword(s):

Radical Prostatectomy ◽

Propensity Score ◽

Da Vinci ◽

Single Port ◽

Propensity Score Analysis ◽

Perioperative Outcomes ◽

Da Vinci Xi ◽

Score Analysis

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A comparison of the da Vinci Xi vs. da Vinci Si surgical systems for radical prostatectomy

BMC Surgery ◽

10.1186/s12893-021-01406-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kun-Yang Lei ◽

Wen-Jie Xie ◽

Sheng-Qiang Fu ◽

Ming Ma ◽

Ting Sun

Keyword(s):

Radical Prostatectomy ◽

Da Vinci ◽

Laparoscopic Radical Prostatectomy ◽

Perioperative Outcomes ◽

Da Vinci Xi ◽

Robot Assisted ◽

Short Term ◽

Term Efficacy ◽

Da Vinci Si ◽

The Cost

Abstract Background To compare the perioperative and short-term efficacy and cost of the da Vinci Xi and da Vinci Si surgical systems for radical prostatectomy. Methods We retrospectively analyzed the clinical data of 175 patients with prostate cancer who underwent radical prostatectomy with the da Vinci Si or Xi surgical systems in our hospital from June 2019 to June 2020. Of the 175 patients, 82 underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Xi surgery system, and 93 patients underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Si surgical system. The perioperative outcomes, short-term efficacy and costs were compared between the two groups. Results The anesthesia time, operation time, docking time, indwelling catheter time and postoperative bed rest time in the Xi group were shorter than those in the Si group (respectively, 268.8 min vs. 219.3 min, P = 0.001; 228.2 min vs. 259.6 min, P < 0.001; 7.4 min vs. 12.7 min, P < 0.001; 8.6 d vs. 9.7 d, P = 0.036; 2.2 d vs. 2.6 d, P = 0.002). However, the total cost of hospitalization and the cost of intraoperative consumables in the Xi group were higher than those in the Si group (84,740.7 vs. 76,739.1 ¥, P = 0.003; 13,199.4 vs. 10,823.0 ¥, P = 0.019). Conclusions Although the cost of robot-assisted radical prostatectomy is higher, compared with the Si system, the Xi system has better perioperative outcomes and can provide similar short-term efficacy and oncology outcomes.

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