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The Multi-Institutional Experience in Single-Port Robotic Transvesical Simple Prostatectomy for BPH Management.

Authors
  • Zeinab, Mahmoud Abou1
  • Beksac, Alp Tuna1
  • Corse, Tanner2
  • Talamini, Susan3
  • Morgantini, Luca3
  • Kaviani, Aaron1
  • Ferguson, Ethan1
  • Eltemamy, Mohamed1
  • Crivellaro, Simone3
  • Ahmed, Mutahar2
  • Stifelman, Michael2
  • Kaouk, Jihad1
  • 1 Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
  • 2 Hackensack University Medical Center, Hackensack, New Jersey. , (Jersey)
  • 3 University of Illinois Hospital & Health Sciences System, Chicago, Illinois.
Type
Published Article
Journal
The Journal of urology
Publication Date
Apr 04, 2022
Identifiers
DOI: 10.1097/JU.0000000000002692
PMID: 35377779
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Single-port robotic-assisted simple prostatectomy (SP RASP) through the transvesical approach is a novel surgical option in the management of large prostatic glands. We present the first multi-institutional study to further assess the perioperative and postoperative outcomes of SP RASP. From February 2019 to November 2021, 91 consecutive patients of three separate institutions underwent transvesical RASP using the da Vinci SP robotic surgical system. Surgeries were performed by three experienced surgeons. Through a suprapubic incision and transvesical access, the SP robot is docked directly into the bladder, and the prostatic enucleation is performed. Prospective data collection including baseline characteristics, perioperative and postoperative outcomes was performed. The mean follow-up period was 4.6 months. The mean (SD) prostate volume was 156 (62) ml. The mean (SD) total operative time was 159 (45) minutes, and the median (IQR) estimated blood loss (EBL) was 100 (50, 200) cc. The median (IQR) postoperative hospital stay was 21.0 (6.5, 26.0) hours, however, 42% of all patients were discharged the same day. The median (IQR) Foley catheter duration was 5 (5, 7) days. Only 3 patients (3%) developed Grade 2 Clavien grade postoperative complications. At 9 month follow-up, the median (IQR) IPSS and QOL were 4 (2, 5) and 0 (0, 1), with a mean (SD) maximum flow rate and PVR of 21 (17) ml/sec and 40 (55) ml. In a multi-institutional setting, the SP RASP promotes pain-free procedure, same-day discharge, short Foley catheter duration, low complication rate, and quick recovery.

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