Abstract
Objective
To describe our institution’s initial experience with robot-assisted radical prostatectomy (RARP) using the Senhance® robotic system.
Patients and methods
A prospective analysis of 127 robot-assisted radical prostatectomies was performed. Patient demographics, preoperative and intraoperative parameters, histopathological examination results, intraoperative and early postoperative complications were obtained and analyzed.
Results
The median patient age was 61.0 ± 6.36 (from 37 to 73) years, with a mean body mass index of 26.2 ± 3.79 kg/m2. Of 127 patients, 16.5% (n = 21) underwent a pelvic lymph node dissection, 29.1% (n = 37) underwent one sided or bilateral nerve sparing. Post-operative extracapsular invasion (≥ pT3) was found in 15% (n = 19) of the cases and a Gleason score ≥ 7 in 74.8% of all patients. Our median operative time was 180 ± 41.98 min [interquartile range (IQR) 150–215], and median blood loss was 250 ± 236 (IQR 175–430) ml. Of 127 patients, 33.9% (n = 43) had positive margins, of them 28.7% in pT2 and 57.9% in pT3. Fifteen patients (11.8%) experienced complications, of them only three had Clavien–Dindo ≥ 3. Operation time decreased by about 60 min and estimated blood loss decreased by about 200 ml from the initial experience of each surgeon.
Conclusions
Robotic prostatectomy using a Senhance® robotic system is feasible, and warrants further study to determine whether it can improve patient outcomes.
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References
Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359-386
Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67(1):7–30
Ilic D, Evans SM, Allan CA et al (2017) Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer. Cochrane Database Syst Rev 9(9):CD009625
Oberlin DT, Flum AS, Lai JD et al (2016) The effect of minimally invasive prostatectomy on practice patterns of American urologists. Urol Oncol 34(6):255.e1–5
Gandaglia G, Montorsi F, Karakiewicz PI et al (2015) Robot-assisted radical prostatectomy in prostate cancer. Future Oncol 11(20):2767–2773
Kastelan Z, Hudolin T, Kulis T, Knezevic N, Penezic L, Maric M, Zekulic T (2021) Upper urinary tract surgery and radical prostatectomy with Senhance® robotic system: single center experience—first 100 cases. Int J Med Robot. https://doi.org/10.1002/rcs.2269
Rao PP (2018) Robotic surgery: new robots and finally some real competition! World J Urol 36(4):537–541
Stephan D, Salzer H, Willeke F (2018) First experiences with the new Senhance1 telerobotic system in visceral surgery. Visc Med 34:31–36
Godoy G, Chong KT, Cronin A et al (2011) Extent of pelvic lymph node dissection and the impact of standard template dissection on nomogram prediction of lymph node involvement. Eur Urol 60(2):195–201
Dindo DA, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213
Alletti SG, Rossitto C, Cianci S et al (2018) The Senhance™ surgical robotic system (“Senhance”) for total hysterectomy in obese patients: a pilot study. J Robot Surg 12(2):229–234
Samalavicius NE, Janusonis V, Siaulys R et al (2020) Robotic surgery using Senhance® robotic platform: single center experience with first 100 cases. J Robot Surg 14:371–376
Rumolo V, Rosati A, Tropea A et al (2019) Senhance robotic platform for gynecologic surgery: a review of literature. Updates Surg 71(3):419–427
Stephan D, Darwich I, Willeke F (2021) The TransEnterix European patient registry for robotic-assisted laparoscopic procedures in urology, abdominal, thoracic, and gynecologic surgery (“TRUST”). Surg Technol Int. 38:sti38/1394
De Carlo F, Celestino F, Verri C et al (2014) Retropubic, laparoscopic, and robot-assisted radical prostatectomy: surgical, oncological, and functional outcomes: a systematic review. Urol Int 93(4):373–383
Yossepowitch O, Briganti A, Eastham JA et al (2014) Positive surgical margins after radical prostatectomy: a systematic review and contemporary update. Eur Urol 65(2):303–313
Adili AF, Di Giovanni J, Kolesar E et al (2017) Positive surgical margin rates during the robot-assisted laparoscopic radical prostatectomy learning curve of an experienced laparoscopic surgeon. Can Urol Assoc J 11(11):E409–E413
Acknowledgements
RV, TT, MV, VJ and AD performed the research; AD, NES designed the research study; RV, MJ and TT performed the surgeries; TT, MV, VJ analysed the data; TT, MV, RV, NES and AD wrote the paper.
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Venckus, R., Jasenas, M., Telksnys, T. et al. Robotic-assisted radical prostatectomy with the Senhance® robotic platform: single center experience. World J Urol 39, 4305–4310 (2021). https://doi.org/10.1007/s00345-021-03792-5
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DOI: https://doi.org/10.1007/s00345-021-03792-5