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First case of robotic laparoendoscopic single-site radical prostatectomy with single-site VesPa platform

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Abstract

This study aimed at reporting our first experience with robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with single-site VesPa platform (Intuitive Surgical Inc.). A 68-year-old-man presenting with a cT1c adenocarcinoma Gleason Score 3 + 4 = 7 in 4/12 bilateral cores underwent a transperitoneal robotic LESS-RP with a single-site Vespa platform. Initial PSA, prostate weight, and body mass index (BMI) were 4.4 ng/ml, 45 g, and 25, respectively. Instruments and camera cross within the Single-Site port; the da Vinci System software detects and reassigns the user's hands with the instruments position. The single-site port is inserted through a 2-cm intraumbilical incision. The robotic 8.5 mm scope and two surgical curved instruments (fenestrated bipolar forceps and cautery hook) are introduced through the ports and used for most of the procedure, whereas a wristed needle driver on the right hand is used for the reconstructive steps. An additional 12 mm port (Air Seal, SurgiQuest) is placed in a midline between the umbilicus and the right iliac spine in order to facilitate table assistance during surgery and to place a drain at the end of the procedure.

Operative time and blood loss were 300 min and 400 mL, respectively. The postoperative course was uneventful. The drain and the catheter were removed on days 1 and 6, respectively. The patient experienced a temporary mild stress incontinence (one pad at sixth month) and erectile dysfunction.

Our first robotic laparoendoscopic single-site radical prostatectomy (R-LESS-RP) with the single-site VesPa platform was associated with acceptable operative times and perioperative outcome. This procedure is feasible without complications, provided that a proper patient selection has occurred. Limited movements together with the lack of the fourth robotic arm require a considerable expertise in robotic surgery. Some tricks can help overcome technical limitations. The Robotic LESS-RP reduces in some measure the limitations of conventional LESS RP, although further refinement of the robotic instruments is necessary.

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Authors and Affiliations

  1. Department of Urology, Santa Chiara Hospital, Trento, Italy

    L. G. Luciani, V. Vattovani, S. Chiodini, M. Puglisi & G. Malossini

  2. Department of Urology, University Hospital, P.le Stefani 1, 37126, Verona, Italy

    D. Mattevi

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  1. D. Mattevi
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  2. L. G. Luciani
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  3. V. Vattovani
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  4. S. Chiodini
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  5. M. Puglisi
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  6. G. Malossini
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Corresponding author

Correspondence to D. Mattevi.

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Conflict of interest

Mattevi D, Luciani LG, Vattovani V, Chiodini S, Puglisi M, Malossini G, declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Mattevi, D., Luciani, L.G., Vattovani, V. et al. First case of robotic laparoendoscopic single-site radical prostatectomy with single-site VesPa platform. J Robotic Surg 12, 381–385 (2018). https://doi.org/10.1007/s11701-017-0724-y

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  • DOI: https://doi.org/10.1007/s11701-017-0724-y

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