Department of Urology, Ewha Womans University Seoul Hospital, Seoul, Korea.
Department of Urology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Investig Clin Urol. 2020 Mar;61(2):173-179. doi: 10.4111/icu.2020.61.2.173. Epub 2020 Jan 30.
To report an initial single-surgeon experience with single-port robot-assisted radical prostatectomy (SP-RARP) using the da Vinci SP surgical system (Intuitive Surgical, USA).
Between December 2018 and October 2019, a single surgeon performed SP-RARP in 20 patients with prostate cancer. SP-RARP was performed using the conventional approach through an umbilical port with a GelPOINT access system (Applied Medical, USA) and an additional assist port. During surgery, the camera was placed in the 6- or 12-o'clock position, and a traction arm was placed in the counterpart position for upward or downward traction. Clinicopathologic data, perioperative data, and short-term surgical outcomes were analyzed.
Of 20 patients, 45% of patients had pT3 or greater disease and 45% had Gleason grade 4 to 5, respectively. In 11 patients that underwent lymph node dissection, the median number of lymph nodes removed was 19 (interquartile range [IQR], 14-22). Median operative time was 245 minutes (IQR, 200-255), and median console time was 190 minutes (IQR, 165-210). Median blood loss was 200 mL (IQR, 150-300 mL), and there were no intraoperative complications or open conversion. In 10 patients with a follow-up period longer than 3 months, one patient experienced biochemical recurrence, and all patients required 0 to 1 pads per day. Of seven patients that were potent before surgery, four recovered erectile function sufficient for intercourse.
Our report shows the safety and feasibility of SP-RARP, and that the associated surgical outcomes with short-term follow-up are satisfactory.
报告达芬奇 SP 手术系统（美国直觉外科公司）单孔机器人辅助根治性前列腺切除术（SP-RARP）的初步单中心经验。
2018 年 12 月至 2019 年 10 月，一名外科医生对 20 例前列腺癌患者进行了 SP-RARP。SP-RARP 通过常规方法经脐部端口使用 GelPOINT 入路系统（美国应用医疗公司）和附加辅助端口进行。手术过程中，摄像头置于 6 点或 12 点位置，牵引臂置于对应位置以向上或向下牵引。分析了临床病理数据、围手术期数据和短期手术结果。
20 例患者中，45%的患者有 pT3 或更高的疾病，45%的患者有 Gleason 评分 4-5。在 11 例行淋巴结清扫的患者中，中位数切除的淋巴结数为 19 个（四分位距 [IQR]，14-22 个）。中位手术时间为 245 分钟（IQR，200-255 分钟），中位控制台时间为 190 分钟（IQR，165-210 分钟）。中位出血量为 200 毫升（IQR，150-300 毫升），无术中并发症或中转开放。10 例随访时间超过 3 个月的患者中，1 例发生生化复发，所有患者每天需使用 0-1 片尿垫。7 例术前有勃起功能的患者中，4 例恢复了足以进行性交的勃起功能。
本报告显示 SP-RARP 的安全性和可行性，且短期随访的相关手术结果令人满意。
