Li Ching-Chia, Chien Tsu-Ming, Lee Ming-Ru, Lee Hsiang-Ying, Ke Hung-Lung, Wen Sheng-Chen, Chou Yii-Her, Wu Wen-Jeng
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
J Clin Med. 2021 Apr 8;10(8):1563. doi: 10.3390/jcm10081563.
Currently, over 80% of radical prostatectomies have been performed with the da Vinci Surgical System. In order to improve the aesthetic outlook and decrease the morbidity of the operation, the new da Vinci Single Port (SP) system was developed in 2018. However, one major problem is the SP system is still not available in most countries. We aim to present our initial experience and show the safety and feasibility of the single-site robotic-assisted radical prostatectomy (LESS-RP) using the da Vinci Single-Site platform. From June 2017 to January 2020, 120 patients with localized prostate cancer (stage T1-T3b) at Kaohsiung Medical University Hospital were included in this study. We describe our technique and report our initial results of LESS-RP using the da Vinci Si robotic system. Preoperative, intraoperative and postoperative patient variables were recorded. Prostate-specific antigen (PSA)-free survival was also analyzed. A total of 120 patients were enrolled in the study. The median age of patients was 68 years (IQR 63-71), with a median body mass index of 25 kg/m (IQR 23-27). The median PSA value before operation was 10.7 ng/mL (IQR 7.9-21.1). The median setup time for creat-ing the extraperitoneal space and ports document was 25 min (IQR 18-34). The median robotic console time and operation time were 135 min (IQR 110-161) and 225 min (IQR 197-274), respectively. Median blood loss was 365 mL (IQR 200-600). There were 11 (9.2%) patients who experienced complications (Clavien-Dindo classification Gr II). The me-dian catheter duration was 8 days (IQR 7-9), with a median of 10 days (IQR 7-11) of hospital stay. The PSA free-survival rate was 86% at a median 19 months (IQR 6-28) of follow up. Robotic radical prostatectomy using the da Vinci Single-Site platform system is safe and feasible, with acceptable outcomes.
目前，超过80%的根治性前列腺切除术是使用达芬奇手术系统进行的。为了改善美观效果并降低手术发病率，新型达芬奇单孔（SP）系统于2018年研发出来。然而，一个主要问题是大多数国家仍无法使用SP系统。我们旨在介绍我们的初步经验，并展示使用达芬奇单孔平台进行单部位机器人辅助根治性前列腺切除术（LESS-RP）的安全性和可行性。2017年6月至2020年1月，高雄医学大学附属医院的120例局限性前列腺癌（T1-T3b期）患者纳入本研究。我们描述了我们的技术，并报告了使用达芬奇Si机器人系统进行LESS-RP的初步结果。记录术前、术中和术后患者变量。还分析了无前列腺特异性抗原（PSA）生存期。共有120例患者纳入本研究。患者的中位年龄为68岁（四分位间距63-71），中位体重指数为25kg/m²（四分位间距23-27）。术前PSA中位值为10.7ng/mL（四分位间距7.9-21.1）。创建腹膜外空间和端口记录的中位设置时间为25分钟（四分位间距18-34）。中位机器人控制台时间和手术时间分别为135分钟（四分位间距110-161）和225分钟（四分位间距197-274）。中位失血量为365mL（四分位间距200-600）。有11例（9.2%）患者发生并发症（Clavien-Dindo分级II级）。中位导尿管留置时间为8天（四分位间距7-9），中位住院时间为10天（四分位间距7-11）。中位随访19个月（四分位间距6-28）时，无PSA生存率为86%。使用达芬奇单孔平台系统进行机器人根治性前列腺切除术是安全可行的，结果可接受。
