Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey.
J Urol. 2022 Aug;208(2):369-378. doi: 10.1097/JU.0000000000002692. Epub 2022 Apr 4.
Single-port (SP) robotic-assisted simple prostatectomy (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 3 separate institutions underwent transvesical RASP using the da Vinci® SP robotic surgical system. Surgeries were performed by 3 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 followup 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 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 Clavien grade 2 postoperative complications. At 9-month followup, the median (IQR) International Prostate Symptom Score and quality of life score were 4 (2, 5) and 0 (0, 1), respectively, with a mean (SD) maximum flow rate and post-void residual of 21 (17) ml/second and 40 (55) ml, respectively.
In a multi-institutional setting, the SP RASP promotes a pain-free procedure, same-day discharge, short Foley catheter duration, low complication rate and quick recovery.
经膀胱途径的单端口（SP）机器人辅助单纯前列腺切除术（RASP）是一种治疗大型前列腺腺体的新型手术选择。我们首次进行了多机构研究，以进一步评估 SP RASP 的围手术期和术后结果。
从 2019 年 2 月至 2021 年 11 月，3 家不同机构的 91 例连续患者通过达芬奇® SP 机器人手术系统进行经膀胱 RASP。手术由 3 名经验丰富的外科医生进行。通过耻骨上切口和经膀胱入路，将 SP 机器人直接对接入膀胱，并进行前列腺剜除术。进行了前瞻性数据收集，包括基线特征、围手术期和术后结果。平均随访时间为 4.6 个月。
平均（SD）前列腺体积为 156（62）ml。平均（SD）总手术时间为 159（45）分钟，中位（IQR）估计失血量为 100（50，200）cc。中位（IQR）术后住院时间为 21.0（6.5，26.0）小时；然而，所有患者中有 42%在同一天出院。中位（IQR） Foley 导管留置时间为 5（5，7）天。仅 3 名患者（3%）发生 Clavien 2 级术后并发症。在 9 个月随访时，中位（IQR）国际前列腺症状评分和生活质量评分分别为 4（2，5）和 0（0，1），平均（SD）最大尿流率和剩余尿量分别为 21（17）ml/秒和 40（55）ml。
在多机构环境中，SP RASP 可促进无痛手术、当天出院、Foley 导管留置时间短、并发症发生率低、恢复迅速。
