Polom Wojciech, Matuszewski Marcin
Department of Urology, Faculty of Medicine, Medical University od Gdansk, Gdansk, Poland.
Cent European J Urol. 2024;77(1):30-36. doi: 10.5173/ceju.2023.241. Epub 2024 Jan 8.
The study presents the initial outcomes of robot-assisted radical prostatectomies (RARPs) using the Versius robotic system in a urological centre with no prior robotic surgery experience.
A retrospective analysis of 58 RARPs was conducted, including patients' parameters as well as Versius system performance.
The study involved 58 patients (average age 66.9 years). Median preoperative prostate specific antigen (PSA) was 9.8 ng/ml, with 48% having ISUP grade group ≥ 3 on biopsy and 25.8% showing extraprostatic extension on MRI. Median blood loss was 437 ml, with complications (10.3% Clavien-Dindo grade II and 4 grade III cases). One conversion to open surgery occurred (0.58%). Final pathology revealed 46.5% extraprostatic disease, and 25.8% had positive margins. Post-surgery, 96.5% had undetectable PSA at 6 weeks. Continence rates were 89.7% at 6 weeks, increasing to 91.3% at 12 months. Median catheter duration was 7.9 days, and the hospital stay was 4.5 days. Console time averaged 150.9 minutes, with a median operative time of 213 minutes. The Versius system reported medium priority alarms in 24.1% of operations, including 1266 alarms related to robotic arm clashes and 43 instrument swaps. One bedside unit exchange occurred with no console or robotic system failures.
The Versius robotic system can be successfully introduced in a urological centre without prior robotic surgery experience. Our setup and operating room positioning are effective, safe, and reproducible. We encountered and resolved surgical and technical challenges. Further follow-up studies are needed to assess the system's performance.
本研究展示了在一个此前没有机器人手术经验的泌尿外科中心使用Versius机器人系统进行机器人辅助根治性前列腺切除术（RARP）的初步结果。
对58例RARP进行回顾性分析，包括患者参数以及Versius系统性能。
该研究纳入58例患者（平均年龄66.9岁）。术前前列腺特异性抗原（PSA）中位数为9.8 ng/ml，48%的患者活检时国际泌尿病理学会（ISUP）分级组≥3，25.8%的患者磁共振成像（MRI）显示前列腺外侵犯。术中失血中位数为437 ml，出现并发症（Clavien-Dindo二级10.3%，三级4例）。发生1例转为开放手术（0.58%）。最终病理显示46.5%有前列腺外疾病，25.8%切缘阳性。术后6周时，96.5%的患者PSA检测不到。6周时控尿率为89.7%，12个月时升至91.3%。导尿管留置时间中位数为7.9天，住院时间为4.5天。控制台操作时间平均为150.9分钟，手术时间中位数为213分钟。Versius系统在24.1%的手术中报告了中等优先级警报，包括1266次与机械臂碰撞相关的警报和43次器械更换。进行了1次床边单元更换，控制台或机器人系统未出现故障。
Versius机器人系统可在一个此前没有机器人手术经验的泌尿外科中心成功引入。我们的设置和手术室布局有效、安全且可重复。我们遇到并解决了手术和技术方面的挑战。需要进一步的随访研究来评估该系统的性能。
