Yang Jian-Wei, Wang Li, Zhang Yalong, Wan Shun, Li Kun-Peng, Wang Kang-Yu, Li Xiao-Ran, Chen Si-Yu, Yang Li
Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730030, People's Republic of China.
Gansu Province Clinical Research Center for Urology, Lanzhou, People's Republic of China.
J Robot Surg. 2025 Apr 12;19(1):152. doi: 10.1007/s11701-025-02325-1.
With the continuous advancement of robotic-assisted surgical platforms, evaluating the safety and feasibility of emerging systems is essential. This study aims to systematically assess the Senhance robotic system in performing radical prostatectomy for prostate cancer. This investigation employed a systematic review paired with a single-arm meta-analysis, conducted in line with PRISMA standards and with the study protocol pre-registered in the PROSPERO database (CRD42025636976). We queried major databases-including PubMed, Web of Science, Embase, and the Cochrane Library-for articles published until December 2024 that focused on the utilization of the Senhance robotic system in radical prostatectomy. Relevant data were extracted on key surgical parameters (e.g., duration of the procedure, intraoperative blood loss, length of hospital stay, and catheter removal time), as well as on postoperative pain levels and oncological outcomes (including positive surgical margin rates, biochemical recurrence, and urinary incontinence), in addition to overall complication rates. All analyses were performed using Stata 18 SE; heterogeneity among studies was quantified using the I statistic, and the stability of the results was assessed through a leave-one-out sensitivity analysis. Five studies encompassing a total of 567 patients were included. The pooled estimates demonstrated a mean operative time of 200.05 min (95% CI 188.44-211.67) and a mean intraoperative blood loss of 257.02 mL (95% CI 216.18-297.86). The mean hospital stay and catheter removal time were 6.20 days (95% CI 4.70-7.70) and 11.07 days (95% CI 9.26-12.89), respectively. Oncological and functional outcomes revealed a positive surgical margin rate of 30% (95% CI 26-33%), a urinary incontinence rate of 14% (95% CI 4-23%), and a biochemical recurrence rate of 5% (95% CI 1-8%). Postoperative pain, measured by VAS scores, improved from 3.11 on day 1 to 0.38 at discharge. Despite significant heterogeneity in several outcomes, sensitivity analyses confirmed the stability of these findings. Our findings indicate that the Senhance robotic platform is a promising tool for radical prostatectomy, delivering oncological and functional outcomes that align with established surgical methods while also offering potential cost benefits. These results support its feasibility as an alternative to traditional systems. However, to solidify its role in urological practice, further research-especially well-designed randomized controlled trials-is necessary to confirm these initial observations and optimize its clinical application.
随着机器人辅助手术平台的不断发展，评估新兴系统的安全性和可行性至关重要。本研究旨在系统评估森海斯（Senhance）机器人系统在前列腺癌根治性前列腺切除术中的应用。本调查采用系统评价并结合单臂荟萃分析，按照PRISMA标准进行，研究方案已预先注册于PROSPERO数据库（CRD42025636976）。我们查询了包括PubMed、科学网、Embase和考科蓝图书馆在内的主要数据库，以获取截至2024年12月发表的聚焦于森海斯机器人系统在根治性前列腺切除术中应用的文章。提取了关键手术参数（如手术时长、术中失血量、住院时间和导尿管拔除时间）、术后疼痛水平和肿瘤学结局（包括手术切缘阳性率、生化复发和尿失禁）以及总体并发症发生率的相关数据。所有分析均使用Stata 18 SE进行；研究间的异质性使用I统计量进行量化，并通过逐一剔除敏感性分析评估结果的稳定性。纳入了五项研究，共567例患者。汇总估计显示平均手术时间为200.05分钟（95%置信区间188.44 - 211.67），平均术中失血量为257.02毫升（95%置信区间216.18 - 297.86）。平均住院时间和导尿管拔除时间分别为6.20天（95%置信区间4.70 - 7.70）和11.07天（95%置信区间9.26 - 12.89）。肿瘤学和功能结局显示手术切缘阳性率为30%（95%置信区间26 - 33%），尿失禁率为14%（95%置信区间4 - 23%），生化复发率为5%（95%置信区间1 - 8%）。以视觉模拟评分法（VAS）测量的术后疼痛从术后第1天的3.11分改善至出院时的0.38分。尽管在多个结局方面存在显著异质性，但敏感性分析证实了这些发现的稳定性。我们的研究结果表明，森海斯机器人平台是根治性前列腺切除术的一种有前景的工具，其肿瘤学和功能结局与既定手术方法相当，同时还可能具有成本效益。这些结果支持其作为传统系统替代方案的可行性。然而，为巩固其在泌尿外科实践中的作用，需要进一步研究——尤其是精心设计的随机对照试验——来证实这些初步观察结果并优化其临床应用。
