Prospective Comparison Between the AirSeal® System Valve-Less Trocar and a Standard Versaport™ Plus V2 Trocar in Robotic-Assisted Radical Prostatectomy

To prospectively compare the AirSeal® System valve-less Trocar with a standard Versaport™ Plus V2 Trocar as assistant insufflating port in transperitoneal and extraperitoneal robotic-assisted radical prostatectomy (t-RARP/e-RARP).Two consecutive cohorts of patients undergoing RARP using either a 12 mm AirSeal valve-less Trocar (n=19 [14 t-RARP/5 e-RARP]) or a 12 mm Versaport Plus V2 Trocar (n=17 [11 t-RARP/6 e-RARP]) were prospectively evaluated. Age, body mass index, tumor characteristics, and surgical approach were similar in both cohorts. Besides relevant clinical data, episodes of pressure loss (<8 mm Hg), the number of necessary trocar manipulations, the frequency of camera cleaning, and overall carbon dioxide (CO2) consumption were recorded and compared.Mean surgical time was 175 minutes in the AirSeal and 166 minutes in the Versaport group (p=0.55). Whereas in the AirSeal group, only one episode of pressure loss <8 mm Hg was observed; this occurred in mean 38 times in the Versaport group (p<0.0001). No trocar manipulations for specimen or needle retrieval were necessary in the AirSeal group in contrast to in mean 15 in the Versaport group (p<0.0001). Otherwise, no appreciable differences regarding overall operating time, blood loss, camera cleaning, or overall CO2 consumption were observed for the present study. Patient CO2 absorption was not evaluated.In the present study, the AirSeal Trocar offered a more stable pneumocavity and facilitated specimen retrieval and needle extraction.