The Multi-Institutional Experience in Single-Port Robotic Transvesical Simple Prostatectomy for Benign Prostatic Hyperplasia Management

No AccessJournal of UrologyAdult Urology1 Aug 2022The Multi-Institutional Experience in Single-Port Robotic Transvesical Simple Prostatectomy for Benign Prostatic Hyperplasia ManagementThis article is commented on by the following:Editorial CommentEditorial CommentEditorial Comment Mahmoud Abou Zeinab, Alp Tuna Beksac, Tanner Corse, Susan Talamini, Luca Morgantini, Aaron Kaviani, Ethan Ferguson, Mohamed Eltemamy, Simone Crivellaro, Mutahar Ahmed, Michael Stifelman, and Jihad Kaouk Mahmoud Abou ZeinabMahmoud Abou Zeinab https://orcid.org/0000-0001-8855-0004 Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio , Alp Tuna BeksacAlp Tuna Beksac Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio , Tanner CorseTanner Corse Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey , Susan TalaminiSusan Talamini Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois , Luca MorgantiniLuca Morgantini Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois , Aaron KavianiAaron Kaviani Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio , Ethan FergusonEthan Ferguson Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio , Mohamed EltemamyMohamed Eltemamy Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio , Simone CrivellaroSimone Crivellaro Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois , Mutahar AhmedMutahar Ahmed Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey , Michael StifelmanMichael Stifelman Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey , and Jihad KaoukJihad Kaouk *Correspondence: Cleveland Clinic Foundation, Glickman Urological & Kidney Institute, 9500 Euclid Ave., Q10, Cleveland, Ohio , 44195 telephone: 216-444-2976; FAX: 216-636-4492; E-mail Address: [email protected] Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio View All Author Informationhttps://doi.org/10.1097/JU.0000000000002692AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. References 1. : Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part II—surgical evaluation and treatment. J Urol 2021; 206: 818. Link, Google Scholar 2. European Association of Urology: Guidelines. Management of Non-Neurogenic Male LUTS. Arnhem, The Netherlands: EAU Guidelines Office2021. Google Scholar 3. : Robotic simple prostatectomy. J Urol 2008; 179: 513. Link, Google Scholar 4. : Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol 2009; 23: 129. Google Scholar 5. : Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol 2015; 68: 86. Google Scholar 6. : Laparoscopic prostatectomy with vascular control for benign prostatic hyperplasia. J Urol 2002; 167: 2528. Link, Google Scholar 7. : Robotic single port suprapubic transvesical enucleation of the prostate (R-STEP): initial experience. BJU Int 2012; 110: 732. Google Scholar 8. : Pure single-site robot-assisted radical prostatectomy using single-port versus multiport robotic radical prostatectomy: a single-institution comparative study. Eur Urol Focus 2021; 7: 964. Google Scholar 9. : Initial experience with single-port robotic-assisted kidney transplantation and autotransplantation. Eur Urol 2021; 80: 366. Google Scholar 10. : Single port transvesical robotic radical prostatectomy: initial clinical experience and description of technique. Urology 2021; 155: 130 Google Scholar 11. : Single-port percutaneous transvesical simple prostatectomy using the SP robotic system: initial clinical experience. Urology 2020; 141: 173. Google Scholar 12. : Floating docking technique: a simple modification to improve the working space of the instruments during single-port robotic surgery. World J Urol 2021; 39: 1299. Google Scholar 13. : American Urological Association Symptom Index for lower urinary tract symptoms in women: correlation with degree of bother and impact on quality of life. Urology 2003; 61: 1118. Google Scholar 14. : Pain assessment. Eur Spine J, suppl., 2006; 15: S17. Google Scholar 15. : The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250: 187. Google Scholar 16. : Holmium laser enucleation, laparoscopic simple prostatectomy, or open prostatectomy: the role of the prostate volume in terms of operation time. Urol Int 2021; 105: 285. Google Scholar 17. : Open prostatectomy for benign prostate hyperplasia: short-term outcome in 3000 consecutive patients. Prostate Cancer Prostatic Dis 2007; 10: 374. Google Scholar 18. : Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison. World J Urol 2021; 39: 149. Google Scholar 19. : Surgical treatment of large volume prostates: a matched pair analysis comparing the open, endoscopic (ThuVEP) and robotic approach. World J Urol 2019; 37: 1927. Google Scholar 20. : Robotic-assisted simple prostatectomy: a systematic review. J Clin Med 2020; 9: 1798. Google Scholar Funding: None. Conflict of Interest: Jihad Kaouk: Intuitive Surgical Company: Speaker Bureau. Simone Crivellaro: Intuitive Surgical Company: Consultant. Michael Stifelman: Intuitive Surgical Company: Consultant; VTI: Consultant; Ethicon: Lecturer. Mutahar Ahmed: Intuitive Surgical Company: Consultant; ConMed: Consultant. Ethics Statement: Study received Institutional Review Board approval (IRB No. 13-780). Author Contributions: All authors contributed equally to this study. © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesJournal of UrologyMay 16, 2022, 12:00:00 AMEditorial CommentJournal of UrologyMay 16, 2022, 12:00:00 AMEditorial CommentJournal of UrologyMay 16, 2022, 12:00:00 AMEditorial Comment Volume 208Issue 2August 2022Page: 369-378Supplementary Materials PEER REVIEW REPORT Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.Keywordslaparoscopyprostatic neoplasmsprostatectomyrobotic surgical proceduresurologic surgical proceduresMetricsAuthor Information Mahmoud Abou Zeinab Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Alp Tuna Beksac Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Tanner Corse Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey More articles by this author Susan Talamini Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois More articles by this author Luca Morgantini Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois More articles by this author Aaron Kaviani Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Ethan Ferguson Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Mohamed Eltemamy Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio More articles by this author Simone Crivellaro Department of Urology, College of Medicine, University of Illinois, Chicago, Illinois More articles by this author Mutahar Ahmed Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey More articles by this author Michael Stifelman Department of Urology, Hackensack Meridian School of Medicine, Nutley, New Jersey More articles by this author Jihad Kaouk Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, Ohio *Correspondence: Cleveland Clinic Foundation, Glickman Urological & Kidney Institute, 9500 Euclid Ave., Q10, Cleveland, Ohio , 44195 telephone: 216-444-2976; FAX: 216-636-4492; E-mail Address: [email protected] More articles by this author Expand All Funding: None. Conflict of Interest: Jihad Kaouk: Intuitive Surgical Company: Speaker Bureau. Simone Crivellaro: Intuitive Surgical Company: Consultant. Michael Stifelman: Intuitive Surgical Company: Consultant; VTI: Consultant; Ethicon: Lecturer. Mutahar Ahmed: Intuitive Surgical Company: Consultant; ConMed: Consultant. Ethics Statement: Study received Institutional Review Board approval (IRB No. 13-780). Author Contributions: All authors contributed equally to this study. Advertisement PDF DownloadLoading ...