Standard Multiport vs Single-Port Robot-Assisted Simple Prostatectomy: A Single-Center Initial Experience

Background: Robot-assisted simple prostatectomy (RASP) has emerged as a safe surgical treatment for patients with benign prostatic hyperplasia with large glands (>80 mL). Several studies reported on perioperative outcomes of RASP by the standard multiport (MP) da Vinci (R) robotic system approach. Studies conducted on RASP utilizing the novel single-port (SP) da Vinci SP robotic platform (Intuitive Surgical, Sunnyvale, CA) are scarce. We aimed to compare intraoperative and short-term postoperative outcomes between the da Vinci MP and SP robots for patients undergoing RASP in a referral center. Methods: In this retrospective study, we reviewed all patients who underwent RASP using MP or SP robot from September 2016 to March 2021. Intraoperative data, overall 30-day complications, complications by Clavien-Dindo classification, and 90-day readmission and reoperation rates were assessed and compared between the two groups using appropriate statistical methods. Results: Seventy-five patients who underwent RASP were identified. Of these, 47 were in the MP group and 28 were in the SP. Compared with SP, mean operative time in MP group was 216.6 vs 232.4 minutes (p = 0.39), estimated blood loss was 195.7 vs 227.1 mL (p = 0.43), and length of stay was 2 vs 2.5 days (p = 0.45). There was a trend toward higher overall complication rate in SP group vs MP (42.86% vs 21.28%, p = 0.09). There were no significant differences in the readmission (17.02% vs 10.71%, p = 0.52) and reoperation (2.1% vs 7.14%, p = 0.34) rates between MP vs SP group. Conclusion: SP-RASP is safe and shows equivalent perioperative outcomes when compared with the MP robotic system. A marginal increase of complication rate was recorded in the SP group; however, this did not demonstrate statistical significance.