V08-07: Robotic Transvesical Partial Prostatectomy Using a Purpose-Built Single Port Robotic System
Partial prostatectomy has been proposed as an alternative treatment for energy-based ablation of localized prostate cancer. The objective of our study was to evaluate the feasibility of a single port transvesical robotic approach for partial prostatectomy (SP-TVPP) using a novel purpose-built single port surgical platform in a pre-clinical model.
The cadavers were placed in a lithotomy position. A 3-cm midline incision was made in the suprapubic area 4-cm from the symphisis pubis. After opening the Retzius space, a single-port mini device (GelPOINT, Rancho Margarita, California, USA) was introduced percutaneously directly into the bladder. The da Vinci SP1098 robotic platform (Intuitive Surgical, Sunnyvale, CA, USA) was docked to the GelPOINT by inserting a novel single port cannula through the GelSeal Cap. The surgical steps for en bloc anterior prostatectomy were performed in the following order: 1) Retrograde dissection of transition zone at the bladder neck; 2) lateral excision of the peripheral zone; 3) urethrovesical anastomosis. Primary outcomes such as intraoperative complications, rate of conversion to standard techniques and operative times were recorded.
SP-TVPP was technically completed in three male cadavers. All cases were completed successfully using the da Vinci SP1098 surgical system without conversion or the need for additional ports. There were no intraoperative complications. The mean total operative time was 49.3 min. Step-specific times are listed in Table 1.
Transvesical robotic partial prostatectomy is feasible using a novel purpose-built single port surgical platform in a cadaver model. Future clinical evaluation in humans is needed for assessement on patients with anterior localized prostate cancer. Prospective comparison with other surgical platforms and standard techniques are warranted.
Funding: Intuitive Surgical