To report the results of the first quantitative synthesis of literature data from studies comparing Single-Port Robot-Assisted Radical Prostatectomy performed using the novel SP surgical platform (SP-RARP) versus RARP performed by using multi-arms robotic systems.
Studies comparing the use of da Vinci SP versus that of other available multi-arms da Vinci platforms were eligible for inclusion in the present review. From selected studies, data were extracted by using a standardized data extraction form. Patients baseline demographics and disease characteristics and perioperative variables of interest for the present review (operative time, blood losses, complications, length of stay and positive surgical margins rate) were noted whenever available. Weighted mean difference (WMD) was used as a summary measure for continuous outcomes, whereas the odds ratio with 95% confidence interval (CI) was calculated for binary variables. Pooled estimates were calculated by using the random-effect model to account for clinical heterogeneity. Statistical analysis was performed using Review manager 5.3 (Cochrane Collaboration, Oxford, UK).
Four comparative studies were retrieved, analysing a total of 610 patients. Baseline characteristics of treatment groups were statistically similar. No significant differences were found when comparing SP-RARP versus multi-arms robotic systems in terms of operative time, blood losses, complications rate and positive surgical margins. Conversely, SP-RARP was found to allow for a shorter hospital stay (WMD = -0.79 days, 95% CI = -1.07; -0.52, P-value < .001).
The adoption of the SP platform for duplicating the technique of minimally-invasive RARP appears to be safe and feasible.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Urology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Robotic urologic surgical interventions performed with the single port dedicated platform: first clinical investigation.Eur Urol. 2019; 75: 684-691
- Technique for docking and port placement using a purpose-built robotic system (SP1098) in human cadaver.Urology. 2018; 119: 91-96https://doi.org/10.1016/j.urology.2018.05.036
- Robot-assisted surgery for benign distal ureteral strictures: step-by-step technique using the SP® surgical system.BJU Int. 2019; 123: 733-739https://doi.org/10.1111/bju.14635
- Step-by-step technique for single-port robot-assisted radical cystectomy and pelvic lymph nodes dissection using the da Vinci® SP™ surgical system.BJU Int. 2019; https://doi.org/10.1111/bju.14744
- Single-port robotic intracorporeal ileal conduit urinary diversion during radical cystectomy using the sp surgical system: step-by-step technique.Urology. 2019; 130: 196-200https://doi.org/10.1016/j.urology.2019.03.023
- Pure single-site robot-assisted partial nephrectomy using the sp surgical system: initial clinical experience.Urology. 2019; 124: 282-285https://doi.org/10.1016/j.urology.2018.11.024
- Novel system for robotic single-port surgery: feasibility and state of the art in urology.Eur Urol Focus. 2018; 4: 669-673https://doi.org/10.1016/j.euf.2018.06.004
- Single-port robot-assisted radical prostatectomy: first clinical experience using the SP surgical system.Urology. 2019; 124: 309
- Minimizing minimally invasive surgery: current status of the single-port robotic surgery in urology.Actas Urol Esp. 2021; https://doi.org/10.1016/j.acuro.2020.05.007
- Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0. the Cochrane Collaboration.2013
- ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions.BMJ. 2016; 355: i4919
Wells GA, Shea B, O'Connell D, et al.The Newcastle Ottawa 1 Scale (NOS) for Assessing the Quality of Nonrandomized Studies in Meta-Analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed June 1, 2021
- GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926
- Estimating the mean and variance from the median, range, and the size of a sample.BMC Med Res Methodol. 2005; 5: 13
- Perioperative Outcomes between single-port and multi-port robotic assisted radical prostatectomy: a single institutional experience.J Urol. 2020; https://doi.org/10.1097/JU.0000000000000811
- A comparison of perioperative outcomes between single-port and multiport robot-assisted laparoscopic prostatectomy.Eur Urol. 2020; https://doi.org/10.1016/j.eururo.2020.03.031
- Pure single-site robot-assisted radical prostatectomy using single-port versus multiport robotic radical prostatectomy: a single-institution comparative study.Eur Urol Focus. 2020; https://doi.org/10.1016/j.euf.2020.10.006
- Comparing the approach to radical prostatectomy using the multiport da vinci xi and da vinci sp robots: a propensity score analysis of perioperative outcomes.Eur Urol. 2020; https://doi.org/10.1016/j.eururo.2020.11.042
- Extraperitoneal versus transperitoneal single-port robotic radical prostatectomy: a comparative analysis of perioperative outcomes.J Urol. 2020; 203 (Accessed December 17, 2019): 1135-1140https://doi.org/10.1097/JU.0000000000000700
- Single-institution cost comparison: single-port versus multiport robotic prostatectomy. Single-institution cost comparison: single-port versus multiport robotic prostatectomy.Eur Urol Focus. 2020; https://doi.org/10.1016/j.euf.2020.06.010
- Same-day discharge surgery for robot-assisted radical prostatectomy in the era of ERAS and prehabilitation pathways: a contemporary, comparative, feasibility study.World J Urol. 2020; https://doi.org/10.1007/s00345-020-03119-w
- Outpatient robot-assisted radical prostatectomy: are patients ready for same-day discharge?.J Endourol. 2020; 34: 450-455https://doi.org/10.1089/end.2019.0796
- Perioperative mortality and morbidity of outpatient versus inpatient robot-assisted radical prostatectomy: A propensity matched analysis.Urol Oncol. 2020; 38: 3.e1-3.e6https://doi.org/10.1016/j.urolonc.2019.07.008
- Single-port versus multi-port: will "one for all" ever become a new standard for robot-assisted radical prostatectomy?.J Robot Surg. 2020; https://doi.org/10.1007/s11701-020-01124-0
- Different approaches to the prostate: the upcoming role of a purpose-built single-port robotic system.Arab J Urol. 2018; 16: 302-306https://doi.org/10.1016/j.aju.2018.04.003
- Single-port trans-perineal approach to cystoprostatectomy with intracorporeal ileal conduit urinary diversion and lymph-nodes dissection using a purpose-built robotic system: surgical steps in a preclinical model.Int Braz J Urol. 2019; 45: 854-855https://doi.org/10.1590/S1677-5538.IBJU.2018.0524
- The evolution and resurgence of perineal prostatectomy in the robotic surgical era.World J Urol. 2020; 38: 821-828https://doi.org/10.1007/s00345-019-03004-1
- Robot-assisted radical prostatectomy using single-port perineal approach: technique and single-surgeon matched-paired comparative outcomes.Eur Urol. 2021; 79: 384-392https://doi.org/10.1016/j.eururo.2020.12.013
- Robot-assisted transvesical partial prostatectomy using a purpose-built single-port robotic system.BJU Int. 2018; 122: 52-524
- Robotic single-port partial prostatectomy for anterior turmos: transvesical approach.Urology. 2018; 118: 242
Published online: June 18, 2021
Accepted: June 8, 2021
Received: March 16, 2021
© 2021 Elsevier Inc. All rights reserved.