engleski

Extraperitoneal robotic radical prostatectomy with Senhance®, first 77 cases

Introduction & Objectives: Until recently, most of the robotic radical prostatectomies were performed using one available system. Senhance® Surgical System is a novel robotic system, currently used in several centers for Robotic Radical Prostatectomy (RRP). The objective of this study is to present a prospective analysis of our first 77 cases of extraperitoneal RRP (eRRP), analyzing short and long-term postoperative outcomes. Materials & Methods: From November 2019 to November 2020 we performed 77 eRRP using the Senhance® system. Relevant clinical data were collected and analyzed. Complications were reported using Clavien-Dindo classification. Postoperative follow-up of 2-14 months was available for 57 patients. The study has been approved by the institutional ethics committee. Results: Descriptive data are reported in the table. There was no significant difference in operative time when comparing the first 30 cases with the rest of the series. However, there were 150 ml less blood loss in the later series. Grade IV complication was reported in 1, grade II in 3 patients and grade I in 3 patients. The in- hospital stay was on average 5 days and the catheter was removed on average 12 days after surgery. Surgical margins were positive in 23 cases. Two patients underwent salvage radiotherapy because of biochemical relapse. Other patients had postoperative PSA<0.05 ng/ml. In the follow-up, 59 patients are continent, while 8 patients currently have a light form of stress incontinence. Conclusions: The Senhance® system offers several important advantages such as better visualization, 3D vision, eye-tracking technology, reusable instruments and haptic feedback. Considerable surgical proficiency is gained after 30 procedures among surgeons with previous laparoscopic experience and in the need for conversion to LRP, this can be done simply, quickly, and safely, by removing the robotic and placing laparoscopic instruments using the same trocars. Senhance® robotic system is a safe and feasible approach for the minimally invasive treatment of prostate cancer, with good long-term outcomes.

extraperitoneal robotic radical prostatectomy ; Senhance®

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