Elsevier

European Urology

Volume 75, Issue 4, April 2019, Pages 684-691
European Urology

Case Series of the Month
Robotic Urologic Surgical Interventions Performed with the Single Port Dedicated Platform: First Clinical Investigation

https://doi.org/10.1016/j.eururo.2018.11.044Get rights and content

Abstract

We report the first clinical investigation for surgical procedures performed using the da Vinci SP robotic surgical platform (Intuitive Surgical, Sunnyvale, CA, USA) during the first 10 days (September 28–October 12, 2018) after the system was installed at our institution. The aim of the study was to determine the feasibility and safety of major urologic procedures, measured as the rate of conversions and the incidence of perioperative complications. Secondary aims of the study consisted of key perioperative surgical outcomes, including operative time, blood loss, and length of stay. Pathology data were reported. Data collection was performed under institutional review board approval (IRB 13-780). A total of nine patients were treated (3 robot-assisted radical prostatectomies, 3 transperitoneal robot-assisted partial nephrectomies, 1 simple cystectomy with intracorporeal ileal conduit urinary diversion, 2 ureteral reimplantations). No intraoperative complications occurred. In six cases the surgeries were performed according to a pure single-site approach. The mean operative time was slightly longer than that reported for the corresponding multiarm robotic procedures in the literature, which can easily be explained by the expected learning curve. One minor and one major complication occurred. A learning curve exists when embarking with this surgery. Further investigations are awaited.

Section snippets

Case series

Prospective data collection for this series was conducted by investigators from the Cleveland Clinic (Cleveland, OH, USA). The surgical procedures were performed by a single surgeon (J.K.) using the da Vinci SP robotic surgical platform (Intuitive Surgical, Sunnyvale, CA, USA) during the first 10 days (September 28–October 12, 2018) after the system was installed. Data for perioperative outcomes were collected under institutional review board approval (IRB 13-780). Subjects provided informed

Results

A total of nine patients were counseled for potential enrollment. All patients consented to undergo the surgery performed with the da Vinci SP surgical system. The demographic and clinical characteristics of the patients are reported in Table 1. Procedures performed included three robot-assisted radical prostatectomies (2 performed via a transperitoneal and 1 via a transperineal approach; Fig. 2), three transperitoneal robot-assisted partial nephrectomies (Fig. 3), one simple cystectomy with an

Discussion

The recent advances in surgical robotics combined with the pursuit to reduce the invasiveness of laparoscopic surgery have led to the development of novel robotic platforms specifically designed for single-port surgery [3]. Among the latest developments in the field, the da Vinci SP1098 system (Intuitive Surgical) is a robotic platform purpose-built for single-site, single-port surgery [4]. Kaouk et al. [5] described the first clinical application of its earlier SP999 version and successfully

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