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Franco A, Ditonno F, Manfredi C, Licari LC, Bologna E, Cherullo EE, Chow AK, Vourganti S, Autorino R. Robot-assisted single-port transvesical enucleation of the prostate: step-by-step technique and early single-centre experience. BJU Int 2024; 133:778-782. [PMID: 38483153 DOI: 10.1111/bju.16324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Antonio Franco
- Department of Urology, Rush University, Chicago, IL, USA
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Lombardo R, Romagnoli M, De Nunzio C, Albisinni S. Editorial: new horizons in robotic platforms. Prostate Cancer Prostatic Dis 2024; 27:7-8. [PMID: 37932521 DOI: 10.1038/s41391-023-00753-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
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Balestrazzi E, Paciotti M, Piro A, Piramide F, Bravi CA, Peraire Lores M, Mottaran A, Sorce G, Ticonosco M, Frego N, Rebuffo S, Colla'-Ruvolo C, Belmonte M, De Groote R, De Naeyer G, Mottrie A. Comparative analysis of robot-assisted simple prostatectomy: the HUGO™ RAS system versus the DaVinci® Xi system. Prostate Cancer Prostatic Dis 2024; 27:122-128. [PMID: 37770613 DOI: 10.1038/s41391-023-00726-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Robot-Assisted Simple Prostatectomy (RASP) has emerged as a promising alternative in the treatment of benign prostatic obstruction (BPO). However, there is currently a lack of comparative studies evaluating different robotic platforms for performing RASP. Therefore, we aimed to compare perioperative and functional outcomes of RASP performed using the HUGO™ RAS System versus the DaVinci® Xi System. METHODS Forty consecutive cases of RASP performed between May 2021 and March 2023 with the HUGO™ RAS and the DaVinci® Xi at OLV Hospital (Aalst, Belgium) were included in this retrospective study. All surgeries were performed by three experienced surgeons using the same approach. Baseline characteristics, peri-operative and functional outcomes were collected and compared between the two groups. RESULTS The population was equally divided between the two groups with 20 patients in each group. There were no significant differences in preoperative patient characteristics between the two groups, except for the presence of bladder stones prior to the surgery (p = 0.03). No significant differences in total operative time and console time between the two groups were reported (p = 0.3). No cases required conversion to open surgery or additional port placement. During one case performed with the HUGO™ RAS, a malfunctioning monopolar curved shear had to be replaced. However, there was no statistically significant differences in terms of technical robotic problems between the groups (p = 0.3). There was no significant difference between the two groups in perioperative and functional outcomes (all p ≥ 0.2). CONCLUSIONS We did not observe any statistically significant difference in perioperative and functional outcomes in case of RASP performed with the HUGO™ RAS System and with the DaVinci® Xi System. These findings provide compelling support for considering the HUGO™ RAS as a promising tool for robot-assisted procedures, thereby expanding the utilization of robotics for benign conditions.
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Affiliation(s)
- E Balestrazzi
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.
- ORSI Academy, Gent, Belgium.
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - M Paciotti
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Urology, Humanitas Research Hospital- IRCCS, Rozzano, Italy
| | - A Piro
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Urology, Azienda Ospedaliero-Universitaria, University of Modena & Reggio Emilia, Modena, Italy
| | - F Piramide
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - C A Bravi
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
| | - M Peraire Lores
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
| | - A Mottaran
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Sorce
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - M Ticonosco
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Urology, Azienda Ospedaliero-Universitaria, University of Modena & Reggio Emilia, Modena, Italy
| | - N Frego
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Urology, Humanitas Research Hospital- IRCCS, Rozzano, Italy
| | - S Rebuffo
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, Italy
| | - C Colla'-Ruvolo
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - M Belmonte
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, Florence, Italy
| | - R De Groote
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - G De Naeyer
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - A Mottrie
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
- ORSI Academy, Gent, Belgium
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Ditonno F, Franco A, Manfredi C, Veccia A, De Nunzio C, De Sio M, Vourganti S, Chow AK, Cherullo EE, Antonelli A, Autorino R. Single-port robot-assisted simple prostatectomy: techniques and outcomes. World J Urol 2024; 42:98. [PMID: 38393399 DOI: 10.1007/s00345-024-04778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/09/2024] [Indexed: 02/25/2024] Open
Abstract
PURPOSE To describe the surgical techniques and to analyse the outcomes of single-port robot-assisted simple prostatectomy (SP RASP) procedure for the surgical treatment of benign prostatic hyperplasia (BPH). METHODS Three databases (PubMed®, Web of Science™, and Scopus®) were queried to identify studies reporting on the technical aspects and outcomes of SP RASP. Different combinations of keywords were used, according to a free-text protocol, to identify retrospective and prospective studies, both comparative and non-comparative, systematic reviews (SR) and meta-analysis (MA) describing surgical techniques for SP RASP and the associated surgical and functional outcomes. RESULTS The transvesical approach represents the most common approach for SP RASP. A decrease in terms of estimated blood loss was observed when SP RASP was compared to open simple prostatectomy (OSP) and multi-port (MP) RASP. Furthermore, this technique allowed for a shorter length of hospital stay (LoS) and a lower post-operative complication rate, compared to OSP. Post-operative subjective and objective functional outcomes are satisfying and comparable to OSP and MP RASP. CONCLUSION SP RASP represents a safe and feasible approach for the surgical management of BPH. It provides comparable surgical and functional outcomes to MP RASP, enabling for minimal invasiveness, enhanced recovery, and potential for improving patient care.
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Affiliation(s)
- Francesco Ditonno
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
- Department of Urology, University of Verona, Verona, Italy
| | - Antonio Franco
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, Rome, Italy
| | - Celeste Manfredi
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli" University, Naples, Italy
| | | | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, Rome, Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli" University, Naples, Italy
| | - Srinivas Vourganti
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Alexander K Chow
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | - Edward E Cherullo
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA
| | | | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.
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Franco A, Ditonno F, Manfredi C, Pellegrino AA, Licari LC, Bologna E, Feng C, Antonelli A, De Sio M, De Nunzio C, Porpiglia F, Cherullo EE, Kaouk J, Crivellaro S, Autorino R. Single port robot-assisted radical and simple prostatectomy: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00787-2. [PMID: 38263281 DOI: 10.1038/s41391-024-00787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/28/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Aim of our study was to review the current evidence on single port robot-assisted radical prostatectomy (SP-RARP) and SP robot-assisted simple prostatectomy (SP-RASP) procedures. METHODS A comprehensive bibliographic search on multiple databases was conducted in July 2023. Studies were included if they assessed patients with non-metastatic prostate cancer or candidate for benign prostatic hyperplasia surgery (P) who underwent SP-RARP or SP-RASP, respectively, (I), compared or not with other surgical techniques (C), evaluating perioperative, oncological, or functional outcomes (O). Prospective and retrospective original articles were included (S). A meta-analysis of comparative studies between SP-RARP and MP-RARP was performed. RESULTS A total of 21 studies investigating 1400 patients were included in our systematic review, 18 were related to SP-RARP while 3 to SP-RASP. Only 8 comparative studies were eligible for meta-analysis. Mean follow-up was 8.1 (±5.8) months. Similar outcomes were observed for SP-RARP and MP-RARP in terms of operative time, catheterization time, pain score, complications rate, continence and potency rates, positive surgical margin, and biochemical recurrence. Length of hospital stay was shorter in the SP group after sensitivity analysis (WMD -0.58, 95% IC -1.17 to -0.9, p < 0.05). Subgroup analysis by extraperitoneal approach did not show any statistical difference, except for a lower positive margins rate in the SP extraperitoneal technique compared to MP-RARP. Overall, SP-RASP exhibited shorter hospital stay and lower rate of de novo urinary incontinence when compared to other techniques, while no differences were reported in terms of postoperative International Prostate Symptom Score, post void residual and maximum flow. CONCLUSIONS Overall comparable oncological, functional, and perioperative outcomes can be achieved with SP platform. Subgroup analysis by different approaches did not reveal significant variations in outcomes. However, the retrospective nature of the studies, the limited follow-up, and the relatively small sample size of selected Centers may impact these results.
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Affiliation(s)
- Antonio Franco
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Francesco Ditonno
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Urology, University of Verona, Verona, Italy
| | - Celeste Manfredi
- Department of Urology, Rush University, Chicago, IL, USA
- Urology Unit, "Luigi Vanvitelli" University, Naples, Italy
| | | | - Leslie Claire Licari
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Eugenio Bologna
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Carol Feng
- Department of Urology, Rush University, Chicago, IL, USA
| | | | - Marco De Sio
- Urology Unit, "Luigi Vanvitelli" University, Naples, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Francesco Porpiglia
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | | | - Jihad Kaouk
- Department of Urology, Glickman Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Simone Crivellaro
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
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Santarelli V, Lombardo R, De Nunzio C. The influence of preoperative urodynamic parameters on clinical results in patients with benign prostatic hyperplasia after transurethral resection of the prostate. World J Urol 2024; 42:16. [PMID: 38197997 DOI: 10.1007/s00345-023-04763-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Valerio Santarelli
- Department of Urology, Sapienza Università di Roma, Via di Grottarossa 1089, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, Sapienza Università di Roma, Via di Grottarossa 1089, Rome, Italy.
| | - Cosimo De Nunzio
- Department of Urology, Sapienza Università di Roma, Via di Grottarossa 1089, Rome, Italy
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Franco A, Ditonno F, Manfredi C, Johnson AD, Mamgain A, Feldman-Schultz O, Feng CL, Pellegrino AA, Mir MC, Porpiglia F, Crivellaro S, De Nunzio C, Chow AK, Autorino R. Robot-assisted Surgery in the Field of Urology: The Most Pioneering Approaches 2015-2023. Res Rep Urol 2023; 15:453-470. [PMID: 37842031 PMCID: PMC10575039 DOI: 10.2147/rru.s386025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/30/2023] [Indexed: 10/17/2023] Open
Abstract
Robot-assisted surgery has emerged as a transformative technology, revolutionizing surgical approaches and techniques that decades ago could barely be imagined. The field of urology has taken charge in pioneering a new era of minimally invasive surgery with the ascent of robotic systems which offer enhanced visualization, precision, dexterity, and enabling surgeons to perform intricate maneuvers with improved accuracy. This has led to improved surgical outcomes, including reduced blood loss, lower complication rates, and faster patient recovery. The aim of our review is to present an evidence-based critical analysis on the most pioneering robotic urologic approaches described over the last eight years (2015-2023).
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Affiliation(s)
- Antonio Franco
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Francesco Ditonno
- Department of Urology, Rush University, Chicago, IL, USA
- Department of Urology, University of Verona, Verona, Italy
| | - Celeste Manfredi
- Department of Urology, Rush University, Chicago, IL, USA
- Urology Unit, “Luigi Vanvitelli” University, Naples, Italy
| | | | | | | | - Carol L Feng
- Department of Urology, Rush University, Chicago, IL, USA
| | - Antony A Pellegrino
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois, USA
- Unit of Urology/Division of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Carmen Mir
- Department of Urology, Hospital Universitario La Ribera, Valencia, Spain
| | - Francesco Porpiglia
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Simone Crivellaro
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Cosimo De Nunzio
- Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy
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Mjaess G, Orecchia L, Albisinni S. New robotic platforms for prostate surgery: the future is now. Prostate Cancer Prostatic Dis 2023; 26:519-520. [PMID: 37454240 DOI: 10.1038/s41391-023-00697-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Georges Mjaess
- Department of Urology, Hôpital Unviersitaire de Bruxelles, Brussels, Belgium.
| | - Luca Orecchia
- Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Simone Albisinni
- Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
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Franco A, Pellegrino AA, De Nunzio C, Salkowski M, Jackson JC, Zukowski LB, Checcucci E, Vourganti S, Chow AK, Porpiglia F, Kaouk J, Crivellaro S, Autorino R. Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand? Curr Oncol 2023; 30:4301-4310. [PMID: 37185441 PMCID: PMC10136812 DOI: 10.3390/curroncol30040328] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
In 2018, the da Vinci Single Port (SP) robotic system was approved by the US Food and Drug Administration for urologic procedures. Available studies for the application of SP to prostate cancer surgery are limited. The aim of our study is to summarize the current evidence on the techniques and outcomes of SP robot-assisted radical prostatectomy (SP-RARLP) procedures. A narrative review of the literature was performed in January 2023. Preliminary results suggest that SP-RALP is safe and feasible, and it can offer comparable outcomes to the standard multiport RALP. Extraperitoneal and transvesical SP-RALP appear to be the two most promising approaches, as they offer decreased invasiveness, potentially shorter length of stay, and better pain control. Long-term, high-quality data are missing and further validation with prospective studies across different sites is required.
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Affiliation(s)
- Antonio Franco
- Department of Urology, Rush University, Chicago, IL 60612, USA
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, 00189 Rome, Italy
| | - Antony A Pellegrino
- Department of Urology, University of Illinois at Chicago, Chicago, IL 60612, USA
- Unit of Urology/Division of Oncology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, 00189 Rome, Italy
| | | | - Jamal C Jackson
- Department of Urology, Rush University, Chicago, IL 60612, USA
| | | | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Turin, Italy
| | | | | | - Francesco Porpiglia
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, 10043 Turin, Italy
| | - Jihad Kaouk
- Department of Urology, Cleveland Clinic, Cleveland, OH 44106, USA
| | - Simone Crivellaro
- Department of Urology, University of Illinois at Chicago, Chicago, IL 60612, USA
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