Retzius-sparing Robot-assisted Radical Prostatectomy using Revo-i robotic surgical system: Surgical Technique and Results of the First Human Trial

Recently, Revo-i® robotic surgical system has been proved to be safe in the preclinical animal studies. Our aim was to evaluate the safety and proficiency of Revo-i® robotic platform in the treatment of prostate cancer (PCa).

A prospective study was carried out on 17 male patients with clinically localized PCa from August 17, 2016, to Feb 23, 2017 at our urology department using Revo-i® . Patients underwent Retzius-sparing robot-assisted radical prostatectomy (RP-RARP). Primary outcome was to describe the RS-RARP step by step surgical technique using Revo-i® . The safety of Revo-i® was assessed by measuring the the intraoperative and the postoperative complications within 30 days following surgery. Early oncological outcomes were assessed by surgical margin status and biochemical recurrence (BCR). Continence was defined as 0-1 pad usage. Surgeons' satisfaction with Revo-i® was assessed using the Likert scale.

All surgeries were completed successfully, with no conversion to open or laparoscopic surgery. Median patient's age was 72 years old. Median docking time (min), console time (min), urethrovesical anastomosis time (min) and EBL (ml) were 8, 92, 26, and 200 respectively. One patient was transfused intraoperatively due to blood loss of 1500ml. Postoperatively, two patients (11.8%) received blood transfusion, and there were no other serious/major complications. The median hospital stay was 4 days. At 3 months, four patients (23.5%) had positive surgical margin, one patient (5.9%) had BCR, and 15 patients (88.2%) were continent. Most of surgeons were satisfied with Revo-i® performance.

The first human study for the treatment of patients with localized PCa using Revo-i® robotic surgical system was carried out successfully. The perioperative, early oncological and continence outcomes are encouraging. Further prospective studies are warranted to support our preliminary results. This article is protected by copyright. All rights reserved.

BJU international. 2018 Apr 12 [Epub ahead of print]

Ki Don Chang, Ali Abdel Raheem, Young Deuk Choi, Byung Ha Chung, Koon Ho Rha

Department of Urologic Science Institute, Yonsei University College of Medicine, Seoul, South Korea.

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