TY - JOUR
T1 - Perioperative Outcomes of Robotic Radical Prostatectomy with Hugo™ RAS versus daVinci Surgical Platform: Propensity Score-Matched Comparative Analysis
AU - Gandi, Carlo
AU - Marino, Filippo
AU - Totaro, Angelo
AU - Scarciglia, Eros
AU - Bellavia, Fabrizio
AU - Bientinesi, Riccardo
AU - Gavi, Filippo
AU - Russo, Pierluigi
AU - Ragonese, Mauro
AU - Palermo, Giuseppe
AU - Racioppi, Marco
AU - Lentini, Nicolò
AU - Pastorino, Roberta
AU - Sacco, Emilio
PY - 2024
Y1 - 2024
N2 - Background/Objectives: There is an urgent need for comparative analyses of the intraoperative, oncological, and functional outcomes of different surgical robotic platforms. We aimed to compare the outcomes of RARP performed at a tertiary referral robotic centre with the novel HugoTM RAS system with those performed with a daVinci surgical system, which is considered the reference standard. Methods: We analysed the data of 400 patients undergoing RARP ± pelvic lymph node dissection between 2021 and 2023, using propensity score (PS) matching to correct for treatment selection bias. All procedures were performed by three surgeons with HugoTM RAS or daVinci. Results: The PS-matched cohort included 198 patients with 99 matched pairs, balanced for all covariates. Positive surgical margins (PSMs) were found in 22.2% and 25.3% (p = 0.616) of patients, respectively, in the HugoTM RAS and daVinci groups. No significant differences were found for other important perioperative outcomes, including median (1st–3rd q) operative time (170 (147.5–195.5) vs. 166 (154–202.5) min; p = 0.540), median (1st–3rd q) estimated blood loss (EBL) (100 (100–150) vs. 100 (100–150) ml; p = 0.834), Clavien–Dindo (CD) ≥ 2 complications (3% vs. 4%; p = 0.498), and social continence at 3 months (73.7% vs. 74.7%; p = 0.353). In multiple analyses, no associations were found between surgical outcomes (PSM, length of PSM, operative time, EBL, length of catheterization, length of hospital stay, social continence at three months after surgery, and CD ≥ 2 complications) and the robotic platform. Conclusions: Our findings demonstrate that HugoTM RAS enables surgeons to safely and effectively transfer the level of proficiency they reached during their previous experience with the daVinci systems.
AB - Background/Objectives: There is an urgent need for comparative analyses of the intraoperative, oncological, and functional outcomes of different surgical robotic platforms. We aimed to compare the outcomes of RARP performed at a tertiary referral robotic centre with the novel HugoTM RAS system with those performed with a daVinci surgical system, which is considered the reference standard. Methods: We analysed the data of 400 patients undergoing RARP ± pelvic lymph node dissection between 2021 and 2023, using propensity score (PS) matching to correct for treatment selection bias. All procedures were performed by three surgeons with HugoTM RAS or daVinci. Results: The PS-matched cohort included 198 patients with 99 matched pairs, balanced for all covariates. Positive surgical margins (PSMs) were found in 22.2% and 25.3% (p = 0.616) of patients, respectively, in the HugoTM RAS and daVinci groups. No significant differences were found for other important perioperative outcomes, including median (1st–3rd q) operative time (170 (147.5–195.5) vs. 166 (154–202.5) min; p = 0.540), median (1st–3rd q) estimated blood loss (EBL) (100 (100–150) vs. 100 (100–150) ml; p = 0.834), Clavien–Dindo (CD) ≥ 2 complications (3% vs. 4%; p = 0.498), and social continence at 3 months (73.7% vs. 74.7%; p = 0.353). In multiple analyses, no associations were found between surgical outcomes (PSM, length of PSM, operative time, EBL, length of catheterization, length of hospital stay, social continence at three months after surgery, and CD ≥ 2 complications) and the robotic platform. Conclusions: Our findings demonstrate that HugoTM RAS enables surgeons to safely and effectively transfer the level of proficiency they reached during their previous experience with the daVinci systems.
KW - HugoTM RAS system
KW - comparative outcomes
KW - robotic surgery
KW - prostate cancer
KW - robot-assisted radical prostatectomy
KW - daVinci surgical platform
KW - HugoTM RAS system
KW - comparative outcomes
KW - robotic surgery
KW - prostate cancer
KW - robot-assisted radical prostatectomy
KW - daVinci surgical platform
UR - http://hdl.handle.net/10807/302183
U2 - 10.3390/jcm13113157
DO - 10.3390/jcm13113157
M3 - Article
SN - 2077-0383
VL - 13
SP - N/A-N/A
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
ER -