Glove port®機器人輔助腹膜外單孔攝護腺根治性切除術
方琬云、黃勝賢
彰化基督教醫院 秘尿科
Glove port® Robot-assisted Extraperitoneal Single-port Radical Prostatectomy
Wanyun Fang, Sheng-Hsien Huang
Department of Urology, Chunghwa Christian Hospital, Taiwan
Objective: To achieve better cosmetic outcome and shortening the course of recovery, we designed and performed robot-assisted extraperitoneal single-port radical prostatectomy with da Vinci Si system using Glove port® (NELIS, Korea) . single port access combined with multi-port surgical instruments.
Patients and Methods: Patients with prostate cancer and received robot-assisted extraperitoneal single-port radical prostatectomy with da Vinci Si system, which was performed by single doctor, were included. Total extraperitoneal approach was performed and the Glove port® (NELIS, Korea) was used as single site platform. An addition 8mm da Vinci Trocar was made over right lower quadrant of abdomen. Traditional da Vinci Multi-port surgical instruments were used. Primary outcome measure included continent rate, postoperative complication, and oncological outcome. Secondary outcome measures included operative time, blood loss, and final pathology outcomes.
Results: 18 consecutive patients were included. The mean age was 69.11 years old and mean preoperative prostate-specific antigen (PSA) was 14.26 ng/ml. Preoperatively, three (16.67%) patients belonged to low risk group, five (27.78%) belonged to intermediate risk group, four (22.22%) belonged to high risk group, and three (16.67%) belonged to very high risk group. The mean prostate volume was 33.66 ml. The mean operative time was 276 minutes, and mean blood loss was 398.89 ml. None of the patients needed conversion. In final pathology report, five (27.78%) patients had T2 disease, seven had T3a disease, and six had T3b disease. Urinary continence rate right after removing Foley’s catheter was 76.07% and continence rate at 3 months after operation was 89.5%.
Conclusion: Glove port robot-assisted extraperitoneal single-port radical prostatectomy using da Vinci Si system is a safe and feasible procedure. The strength of multi-port instruments is better than single site instruments.