Photo Credit: Gorodenkoff

The following is a summary of “Transition Toward Opioid-sparing Outpatient Radical Prostatectomy: A Single Institution Experience With Three Contemporary Robotic Approaches,” published in the OCTOBER 2023 issue of Urology by Soputro, et al.

For a study, researchers sought to compare perioperative and early postoperative outcomes among three contemporary approaches to robotic radical prostatectomy (RARP): Single-Port (SP) Transvesical (TV), SP Extraperitoneal (EP), and Multi-Port (MP) Transperitoneal (TP).

A retrospective analysis included 865 patients with localized prostate cancer who underwent SP-TV, SP-EP, and MP-TP RARP. The procedures were performed by a single experienced surgeon, and data were collected from a prospectively-maintained database. Demographics, perioperative, and early postoperative outcomes were compared among the three approaches.

All SP cases were completed without conversion or additional ports, and compared to MP-TP RARP, both SP-EP and SP-TV RARP demonstrated significantly reduced length of stay (median, SP-TV 5.07 vs SP-EP 5.1 vs MP-TP 26.6 hours, P < .05), with most patients discharged within 24 hours (SP-TV 92.3% vs SP-EP 84.6% vs MP-TP 30.4%, P < .05). Postoperative analgesia requirements were notably lower following SP-TV RARP, with 95% not requiring opioid analgesia after discharge, compared to 77.6% and 12.1% in the SP-EP and MP-TP RARP cohorts, respectively (P < .05). Additionally, SP-TV RARP showed a shorter Foley catheter duration of 4 days and an earlier return of urinary continence.

Utilizing the SP robotic platform in RARP led to enhanced postoperative recovery, evidenced by reduced length of admission and postoperative pain. The findings supported the growing adoption of opioid-sparing outpatient prostatectomy.

Source: goldjournal.net/article/S0090-4295(23)00589-7/fulltext