Introduction: The purpose of this study is to determine potential patient reported advantages of the da Vinci Single-Port (SP) robotic system for urological procedures compared to the previous model, the da Vinci Multi-Port (MP) system. The SP model utilizes a single 25 mm incision rather than the multiple 5 to 22 mm incisions of its predecessor. This project aims to prospectively investigate the impact of the novel SP-system on patient reported cosmetic and psychometric surgical outcomes.
Methods: We conducted a prospective study of patients who underwent uro-oncologic surgery by three Urologists at the University of Illinois at Chicago from April 2021 to November 2021. Study participants completed a Patient Scar Assessment Questionnaire (PSAQ) 20 and 90 days post-procedure. The PSAQ is a reliable measure of surgical scars that includes 5 subscales: Appearance, Symptoms, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms.
Results: Table 1. Singleport vs Multiport Robotic-Assisted Procedures at Postoperative Day 20
Questionnaire Metric
Total (N=77)
MP (N=24)
SP (N=53)
p-value
Days since surgery (SD)
24 (6)
23 (7)
24 (6)
0.82
Pain Score 0 to 10 (SD)
2 (2)
2 (2)
2 (2)
0.65
% Taking Pain Medication
30%
50%
21%
0.009
Appearance (SD)
15 (4)
17 (4)
14 (3)
<0.001
Symptoms (SD)
8 (3)
10 (4)
8 (2)
0.012
Consciousness (SD)
10 (3)
11 (3)
9 (2)
<0.001
Satisfaction with Appearance (SD)
12 (4)
13 (3)
12 (4)
0.32
Satisfaction with Symptoms (SD)
8 (3)
9 (3)
8 (3)
0.47
Table 2. Singleport vs Multiport Robotic-Assisted Procedures at Postoperative Day 90
Questionnaire Metric
Total (N=37)
MP (N=13)
SP (N=24)
p-value
Days since surgery (SD)
94 (6)
94 (7)
94 (6)
0.76
Pain Score 0 to 10 (SD)
0 (1)
0 (1)
0 (1)
0.59
% Taking Pain Medication
0
0
0
Appearance (SD)
13 (3)
14 (3)
12 (2)
0.016
Symptoms (SD)
7 (1)
7 (1)
7 (1)
0.58
Consciousness (SD)
8 (2)
9 (1)
8 (2)
0.091
Satisfaction with Appearance (SD)
10 (3)
10 (2)
11 (4)
0.51
Satisfaction with Symptoms (SD)
6 (2)
6 (1)
7 (2)
0.29
Conclusions: This study demonstrates the superiority of the SP in patient reported cosmetic and pain outcomes on short and long-term follow up after uro-oncological surgical procedures. Symptomatic and cosmetic advantages are present at the 20-day follow up, with better scar appearance being significant also 90 days after surgery.
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