National Taiwan University Hospital Yunlin branch, Urology Department
Introduction: The Senhance robotic surgical system (TransEnterix Inc, Morrisville, NC, USA) is a novel laparoscopy-based robotic system, equipped with eye tracking system, haptic feedback system, and reusasble instruments. Currently, only two studies reported their experiences on extra-peritoneal radical prostatectomy.
Objective: To assess the feasibility, learning curve and cost analysis of the transperitoneal Senhance robotic radical prostatectomy.
Methods: From Aug 2019 to July 2021, the Senhance robotic radical prostatectomies were performed in 44 biopsy confirmed prostate cancer patients.Perioperative data were collected. Complications were graded with Clavien-Dindo classification. Learning curve was analyzed with CUSUM (cumulative summation) method classified by surgeon’s laparoscopic experiences. Total cost for the each operation was also recorded.
Results: The median patient age was 67 [64-71.5] years with a mean body mass index of 25.35 [23.3-27.9] kg/m2. The median ASA score was 2 ± 0.35. Median operative time was 246 (107-340) minutes. The median blood loss was 162.5 [50-287.5]ml. Foleys were removed at a median of 7 (3-17) days after surgery. There were 10 cases(22.7%) with Clavien-Dindo grade I/II complications and no case with grade III or IV complications. Among 44 patients, 17( (38.6%) had positive margins, of those 6 cases (13.6%) in pT2 and 11 (25.0%) cases in pT3.
Total cost for each Senhance robotic radical prostatectomy was NT$61000-110000 (about US $2200-3970), compared with NT$180000-250000 (abouot US 6400-8900) in da Vinci robotic radical prostatectomy in Taiwan.
Conclusions: The Senhance robotic system is technically feasible and economically affordable. The learning curve depends on surgeons laparoscopic experiences. It may serve as an alternative tool for robotic radical prostatectomy.
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