Comparing Perioperative Outcomes Using Single and Multiple Robot Systems During the Learning Period for Robot-Assisted Radical Prostatectomy.

Introduction: This study aimed to assess the perioperative outcomes during the learning period for robot-assisted radical prostatectomy (RARP) using multiple surgical robot systems, namely hinotori and da Vinci, and compare them with those observed for surgeons trained using only da Vinci.

Methods: This study included two surgeons who learned RARP using multiple robot systems (hinotori and da Vinci Xi [H&D] group) and four surgeons who learned using only da Vinci (D group). We retrospectively collected data from the initial 25 cases of each surgeon. Perioperative outcomes, including the time using the robotic system, PSA recurrence, and urinary continence at 3 months after surgery, were compared between the two groups.

Results: The patient characteristics were not significantly different between the two groups. The H&D group surgeons had shorter experience as urologists and laparoscopic surgeons but had extensive experience as assistants of RARP, and the institutional experience with RARP was greater in the H&D group. The perioperative outcomes, specifically the time using the robotic system, PSA recurrence rate, and pad-free rate at 3 months after surgery, did not significantly differ between the two groups. The multivariate analysis indicated that the time using the robotic system and pad-free rate were not significantly different between the two groups.

Conclusions: The perioperative outcomes during the RARP learning period using both hinotori and da Vinci were not significantly different from those using only da Vinci; although the H&D group surgeons in training were relatively younger, they had slightly more practice as RARP assistants at a more experienced institution.