Comparison of Senhance and Da Vinci Robotic Radical Prostatectomy: Short-term Outcomes, Learning Curve, and Cost Analysis

Abstract Background The Senhance® Robotic System is a new laparoscopy-based platform that has been increasingly used in radical prostatectomy (RP) procedures. The purpose of this study is to compare the outcome of Senhance RP (SRP) with da Vinci RP (DRP) cases. Methods From August 2019 to April 2022, we prospectively recruited 65 cases of SRP. We compared the peri-operative data, postoperative complication rates, short-term surgical outcomes (3-month postoperative undetectable prostate-specific antigen (PSA) and incontinence rates), learning curves, and cost analysis with data from 60 recent da Vinci Xi RP cases (rdRP), as well as an additional cohort of 60 initial da Vinci Si RP cases (idRP). Results There was no difference in operating time (231vs. 256 minutes), blood loss (180 vs, 165 ml), and postoperative surgical complication rate (Clavient -Dindo grade I-IV, 24.6 vs, 26.7%) between the SRP cases and the rdRP. Regarding the oncologic and continence function, there was no difference between positive margin rate (38.5% vs. 40.0%), rate of undetectable PSA level at postoperative 3 months (64.6 vs. 76.8%), and incontinence rate (15.4 vs. 16.7%) at postoperative 3 months between the two cohorts. The learning curve showed a quick downward slope for laparoscopic experienced surgeons. The median pocket cost for SRP patients in our hospital was $4170, which was lower than $7675 for the DRP patients. Conclusions Safety and short-term outcomes are comparable between SRP and DRP. For experienced LRP surgeons, using the Senhance system to perform RP is straightforward. With a more affordable price as its biggest advantage, the Senhance system may serve as a safe and effective alternative for robotic RP.