Preliminary comparison of modified extraperitoneal free-PORT single incision technique and transabdominal multi-incision robot-assisted laparoscopic radical prostatectomy

Objective: To compare the clinical efficacy of modified single-incision technique without special extraperitoneal PORT with that of transperitoneal multi-incision robot-assisted laparoscopic radical prostatectomy, and to explore the feasibility and safety of this innovative technique. Method: A retrospective analysis was performed on 259 cases who received robot-assisted laparoscopic radical prostatectomy in the Robot Minimally Invasive Center of Sichuan Provincial People's Hospital from September 2018 to August 2021. Among them, there were 147 cases with no special PORT extraperitoneal single incision (Group A) and 112 cases with multiple incisions by transperitoneal method(Group B). The differences in age, PSA level, Gleason score, prostate volume, body mass index, clinical stage, lower abdominal operation history, and lymph node dissection ratio between the two groups were not statistically significant (P > 0.05). All operations were performed by the same operator. Results: : In this study, all the 259 operations were completed successfully and there was no conversion. There was no significant difference in transperitoneal blood loss, postoperative hospital stay, positive rate of incision margin, indwelling time of urinary catheter, satisfaction rate of immediate urine control, satisfaction rate of urine control 3 months after operation, positive rate of postoperative lymph node pathology and postoperative pathological stage between the two groups (P > 0.05). There were significant differences in operation time, postoperative exhaust time and incision length (P < 0.05). Conclusion: Modified extraperitoneal no special PORT single incision technique is safe and feasible for robot-assisted laparoscopic radical prostatectomy, and its curative effect is similar to that of transperitoneal multi-incision RARP. It has the advantages of short operation time, less impact on gastrointestinal tract and more beautiful incision. The long-term effect of treatment needs to be further confirmed by prospective studies.