Effectiveness and Economic Outcomes in Patients Undergoing Laparoscopic Prostate Resection with a New Surgical Shear with Integrated Energy System: a retrospective study based on a tertiary hospital database in China

Abstract Background Each year over 1.4 million men are diagnosed with prostate cancer. Surgical prostate resection offers patients with early-stage prostate cancer a high likelihood of remission and has low reoperation rates. A new surgical shear with integrated energy system (Harmonic ACE + 7) is an integrated ultrasonic and electrosurgical energy system that can aid surgeons in laparoscopic prostate resections. This study aimed to demonstrate the ACE + 7’s value by determining its effectiveness and economic outcomes compared to conventional ultrasonic shear (CUS) in a real-world setting. Methods This was a multi-center clinical study of adults with prostate cancer undergoing a laparoscopic prostate resection procedure with the ACE + 7 shear or CUS between August 2019 and April 2021 at Shanghai Ruijin Hospital and two affiliated centers. Demographic and diagnosis information, intraoperative and postoperative clinical outcomes, and total and categorical costs were collected. 1:1 Propensity Score Matching was performed to form the study population for each clinical group. Data were compared between the two groups using t-tests and chi-squared tests. Results The ACE + 7 was associated with a lower number of hemostatic clips used per surgery (12.8 in the ACE + 7 group vs 19.8 in the CUS group, P < 0.001), a moderate but not significant difference in average postoperative drainage duration (6.6 ± 2.2 d vs. 7.9 ± 4.1 d, P = 0.082), a reduction on total drainage volume (275.5 ± 374.3 ml vs. 492.9 ± 1495.0 ml, P = 0.321) and a lower average rate of postoperative hemostatic drug usage (16% vs. 52%, P < 0.001). There was no significant difference in total costs between the ACE + 7 and CUS groups. Conclusion This study provides real-world data demonstrating that the ACE + 7 shear with integrated energy system improves clinical outcomes compared to CUS and can offer cost savings for hospitals and health systems. Using the ACE + 7's during LPRs allows physicians to help their patients achieve better outcomes and not spend additional money. Trial Registration: This study is a retrospective, observational study based on data from existing Electronical Hospital Information System and no human intervention was involved.