Presented by: ATSUSHI YAMAMOTO MD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

Introduction

To compare the perioperative outcomes of robot-assisted radical prostatectomy (RARP) performed using the hinotori^TM and the da Vinci surgical system.

RARP is being routinely performed at our center using the da Vinci surgical system since 2010. Recently, the first made in Japan surgical robotic system called the hinotori^TM has been introduced in our center. Over the last 14 months, we have been performing RARP at our center using both robotic systems.

Materials

This was a retrospective analysis of prospectively maintained data from the medical records. A total of ninety-three patients who underwent RARP between April 2022 and May 2023 using the da　Vinci and the hinotori^TM were included in this study. Port placements in both the groups were similar to the conventional port placement (4 robotic and 2 assistant trocars). Data of both the groups were analyzed for perioperative outcomes like operating time, console time, blood loss, post operative complications. Perioperative outcomes between the two groups were compared using t-test and chi-square test.

Results

,

For the hinotori™ group and the da Vinci group respectively, the median total operative time was 343 (range: 22-448) minutes and 334 (range: 187-432) minutes (p=0.949), median console time was 271 (range: 147-337) minutes and 254 (range: 126-356) minutes (p=0.982), median blood loss was 180 (range: 50-600) ml, 172.5 (range: 0-800) ml (p=0.345). Forty patients (62.5%) underwent lymph node dissection in the hinotori™ group and 18 patients (62.0%) in the da Vinci group. The median number of lymph nodes removed were 22 (range: 3-36) and 24 (range: 9-47) (p=0.288), respectively. Perioperative complications according to Clavien dindo gradeⅢ or higher complications were 1 (common bile duct stone) in the hinotori™ group and 2 (common bile duct stone, pulmonary thromboembolism) in the da Vinci group.

Conclusion

We did not find clinically significant differences in the operating time, the blood loss, the number of lymph nodes removed, and complications between 2 groups. RARP can be performed using the hinotori^TM with comparable perioperative outcomes to that of the da Vinci.

Funding

The hinotori^TM seems to be a safe system for RARP.

Lead Authors

SHUICHI MORIZANE,, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

HIROSHI YAMANE, MD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

RYUTARO SHIMIZU, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

RYOMA NISHIKAWA, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

YUSUKE KIMURA, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

NORIYA YAMAGICHI, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

KATSUYA HIKITA, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

MASASHI HONDA, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine

ATSUSHI TAKENAKA, PHD
division of Urology, Department of Surgery, Tottori University Faculty of Medicine