Comparing Revo-i and da Vinci in Retzius-sparing robot-assisted radical prostatectomy: a preliminary propensity score analysis of outcomes.

Abstract

PURPOSE\n. This study aims to compare perioperative and oncologic outcomes between matched cohorts of localized Prostate cancer (PCa) operated on by the same surgeon using the DaVinci Si robot and the Revo-i robot.\n\n\nMATERIALS AND METHODS\nNon-metastatic prostate cancer patients undergoing Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) from January 2016 to December 2020 were matched one-to-one (33:33) to DaVinci Si controls using nearest neighbor propensity score matching according to the following covariates: age, American Society of Anesthesiology (ASA) score, body mass index, previous abdominal and endoscopic surgery, pre-operative prostate specific antigen (PSA), prostate volume, ISUP grade group, tumor stage, and need for pelvic lymphadenectomy. Outcomes of interest were estimated blood loss, length-of-stay, complication rate, operative times, positive surgical margins, and biochemical recurrence at six months.\n\n\nRESULTS\nBoth cohorts were similar in estimated blood loss, rate of margin positivity, and rate of complications. Length of stay was significantly shorter with the Revo-i cohort. The DaVinci showed faster console, suture, total operation times. Positive margin rate and biochemical recurrence at six months were similar in both groups.\n\n\nCONCLUSION\nDespite the longer suture, console, and operative time compared to the da Vinci in the authors institution, the Revo-i robot-assisted radical prostatectomy had equivalent short-term oncologic outcomes with the da Vinci standard.