Presentation (CTI)

OBJECTIVES: To assess the perioperative outcomes in patients undergoing robotic-assisted surgery with the da Vinci Single Port (SP) and da Vinci Multi Port (MP) surgical systems for five cancer indications.
METHODS: A PRISMA guided review and search was conducted on studies published between 2018 and March 1, 2024 and comparing RAS with SP and MP systems. Publications evaluating prostatectomy, partial nephrectomy, transoral surgery, and colorectal procedures were included. Outcomes assessed were operative time, conversions, estimated blood loss, blood transfusions, hospital stay, postoperative complications, pain, reoperations, readmission, and short-term mortality.
RESULTS: We identified 32 studies (1 prospective and 31 retrospective), representing 2,440 SP and 7,897 MP patients. Most studies focused on radical prostatectomy (N=17), followed by partial nephrectomy (N=8), transoral robotic surgery (TORS) (N=4), rectal resection (N=2), and colectomy procedures (N=1). Compared to MP, SP patients had lower estimated blood loss (MD:-24.30[-36.75,-11.86],p<0.01) and shorter length of hospital stay (MD:-0.57[-0.76,-0.39],p<0.01). They also were less likely to use opioids upon discharge (OR:0.10[0.03,0.37],p<0.01). Both groups had similar operative time, blood transfusions, conversions to open surgery, 30-day postoperative complications, pain scores at discharge, 30-day readmissions, 30-day mortality, and 30-day reoperations.
CONCLUSIONS: Our results demonstrate that using the da Vinci SP system may provide enhanced perioperative clinical outcomes, including shorter hospital stay and less opioid use at discharge. Additional research is needed to explore long-term oncological outcomes and patient quality of life.