Single-port Versus Multi-port Robotic-assisted Procedures From the Patient's Perspective: A Retrospective Cohort Study

Luca A Morgantini; Matthew Del Pino; Arthi Bharadwaj; Ahmad Alzein; Ashwin Ganesh; Erin Egan; Francesco Del Giudice; Simone Crivellaro

doi:10.1097/UPJ.0000000000000340

Single-port Versus Multi-port Robotic-assisted Procedures From the Patient's Perspective: A Retrospective Cohort Study

Urol Pract. 2022 Nov;9(6):575-579. doi: 10.1097/UPJ.0000000000000340. Epub 2022 Sep 5.

Authors

Luca A Morgantini¹, Matthew Del Pino¹, Arthi Bharadwaj¹, Ahmad Alzein¹, Ashwin Ganesh¹, Erin Egan¹, Francesco Del Giudice², Simone Crivellaro¹

Affiliations

¹ Department of Urology, University of Illinois at Chicago, Chicago, Illinois.
² Department of Urology, Stanford University, Palo Alto, California.

PMID: 37145805
DOI: 10.1097/UPJ.0000000000000340

Abstract

Introduction: The da Vinci SP^® single-port system, differently from prior platforms, utilizes a single 2.5 cm incision to accommodate 1 flexible camera and 3 articulated robotic arms. Potential advantages include shorter hospitalization, improved cosmesis, and reduced postoperative pain. This project investigates the impact of the novel single-port system on cosmetic and psychometric patient assessment.

Methods: The Patient Scar Assessment Questionnaire (a validated patient-reported outcomes measure for surgical scar) has been administered retrospectively to patients who underwent either an SP or Xi^® urological procedure at a single center. Four domains were assessed: Appearance, Consciousness, Satisfaction With Appearance, and Satisfaction With Symptoms. Higher scores represent worse reported outcomes.

Results: Compared to 78 Xi procedure recipients (mean 15.28), 104 SP procedure recipients (mean 13.84) reported significantly better cosmetic scar appearance U(N_SP=104, N_MP=78) = 3,739 (P = .007) where U is the difference between the 2 rank totals, and N_SP and N_MP represent the number of single-port and multi-port procedure recipient respondents, respectively. Similarly, the SP cohort (mean 8.80) compared to the Xi group (mean 9.87) demonstrated significantly better consciousness of their surgical scar, U(N_SP=104, N_MP=78) = 3,329 (P = .045), and higher satisfaction with the cosmetic appearance of their surgical scar, U(N_SP=103, N_MP=78) = 3,232 (P = .022), with the SP group (mean 11.35) attaining better scores than the Xi group (mean 12.54). No significant difference was found for "Satisfaction With Symptoms," U(N_SP=103, N_MP=78) = 3,969 (P = .88), despite the SP group (mean 6.58) attaining lower scores than the Xi group (mean 6.74).

Conclusions: This study demonstrates patients' favorable perception of SP versus XI surgery in terms of aesthetic outcomes. An ongoing study is investigating the relationship between cosmetic satisfaction and length of stay, postoperative pain, and narcotic use.

Keywords: cicatrix; patient reported outcome measures; psychometrics; robotic surgical procedures; urologic neoplasms.