Perioperative and Short-Term Functional Outcomes of Robot-Assisted Radical Prostatectomy with the Dexter Robotic System.

Introduction

Previous data have demonstrated the feasibility of robot-assisted radical prostatectomy (RARP) performed with the Dexter robotic system. This study aimed to assess the early functional and oncological outcomes of RARP performed at our center using Dexter.

Methods

Forty-seven consecutive patients underwent RARP ± lymph node dissection at our institution between April 2022 and May 2023. Prospectively collected medical records from routine care were retrospectively analyzed. RARP was performed using a standard transperitoneal anterior approach with the Dexter system. We assessed intraoperative safety and performance outcomes, as well as postoperative safety, early oncological outcomes, and functional recovery at 3 months of follow-up.

Results

All procedures were successfully completed, without any intraprocedural complications, conversions to open surgery, or major technical failures. The median operative time was 198 minutes (interquartile range [IQR]: 163-232), and the median length of stay was 2 days (IQR: 2-3). Positive surgical margins were observed in 8/47 cases (17%). Two patients (4%) had rising prostate-specific antigen levels during follow-up. Urinary continence was achieved for 94% of patients at 3 months postoperatively and 52% had recovered sexual function. The study's limitation includes its retrospective design and the varying levels of robotic expertise among surgeons transitioning to the Dexter system.

Conclusion

This study highlights the oncological safety and encouraging functional outcomes of RARP performed with the Dexter system.