Comparison of Single-Port and Multiple-Port Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis.

OBJECTIVE

The objective of this review was to collate and critically appraise the nascent body of evidence juxtaposing the da Vinci single-port (SP) system with its multiple-port (MP) antecedent, with the goal of ascertaining its surgical efficacy and postoperative outcomes.

METHODS

The databases searched included PubMed, Web of Science, and Embase. Two independent reviewers conducted the initial screening for potential inclusion, assessed the quality of the studies via the Newcastle-Ottawa Scale, and extracted relevant data. A third reviewer was responsible for reconciling the data. Random effects models were utilized.

RESULTS

The final meta-analysis included eight studies, encompassing a cohort of 1389 patients, with 502 patients allocated to the SP group and 887 to the multiple-port group. We observed no significant differences in operative duration (WMD: 0.12, 95% confidence interval (CI): -7.44-7.67), blood loss (weighted mean difference (WMD): -11.50, 95% CI: -28.89-5.90), positive surgical margins (odds ratio (OR): 0.80, 95% CI: 0.59-1.08), complications (OR: 1.29, 95% CI: 0.77-2.16), urinary continence (OR: 1.18, 95% CI: 0.86-1.62), or erectile function (OR: 0.84, 95% CI: 0.58-1.24) between the two procedural types. The meta-analysis revealed a mean difference of -0.86 days (95% CI: -1.64 to -0.08), suggesting a tendency toward shorter hospitalization for the SP group.

CONCLUSIONS

The da Vinci SP system presents itself as a formidable contender when juxtaposed with its MP counterparts. Notwithstanding the encouraging preliminary data, a more substantial evidence base is needed to ascertain the definitive role of the SP system within the domain of urological surgery.