Versius robotic surgical system: case series of 18 robot-assisted radical prostatectomies

Abstract

Objective: To present the results of the first series of patients treated with robot-assisted radical prostatectomy (RARP) with the use of the Versius® Surgical System (CMR Surgical Ltd., Cambridge, UK). RARP has demonstrated better perioperative outcomes compared to open RP. However, RARP remains limited by platform availability and cost-effectiveness issues. The increasing competition from new robotic surgical platforms may further drive utilisation of the robotic approach. Patients and Methods: Data were collected prospectively for our first 18 consecutive patients with localised prostate cancer who underwent RARP at our centre over a 3-month period. We recorded parameters, including patient demographics and perioperative outcomes. We also report our optimised set-up with regard to trocar placement, bedside unit placement, and overall composition of the operating room for this procedure. Describing the incremental modifications carried out to achieve reductions in set-up and operating times to optimise utilisation of the Versius system. Results: The median (interquartile range [IQR]) set-up time was 8.5 (7–10) min. The median (IQR) console time was 201 (170–242) min. The median (IQR) operative time was 213 (186–266) min. The median (IQR) total surgery time was 226 (201–277) min. Bilateral pelvic lymphadenectomy median (IQR) time was 19 (17–20) min. There were no complications and/or limitations related to the use of the Versius system including need for conversion. There were no relevant intra- or postoperative complications at the 1-month follow-up related to the use of the Versius system. Patients were discharged after a median (IQR) of 4 (3.75–5) days, and the transurethral catheter was removed after a mean (range) of 8 (7–14) days. Continence at 2 months was achieved in 72.2% of the patients. Conclusions: Performing RARP using the Versius system is feasible, safe, and easily reproducible. Our set-up enables a rapid docking approach and efficient completion of the surgery.