surgoncoКреативная хирургия и онкологияCreative surgery and oncology2076-30932307-0501Башкирский государственный медицинский университет10.24060/2076-3093-2024-14-4-303-308surgonco-1015Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESСравнение хирургических систем Da Vinci XI и SI при выполнении робот-ассистированной радикальной простатэктомииComparison of Da Vinci XI and Da Vinci SI Surgical Systems in Robot-Assisted Radical Prostatectomyhttps://orcid.org/0000-0002-2302-3315ПапоянА. О.PapoyanA. O.

Папоян Анушаван Оганесович — кафедра урологии и онкологии

Республика Башкортостан, Уфа

Anushavan O. Papoyan — Department of Urology and Oncology

Ufa

anara_74@mail.ruhttps://orcid.org/0000-0002-4657-6625УрманцевМ. Ф.UrmantsevM. F.

Урманцев Марат Фаязович — к.м.н., доцент, кафедра урологии и онкологии

Республика Башкортостан, Уфа

Marat F. Urmantsev — Cand. Sci. (Med.), Assoc. Prof., Department of Urology and Oncology

Ufa

https://orcid.org/0000-0002-1197-1991ПавловВ. Н.PavlovV. N.

Павлов Валентин Николаевич — д.м.н., профессор, академик РАН, кафедра урологии и онкологии

Республика Башкортостан, Уфа

Valentin N. Pavlov — Dr. Sci. (Med.), Prof., Academician of Academician of the Russian Academy of Sciences, Department of Urology and Oncology

Ufa

Башкирский государственный медицинский университетРоссияBashkir State Medical UniversityRussian Federation202428122024144303308Copyright © Папоян А.О., Урманцев М.Ф., Павлов В.Н., 20242024Папоян А.О., Урманцев М.Ф., Павлов В.Н.Papoyan A.O., Urmantsev M.F., Pavlov V.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.surgonco.ru/jour/article/view/1015Введение

Введение. Робот-ассистированная радикальная простатэктомия (РАРП) позволяет достичь отличных онкологических результатов при низкой частоте осложнений и является «золотым стандартом» радикального лечения рака предстательной железы. Целью исследования было провести сравнительный анализ эффективности двух поколений хирургических систем Da Vinci Xi и Si при выполнении РАРП.

Материалы и методы

Материалы и методы. Сто шестьдесят пять пациентов были разделены на группу Xi (n = 77) и группу Si (n = 88). Сравнивали периоперационные характеристики и онкологические исходы.

Результаты

Результаты. Демографические, клинические и онкологические характеристики двух групп пациентов были сходными и сопоставимыми. Операции с сохранением сосудисто-нервного пучка, внутритазовой фасции и лонно-простатической связки статистически значимо чаще выполнялись на системе Xi. Операционное время было значимо короче в группе Xi. Время послеоперационного восстановления и частота послеоперационных осложнений были одинаковыми. Не было различий в частоте положительных хирургических краев и биохимических рецидивов.

Обсуждение

Обсуждение. Мы обобщили причины сокращения времени операции: во-первых, стыковка системы Xi более удобная и время стыковки сокращается; во-вторых, производительность работы системы Xi улучшена, поэтому время работы сокращено; в-третьих, значительно уменьшаются столкновения между роботизированными руками во время операции, что ускоряет хирургический процесс.

Заключение

Заключение. В опытных руках выполнение РАРП безопасно и осуществимо с применением хирургических систем Da Vinci Xi и Si без повышенного риска серьезных осложнений, но периоперационные исходы лучше с системой Xi при сходных онкологических исходах.

Introduction

Introduction. Robot-assisted radical prostatectomy is considered to be the “gold standard” for the radical treatment of prostate cancer, achieving excellent oncological outcomes with a low incidence of complications.

Aim

Aim. To analyze and compare the efficiency of Da Vinci Xi and Da Vinci Si surgical systems applied in performing robot-assisted radical prostatectomy. Materials and methods. 165 patients were divided into two groups: Xi-group (n = 77) and Si-group (n = 88). The perioperative characteristics and oncological outcomes were analyzed and compared.

Results

Results. The demographic, clinical, and oncological characteristics of the two patient groups appeared similar and comparable. Interventions involving the preservation of the neurovascular bundle, the pelvic fascia, and the puboprostatic ligament were performed using Xi system significantly more often. The surgery duration was significantly shorter in the Xi-group. The postoperative recovery time and the incidence of postoperative complications appeared to be identical across both groups. No differences were revealed in the rates of positive surgical margins or biochemical recurrence.

Discussion

Discussion. Reasons behind the reduced operative time were considered as follows: first, the docking of the Xi system is more user-friendly, resulting in decreased docking time; second, the operational efficiency of the Xi system had been enhanced, thereby leading to reduced workflow times; third, a number of collisions between robotic arms was significantly lower during the procedure, which accelerates the surgical process.

Conclusion

Conclusion. A robot-assisted radical prostatectomy performed by an experienced professional, using the Da Vinci Xi or Da Vinci Si surgical systems, appears to be safe and feasible without an increased risk of serious complications. However, the Xi system ensures better perioperative outcomes with comparable oncological results.

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The authors declare that there are no conflicts of interest present.