Hypothesis / aims of study
The da Vinci Single-Port (SP) differs from prior robotic platforms, utilizing a single 2.5cm incision to accommodate all robotic arms. We postulate advantages of this new platform may include shorter hospitalization, improved cosmesis, and reduced postoperative pain. This project investigates the impact of the novel SP-system on cosmetic and psychometric patient assessment to evaluate our hypothesis.
Study design, materials and methods
This study utilized a prospective, anonymous survey to compare patients who underwent either SP or Multiport (Xi) urologic procedures at a single center, the University of Illinois Hospital & Health Sciences System. Each enrolled patient completed the Patient Scar Assessment Questionnaire: a validated patient-reported outcomes measure for surgical scars after obtaining informed consent. [1] Four domains were assessed: Appearance, Consciousness, Satisfaction with appearance, Satisfaction with symptoms. Higher scores represent worse reported outcomes.
Results
Out of 149 patients who underwent SP urologic procedures and 143 patients who underwent Xi urologic procedures between December 2018 and September 2020 respectively 67 and 54 patients agreed to participate in the study. Surgical procedures included radical prostatectomy, radical and partial nephrectomy, pyeloplasty, ureteral reimplantation, cystectomy, gender-affirming vaginoplasty, and were not statistically different between the two groups. Detailed results are summarized in Table 1. The SP procedure recipients reported significantly better cosmetic scar appearance t(123)= -2.98, p=.002. Similarly, the SP cohort compared to the Xi group (M=11.59, SD=3.48) demonstrated significantly higher satisfaction with the cosmetic appearance of their surgical scar, t(123) = -1.79, p=.037.
No significant difference was found for “Consciousness”, t(123)= -0.52, p=.3, despite the SP group attaining lower scores than the Xi group, and for “Satisfaction with Symptoms”, t(123)= - 0.48, p=.32, despite the SP group attaining lower scores than the Xi group.
Interpretation of results
Our results demonstrate a significant finding that patients’ have a favorable reception of SP vs Xi surgery in terms of aesthetic outcomes demonstrated by better scar appearance and cosmetic satisfaction. A similar result was found with regard to the conscientiousness of scars and symptoms of scars in these two groups however, they did not result in a statistically significant difference likely due to our limited sample population.
Concluding message
Our results show favorability of the SP robotic platform with regard to aesthetic outcomes compared to the Xi platform however, further research is required to evaluate other outcome measures of the SP platform. An ongoing study is investigating the relationship between cosmetic satisfaction, consciousness, satisfaction, and other postoperative outcomes such as length of stay, postoperative pain, and narcotic use.