Comparison of Step-Specific Operative Times Between the da Vinci Surgical System and the Hinotori Surgical Robot System in Robot-Assisted Radical Prostatectomy

Abstract

Introduction: The da Vinci surgical system (DVSS) has been the prevalent surgical robotic platform; however, novel systems, such as the hinotori surgical robot system (HSRS), are emerging. In this study, we compared the short-term surgical outcomes and step-specific operative times between the DVSS and HSRS for robot-assisted radical prostatectomy (RARP).

Methods: Two experienced DVSS-RARP surgeons transitioned to HSRS-RARP. They performed 88 DVSS-RARP procedures between 2019 and 2022 and 42 HSRS-RARP procedures beginning in 2022. We compared the perioperative outcomes and step-specific operative times between the DVSS-RARP and the HSRS-RARP groups.

Results: The perioperative and short-term postoperative outcomes were comparable between the two groups. The total operative and console times were significantly longer in the HSRS-RARP group than in the DVSS-RARP group (235 min vs. 200 min, p = 0.0001; 168.5 min vs. 142.5 min, p = 0.0008). Surgical steps, such as preparation, posterior dissection, Retzius space dissection, prostate removal, and reconstruction, were longer in the HSRS-RARP group compared to the DVSS-RARP group. No significant differences in the surgical step time of pelvic lymph node dissection and vesico-urethral anastomosis were observed between the two groups.

Conclusion: Although HSRS-RARP exhibited short-term surgical outcomes comparable to those of DVSS-RARP, it required longer total operative and console times. Notably, technically demanding steps, such as pelvic lymph node dissection and vesico-urethral anastomosis, remained unaffected, suggesting that the DVSS-RARP skills can be transferred to HSRS-RARP professionals without major challenges.

Keywords: hinotori surgical robot system; operative time; robot‐assisted radical prostatectomy.