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.