Perioperative and Short-Term Functional Outcomes of Robot-Assisted Radical Prostatectomy with the Dexter Robotic System.

Abstract

Introduction: Previous data have demonstrated the feasibility of robot-assisted radical prostatectomy (RARP) performed with the Dexter robotic system. This study aimed to assess the early functional and oncological outcomes of RARP performed at our center using Dexter. Methods: Forty-seven consecutive patients underwent RARP ± lymph node dissection at our institution between April 2022 and May 2023. Prospectively collected medical records from routine care were retrospectively analyzed. RARP was performed using a standard transperitoneal anterior approach with the Dexter system. We assessed intraoperative safety and performance outcomes, as well as postoperative safety, early oncological outcomes, and functional recovery at 3 months of follow-up. Results: All procedures were successfully completed, without any intraprocedural complications, conversions to open surgery, or major technical failures. The median operative time was 198 minutes (interquartile range [IQR]: 163-232), and the median length of stay was 2 days (IQR: 2-3). Positive surgical margins were observed in 8/47 cases (17%). Two patients (4%) had rising prostate-specific antigen levels during follow-up. Urinary continence was achieved for 94% of patients at 3 months postoperatively and 52% had recovered sexual function. The study's limitation includes its retrospective design and the varying levels of robotic expertise among surgeons transitioning to the Dexter system. Conclusion: This study highlights the oncological safety and encouraging functional outcomes of RARP performed with the Dexter system.