Clinical Outcomes and Cost-effectiveness between the Sentire® and da Vinci® systems in Robot-assisted Radical Prostatectomy.

Objective: Robotic surgery has enhanced minimally invasive procedures with greater precision and control, but high costs have limited its widespread adoption. The Sentire® surgical system is hypothesized to achieve clinical outcomes comparable to those of the da Vinci® system while demonstrating superior cost-effectiveness in robot-assisted radical prostatectomy (RARP) procedures. This study aimed to compare RARP outcomes using Sentire® and da Vinci® ®, focusing on clinical efficacy and economic impact.

Materials and methods: A retrospective analysis was conducted at three high-volume urology centers in China, including 22 patients who underwent RARP with the Sentire® system and 287 patients who underwent RARP with the da Vinci® system. After 1:3 propensity score matching (PSM), 66 patients were successfully matched in the control group. Perioperative outcomes and cost metrics were assessed. Key measures included operative and console times, docking time, blood loss, recovery, positive surgical margins, surgeon evaluations of performance and comfort, and cost-effectiveness.

Results: The Sentire® group had a longer median operative time (143 vs. 112 minutes, p=0.024), while console time (85 vs. 76 minutes, p=0.323) and docking time (9.0 vs. 6.0 minutes, p=0.279) were comparable. Blood loss was also similar between the groups (p=0.093). Positive surgical margin rates were 22.7% for Sentire® and 20.0% for da Vinci® (p=1.000), and no significant differences were observed in pathological ISUP grades or prostate volumes (p=0.327 and p=0.856, respectively). At 1-year follow-up, PSA recurrence was observed in 3 patients in the Sentire® group (4.5%) and 4 in the control group (6.1%) (p=0.625), with similar median PSA levels (0.012 vs. 0.014 ng/mL, p=0.410). Urinary continence rates were also comparable at 1, 3, and 12 months (all p > 0.05). Cost-effectiveness analysis revealed lower total and direct costs in the Sentire® group, including surgery expenses ($8,750 vs. $10,500, p=0.021), although differences in consumable and indirect costs were not statistically significant. Surgeon satisfaction scores for performance and comfort were slightly better for Sentire® but did not reach statistical significance (p > 0.05).

Conclusion: This study demonstrates that the Sentire® system is well-suited for urological surgeries, offering comparable clinical outcomes and shorter hospital stays while improving cost-effectiveness compared to the da Vinci® system.