Robot-assisted radical prostatectomy using the novel hinotoriTM surgical robot system: initial experience and operation learning curve at a single institution

Akinori Nakayama; Keita Izumi; Erika Ikezoe; Minoru Inoue; Hiroki Tsujioka; Asumi Nirazuka; Kintaro Hasegawa; Akiyoshi Osaka; Yuka Yasuda; Yuichi Fukuda; Yasuyuki Inoue; Toshiyuki Iwahata; Kiyoshi Setoguchi; Kazutaka Saito

doi:10.21037/tcr-23-1025

Robot-assisted radical prostatectomy using the novel hinotori^TM surgical robot system: initial experience and operation learning curve at a single institution

Transl Cancer Res. 2024 Jan 31;13(1):57-64. doi: 10.21037/tcr-23-1025. Epub 2024 Jan 29.

Affiliation

¹ Department of Urology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.

Abstract

Background: The hinotori^TM surgical robot system (HSRS) is the first made-in-Japan robotic system used for radical prostatectomy. Here, we report initial results and describe our learning curve (skill development) implementing robot-assisted radical prostatectomy using HSRS (h-RARP).

Methods: Between November 2021 and December 2022, 97 patients who underwent h-RARP at our institution were enrolled in this study. We retrospectively evaluated the surgical outcomes of the initial cases using h-RARP, comparing those of RARP using da Vinci surgical robot system (d-RARP) in our institution. Furthermore, the learning curves of two surgeons with the highest number of h-RARP were analyzed. Patients treated by each surgeon were categorized into two groups: 1-15 cases (earlier group) and >15 cases (later group). Preoperative patient characteristics, operation parameters, and complication rates were compared between the two groups.

Results: In terms of surgical outcome, h-RARP was comparable to d-RARP. The procedures performed by the HSRS were successfully completed in all cases. There was no complication of grade 3 or higher. Comparing the two surgeons, surgeon 1, who had performed 40 d-RARP procedures, had time using robot system of the later group that was significantly shorter than that of the earlier group. However, for surgeon 2 with more than 100 d-RARP procedures, there was no statistically significant difference in time using robot system between groups. Other parameters showed no difference between earlier and later groups for the two surgeons.

Conclusions: Our results show that surgical outcomes of h-RARP are comparable to those of d-RARP during the initial experience of clinical application. In addition, the surgeons' learning curves for the total RARP experience suggest that the experience of d-RARP can carry over to performance using the novel HSRS.

Keywords: hinotoriTM surgical robot system (HSRS); learning curve; robot-assisted radical prostatectomy (RARP).