Single port vs. Multi-port DaVinci Robot for RARP

Posted by undetectable @undetectable, Jul 22, 2023

How important is it to find a surgeon who has access to the newer single port DaVinci? Is it better to work with someone who has vast experience with the multi port? Is it true that the multi-port is more effective in removing lymph nodes?

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@undetectable

Thanks, this is very helpful. My husband has interviewed an impressive surgeon who has done 4500 RALP procedures but his center uses multi-port. One friend said this could be a minus, but didn't seem like a dealbreaker to us.

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Here's a review article from April 2023 comparing multi to single-port RALP:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136812/

Here is the one-sentence conclusion: "Long-term, high-quality data are missing and further validation with prospective studies across different sites is required."

I'd go with a guy who's done 4500 multi-port cases...the difference (and it is not very significant) seems to be post-op pain and days in hospital. For otherwise healthy men who have had multi-port, the large majority seem to say minimal to no post-op pain, and one day in hospital (discharged the evening of or the day after procedure.)

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@undetectable

Thanks, this is very helpful. My husband has interviewed an impressive surgeon who has done 4500 RALP procedures but his center uses multi-port. One friend said this could be a minus, but didn't seem like a dealbreaker to us.

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Distinction w/o a difference.
Listen to the retired surgeon, not "a friend".
4500 RPs is a lifetime of experience.

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I would definitely recommend going with the proven method over the "latest and greatest". You want a surgeon that has done radical prostatectomies thousands of times, using a well tested and proven procedure. It is not the incisions that you need to worry about during recovery, but rather the internals.

Good luck

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@michaelcharles

Distinction w/o a difference.
Listen to the retired surgeon, not "a friend".
4500 RPs is a lifetime of experience.

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Thanks - that's our intuition of course

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@hammer101

I would definitely recommend going with the proven method over the "latest and greatest". You want a surgeon that has done radical prostatectomies thousands of times, using a well tested and proven procedure. It is not the incisions that you need to worry about during recovery, but rather the internals.

Good luck

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Yes, our thoughts as well. Just wanted to find out if single port was really the gold standard

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@trusam1

Here's a review article from April 2023 comparing multi to single-port RALP:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136812/

Here is the one-sentence conclusion: "Long-term, high-quality data are missing and further validation with prospective studies across different sites is required."

I'd go with a guy who's done 4500 multi-port cases...the difference (and it is not very significant) seems to be post-op pain and days in hospital. For otherwise healthy men who have had multi-port, the large majority seem to say minimal to no post-op pain, and one day in hospital (discharged the evening of or the day after procedure.)

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Thanks, very helpful

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@keywest19

Great news! I'm scheduled there for next month. I assume it's multi-port but not sure. What Dr. performed your surgery? Thanks

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Dr. Raymond Pak. No problems. Chose to stay two nights in on-campus care hotel (due to distance from home to Mayo) for just a little extra rest and peace of mind before hitting the road. I’m now 16 days post-op and getting around normally with no tenderness whatsoever. Don’t like wearing diapers but realize continence will take some time. Peace of mind about having cancer removed is worth some temporary inconvenience. Prayers for your procedure and recovery.

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@donaldguy

Dr. Raymond Pak. No problems. Chose to stay two nights in on-campus care hotel (due to distance from home to Mayo) for just a little extra rest and peace of mind before hitting the road. I’m now 16 days post-op and getting around normally with no tenderness whatsoever. Don’t like wearing diapers but realize continence will take some time. Peace of mind about having cancer removed is worth some temporary inconvenience. Prayers for your procedure and recovery.

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Thank you! Glad you're doing well. I also will stay at a nearby hotel for a few days after because I live 3 hours away. I want to make sure catheter etc ok before traveling home. I'll be heading there in a few weeks for an MRI. I hope they don't use an endorectal coil for that. Thanks and prayer for your recovery as well.

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@trusam1

Just because something is new doesn't mean it's better. A surgeon with 50+ multi-port cases/ year for more than 5 years is probably a very good bet. Sometimes equipment manufacturers are bringing out new stuff to make a buck, and some doctors like to play around with new toys. Best not to be an early adopter.

I had multi-port RALP 3+ months ago with no pain after leaving the recovery room, no narcotics @ home, walking the afternoon of surgery. I don't know anything about single port, but have trouble (as a retired surgeon who did laparoscopies for 40 years) envisioning why it would be "better" than multi-port.

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I couldn't agree more. I had RALRP 10 days ago. My surgeon was the head of the urology dept. At Moffitt Cancer center in Tampa, Fl. He has done 0ver 250 of these. Results far exceeded my expectations.

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