Technique for Docking and Port Placement Using a Purpose-built Robotic System (SP1098) in Human Cadaver

Objectives: To describe step-by-step the port placement and the robot docking of the new purpose-built robotic platform for R-LESS. The feasibility of different approaches to the pelvic fossa and the retroperitoneum was reported in cadaver models. Methods: This was a preclinical study on human cadavers to assess the feasibility of the da Vinci SP1098 surgical system for R-LESS pelvic fossa and retroperitoneal urological surgeries. We used the SP1098 to perform R-LESS prostatectomies and cystoprostatectomies with transperineal and transvesical approaches, and nephrectomies (radical or partial) with retroperitoneal approach. The primary outcome was to report the port placement and docking. The technical feasibility of the procedures was then demonstrated as measured by the need for adjunctive ports or the occurrence of intraoperative complications. Operative times were recorded. Results: A total of 14 procedures were performed on 12 human cadavers. Namely 4 prostatectomies and 2 cystoprostatectomies with transperineal approach, 3 transvesical prostatectomies, 1 retroperitoneal radical, and 4 retroperitoneal partial nephrectomies. Operative times were in line with those of standard multiport robotic surgery. Neither additional ports nor percutaneous instruments were required. No intraoperative complications occurred. Limitations include the preclinical model, the small sample size, and the lack of a control group. Conclusion: In this preclinical model, the port placement and robot docking using the SP1098 robotic platform is reproducible and feasible for pelvic fossa and retroperitoneal urological surgeries.