LAUSR

INTRODUCTION Tissue retraction during minimally invasive surgery has been achieved to date with patient positioning or additional instrumentation. The LevitaTM Magnetic Surgical System (San Mateo, CA, USA), a novel, non-invasive, magnetic retraction device for minimally invasive surgery, has been used to facilitate reduced-port robotic prostatectomy using a multi-port robotic platform. With the release of the DaVinci SP robotic system (Intuitive, Sunnyvale, CA, USA), we now report a multi-institutional initial case series of magnetic-assisted robotic prostatectomy using the single-port robotic platform. MATERIALS AND METHODS An IRB-approved, retrospective chart review was performed of all patients undergoing robotic-assisted radical prostatectomy using the Da Vinci SP surgical system and a single LevitaTM magnetic retractor in the treatment of prostatic adenocarcinoma at two institutions from November 2018 to January 2019. Pre-operative, intraoperative, and post-operative data were collected for descriptive analysis. RESULTS A total of 15 men, median age 62 years (range 57-71) with mean PSA 7.0 ± 2.3 underwent surgery. The robotic cannula and a single 12 mm assistant port were utilized in all cases, the latter for suction, suture passage, and clip placement; the magnetic retractor aided with the posterior dissection, DVC stitch placement, bladder neck dissection and lymphadenectomy. No cases required conversion to a multi-port robotic platform, laparoscopy, or open, nor placement of additional assistant ports. No intraoperative or post-operative complications occurred. Average operative time was 224 ± 43 minutes and blood loss was 198 ± 115 mL. All patients were discharged home within 2 days of surgery. CONCLUSIONS Robotic prostatectomy utilizing the DaVinci SP system is feasible, safe, and effective. Use of the magnetic retractor facilitates tissue exposure and improves procedure ergonomics, mimicking the conventional multi-port technique. Further exploration of magnet utilization in robotic surgery and optimizing assistant port placement for true single-site surgery is warranted.