CUHK introduces new modular robot-assisted system for radical prostatectomy

Urological surgeons from the Chinese University of Hong Kong (CUHK) have become the first in the Greater China region to perform radical prostatectomy with a new modular robot-assisted system, enhancing accessibility and mobility of robotic surgery across operating theatres (OTs).

From May to mid-July 2023, the team treated 10 patients with localized prostate cancer using the new system at the Prince of Wales Hospital. No major postoperative complications occurred among these patients. Within 1 month, 50 percent of them did not require incontinence pads.

“Notably, surgical outcomes with the modular robotic system were minimally affected by the learning curve, highlighting its ease of adoption,” said Professor Chi-Fai Ng of the Department of Surgery, CUHK.

In Hong Kong’s public hospitals, radical prostatectomy is typically performed with multiport or single-port robot-assisted surgery systems. [Surgical Outcomes Monitoring & Improvement Program database, 2022] “These all-in-one instruments with fixed robotic arm configurations are confined to OT size and cannot be transferred across OTs. Their limitations restrict their application in specific surgical settings,” said Dr Samuel Yee of the Department of Surgery, CUHK.

“With the new modular robotic system, four independent robotic arm carts can be transferred across different OTs, providing enhanced accessibility and mobility to meet a variety of surgical needs,” Yee continued.

An open console with intraoperative three-dimensional (3D) view is also incorporated into the new system, enabling simultaneous shared intraoperative viewing by team members within the same OT. “This feature can further support surgical training and demonstration,” commented Ng.

An earlier phase I trial showed satisfactory performance with the modular system in radical prostatectomy. Among prostate cancer patients who underwent surgical treatment, operative time was shorter (median, 182 minutes vs 206 minutes vs 215 minutes) and blood loss was lower (median, 200 mL vs 300 mL vs 350 mL) with the modular robotic system vs single-port or multiport systems. [Int J Urol 2019;26:878-883]

Following radical prostatectomy, the median duration of catheterization was 7 days with the modular system, 8 days with the single-port system and 9 days with the multiport system. The corresponding median hospital stays were 3 days, 4 days and 3 days.

“Integrating the modular and all-in-one robotic systems may improve utilization and management of OTs and surgical resources [in public hospitals]. We hope that this implementation can reduce waiting time for surgery in the long term,” Yee noted. As a next step, the CUHK team will use the modular robotic system to treat patients with kidney cancer.

New modular robot-assisted system with four independent robotic arm carts and an open console with intraoperative 3D view