Authors
Tianyu Zhang, Kunpeng Xie, Junjie Yu, Renfu Chen, Xiaolei Sun, Xin Liu
Published in
Journal of robotic surgery. Volume 20. Issue 1. Jul 20, 2026. Epub Jul 20, 2026.
Abstract
This study evaluated whether use of a valve-less trocar system improves operative efficiency and surgeon workload during robot-assisted radical prostatectomy. Consecutive patients undergoing robot-assisted radical prostatectomy at a tertiary robotic surgery center between January 2023 and March 2026 were prospectively assigned to a valve-less trocar system (VTS) group or a conventional insufflation system (CIS) group according to alternating 3-month periods of system availability. The first 10 study cases were treated as a run-in period and excluded from the primary analysis. Co-primary outcomes were total operative time and surgeon workload assessed with the Surgery Task Load Index (SURG-TLX). Secondary outcomes included objective workflow metrics, blood loss, postoperative recovery, postoperative nausea and vomiting, length of stay, and 30-day complications. Ninety patients were analyzed (45 VTS, 45 CIS). Total operative time was shorter with VTS than with CIS (144.8 ± 27.6 vs. 168.6 ± 31.8 min, p < 0.001). After adjustment, VTS use remained associated with a 19.4-min reduction in operative time (95% confidence interval - 27.8 to - 11.0; p < 0.001). VTS was also associated with fewer pressure-loss episodes, fewer manual smoke evacuations, fewer camera cleanings, and lower SURG-TLX scores across all domains. Early pain scores and postoperative nausea and vomiting favored VTS, whereas length of stay and 30-day complications were similar. During robot-assisted radical prostatectomy, use of a valve-less trocar system was associated with greater operative efficiency and lower surgeon workload.
PMID:
42474824
Bibliographic data and abstract were imported from PubMed on 20 Jul 2026.
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