Prospective Comparison Between the AirSeal® System Valve-Less Trocar and a Standard Versaport™ Plus V2 Trocar in Robotic-Assisted Radical Prostatectomy

Background and Purpose: To prospectively compare the AirSeal (R) System valve-less Trocar with a standard Versaport (TM) Plus V2 Trocar as assistant insufflating port in transperitoneal and extraperitoneal robotic-assisted radical prostatectomy (t-RARP/e-RARP). Patients and Methods: Two consecutive cohorts of patients undergoing RARP using either a 12 mm AirSeal valve-less Trocar (n = 19 [14 t-RARP/5 e-RARP]) or a 12 mm Versaport Plus V2 Trocar (n = 17 [11 t-RARP/6 e-RARP]) were prospectively evaluated. Age, body mass index, tumor characteristics, and surgical approach were similar in both cohorts. Besides relevant clinical data, episodes of pressure loss (<8mm Hg), the number of necessary trocar manipulations, the frequency of camera cleaning, and overall carbon dioxide (CO2) consumption were recorded and compared. Results: Mean surgical time was 175 minutes in the AirSeal and 166 minutes in the Versaport group (p = 0.55). Whereas in the AirSeal group, only one episode of pressure loss <8mm Hg was observed; this occurred in mean 38 times in the Versaport group (p < 0.0001). No trocar manipulations for specimen or needle retrieval were necessary in the AirSeal group in contrast to in mean 15 in the Versaport group (p < 0.0001). Otherwise, no appreciable differences regarding overall operating time, blood loss, camera cleaning, or overall CO2 consumption were observed for the present study. Patient CO2 absorption was not evaluated. Conclusions: In the present study, the AirSeal Trocar offered a more stable pneumocavity and facilitated specimen retrieval and needle extraction.