Session: MP26: Surgical Technology & Simulation: Instrumentation & Technology I
MP26-13: The Impact of AirSeal® on Complications and Pain Management During Robotic-Assisted Radical Prostatectomy: A Single-Tertiary Center Retrospective Study
Introduction: AirSeal® is a valveless insufflation device that allows a stable pneumoperitoneum through continuous smoke evacuation and CO2 recirculation during laparoscopic surgery. We aimed to compare surgical characteristics, post-operative complications, and opioid use between AirSeal® and non-AirSeal® robotic-assisted radical prostatectomy (RARP). Methods: Data on 395 patients who underwent elective RARP with or without AirSeal® at our institution were retrospectively collected between 2013 and 2022. We compared patient demographics, oncologic, pathologic, and surgical characteristics between AirSeal® and non-AirSeal® cases. We also compared operative time, length of stay, morbidity, and opioid use for pain management between the two groups. Multivariable linear and logistic regression models, controlling for age, extra-prostatic extension, prostate size, and pathological grade on TRUS were developed to control for confounders. Results: The AirSeal® and non-AirSeal® group consisted of 125 and 270 patients respectively. Patients who underwent RARP with AirSeal® were older, more likely to have a clinical grade = 3, and more likely to have extraprostatic extension as compared to patients who did not use AirSeal® (p < 0.039). RARP with AirSeal® displayed shorter operative times by 29.2 minutes and length of hospital stay by 0.72 days as compared to non-AirSeal® group (p < 0.001). Furthermore, the AirSeal® group also witnessed lower odds of Clavien-Dindo Class >2 complications (OR= 0.06) and opioid use (OR= 0.46) as compared to non-AirSeal® group (p < 0.022). Conclusions: RARP combined with AirSeal® in our center was associated with shorter operative times, shorter length of hospital stays, lower odds of CVD>2 complications, and lower odds of opioid use in comparison to non-AirSeal® RARP. The feasibility and efficacy of combining the AirSeal® system during RARP should be further studied and evaluated by randomized clinical trials. SOURCE OF Funding: None
