{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:05:41Z","timestamp":1787843141308,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to investigate any differences in the levels of intra\u2010operative (measured by an artificial intelligence device) and post\u2010operative pain between two different abdominal insufflators (AirSeal vs Stryker) used for a low\u2010pressure pneumoperitoneum robotic prostatectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A prospective randomised controlled clinical study was performed at Lister Hospital, Stevenage. The primary aim was to evaluate the feasibility of recruiting 40 patients with localised prostate cancer who underwent a robotic prostatectomy with either an AirSeal\u00ae Insufflation System (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) or Stryker PneumoClear Insufflator (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) for the management of low\u2010pressure pneumoperitoneum (8\u2009mmHg). The co\u2010primary aim was to investigate any differences in intra\u2010operative significant nociceptive stimulus (NOL\u2009\u2265\u200925 for \u22651\u2009min) measured by the Medasense PMD\u2010200 device, in addition to post\u2010operative pain scoring and opioid consumption. The secondary aim of the study was to assess any differences in surgical factors (blood loss, console and total procedure time, length of stay, readmission rates, adverse events, differences in creatinine and haemoglobin and unplanned pneumo\u2010peritoneal pressure changes).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty patients were successfully recruited onto the RALP trial with complete 30\u2010day follow\u2010up. AirSeal has fewer significant nociceptive events per recorded hour than Stryker (20.7 vs. 33.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). Shorter procedure times (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045), console times (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045) and blood loss (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were seen in the AirSeal arm of the trial. There were no statistical differences in post\u2010operative pain scores, analgesia consumption at POD1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.599) and at discharge (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.488). There were four (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) adverse effects reported with the Stryker arm of the trial (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093 ileus,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091 UTI) leading to two (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092) formal re\u2010admissions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>In this study, we were able to successfully recruit 40 participants with complete 30\u2010day follow\u2010up. There were advantageous surgical factors and lesser intra\u2010operative nociceptive insult associated with the AirSeal insufflator. Further RCTs are planned with a larger population to investigate the true causality of this relationship.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70226","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T02:20:03Z","timestamp":1779157203000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Using an artificial intelligence\u2010based device to investigate pain outcomes in robotic prostatectomy at low pressure pneumoperitoneum: The RALP clinical trial"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3966-5734","authenticated-orcid":false,"given":"Nikhil","family":"Vasdev","sequence":"first","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital East and North Hertfordshire Teaching NHS Trust  Stevenage UK"},{"name":"School of Medicine and Life Sciences 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