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Robotic extraperitoneal radical prostatectomy: an alternative approach.
J Urol. 2006 Mar; 175(3 Pt 1):945-50; discussion 951.JU

Abstract

PURPOSE

Laparoscopic radical prostatectomy with or without a robot has been increasingly performed worldwide, primarily using a transperitoneal approach. We report our experience with daVinci(R) robot assisted extraperitoneal laparoscopic radical prostatectomy.

MATERIALS AND METHODS

A total of 325 patients underwent robot assisted extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer at our center during a 2-year period. Perioperative data, and oncological and functional results were prospectively recorded.

RESULTS

Perioperative demographics included mean age, PSA and Gleason score, which were 60 years (range 42 to 76), 6.6 ng/ml (range 0.6 to 26) and 6 (range 5 to 9), respectively. Preoperative clinical stage was 81%, 16% and 3% for T1c, T2a and T2b, respectively. Average total operative time was 130 minutes (range 80 to 480). Intraoperative data included a mean blood loss of 196 cc with no open conversions. Bilateral, unilateral and nonnerve sparing prostatectomy was performed in 70%, 24% and 6% of patients, respectively. Of the patients 96% were discharged home within 8 to 23 hours of surgery. Pathological stage was pT2a, pT2b, pT3a and pT3b in 18%, 63%, 14% and 5% of all radical prostatectomy specimens, respectively, with an overall positive surgical margin rate of 13%. Two of 92 patients had positive nodal disease after lymph node dissection. Continence and erectile function were measured.

CONCLUSIONS

The extraperitoneal approach offers the advantages of improved dexterity and visualization of the robot, while avoiding the abdominal cavity and potential associated morbidity. As surgeons gain more experience with this new technology, the extraperitoneal approach simulating the standard open retropubic technique is likely to gain popularity.

Authors+Show Affiliations

Section of Laparoscopic and Robotic Surgery, Department of Urology, University of Rochester Medical Center, Rochester, New York 14642-8656, USA. jean-joseph@URMC.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

16469589

Citation

Joseph, J V., et al. "Robotic Extraperitoneal Radical Prostatectomy: an Alternative Approach." The Journal of Urology, vol. 175, no. 3 Pt 1, 2006, pp. 945-50; discussion 951.
Joseph JV, Rosenbaum R, Madeb R, et al. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol. 2006;175(3 Pt 1):945-50; discussion 951.
Joseph, J. V., Rosenbaum, R., Madeb, R., Erturk, E., & Patel, H. R. (2006). Robotic extraperitoneal radical prostatectomy: an alternative approach. The Journal of Urology, 175(3 Pt 1), 945-50; discussion 951.
Joseph JV, et al. Robotic Extraperitoneal Radical Prostatectomy: an Alternative Approach. J Urol. 2006;175(3 Pt 1):945-50; discussion 951. PubMed PMID: 16469589.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic extraperitoneal radical prostatectomy: an alternative approach. AU - Joseph,J V, AU - Rosenbaum,R, AU - Madeb,R, AU - Erturk,E, AU - Patel,H R H, PY - 2005/05/02/received PY - 2006/2/14/pubmed PY - 2006/3/31/medline PY - 2006/2/14/entrez SP - 945-50; discussion 951 JF - The Journal of urology JO - J Urol VL - 175 IS - 3 Pt 1 N2 - PURPOSE: Laparoscopic radical prostatectomy with or without a robot has been increasingly performed worldwide, primarily using a transperitoneal approach. We report our experience with daVinci(R) robot assisted extraperitoneal laparoscopic radical prostatectomy. MATERIALS AND METHODS: A total of 325 patients underwent robot assisted extraperitoneal laparoscopic radical prostatectomy for clinically localized prostate cancer at our center during a 2-year period. Perioperative data, and oncological and functional results were prospectively recorded. RESULTS: Perioperative demographics included mean age, PSA and Gleason score, which were 60 years (range 42 to 76), 6.6 ng/ml (range 0.6 to 26) and 6 (range 5 to 9), respectively. Preoperative clinical stage was 81%, 16% and 3% for T1c, T2a and T2b, respectively. Average total operative time was 130 minutes (range 80 to 480). Intraoperative data included a mean blood loss of 196 cc with no open conversions. Bilateral, unilateral and nonnerve sparing prostatectomy was performed in 70%, 24% and 6% of patients, respectively. Of the patients 96% were discharged home within 8 to 23 hours of surgery. Pathological stage was pT2a, pT2b, pT3a and pT3b in 18%, 63%, 14% and 5% of all radical prostatectomy specimens, respectively, with an overall positive surgical margin rate of 13%. Two of 92 patients had positive nodal disease after lymph node dissection. Continence and erectile function were measured. CONCLUSIONS: The extraperitoneal approach offers the advantages of improved dexterity and visualization of the robot, while avoiding the abdominal cavity and potential associated morbidity. As surgeons gain more experience with this new technology, the extraperitoneal approach simulating the standard open retropubic technique is likely to gain popularity. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/16469589/Robotic_extraperitoneal_radical_prostatectomy:_an_alternative_approach_ L2 - https://www.jurology.com/doi/10.1016/S0022-5347(05)00340-X?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -