Tags

Type your tag names separated by a space and hit enter

Vattikuti Institute prostatectomy: contemporary technique and analysis of results.
Eur Urol. 2007 Mar; 51(3):648-57; discussion 657-8.EU

Abstract

OBJECTIVES

Contemporary techniques of radical prostatectomy achieve excellent oncologic outcomes; erectile dysfunction is the most common adverse effect. We have modified our technique of robotic radical prostatectomy (Vattikuti Institute prostatectomy [VIP]) in an attempt to minimize decrease of erectile function while maintaining the excellent oncologic outcomes achieved by the radical retropubic prostatectomy. We present our current technique of VIP with preservation of the lateral prostatic fascia ("veil of Aphrodite").

METHODS

A total of 2652 patients with localized carcinoma prostate underwent VIP. The salient features of our current technique are early transection of the bladder neck, preservation of the prostatic fascia, and control of the dorsal vein complex after dissection of the prostatic apex. Oncologic and functional outcomes were obtained through a questionnaire collected by a third party not involved in patient care.

RESULTS

Complete follow-up information was obtained in 1142 patients with a minimum follow-up of 12 mo (range: 12-66 mo; median: 36 mo). The actuarial 5-yr biochemical recurrence rate was 8.4% and the actual biochemical recurrence rate was 2.3%. Median duration of incontinence was 4 wk; 0.8% patients had total incontinence at 12 mo. The intercourse rate was 93% in men with no preoperative erectile dysfunction undergoing veil nerve-sparing surgery, although only 51% returned to baseline function.

CONCLUSIONS

VIP with veil nerve sparing offers oncologic and continence results that are comparable to the results of conventional nerve-sparing radical prostatectomy. Early potency results are encouraging.

Authors+Show Affiliations

Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202, United States. ashriva1@hfhs.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17097214

Citation

Menon, Mani, et al. "Vattikuti Institute Prostatectomy: Contemporary Technique and Analysis of Results." European Urology, vol. 51, no. 3, 2007, pp. 648-57; discussion 657-8.
Menon M, Shrivastava A, Kaul S, et al. Vattikuti Institute prostatectomy: contemporary technique and analysis of results. Eur Urol. 2007;51(3):648-57; discussion 657-8.
Menon, M., Shrivastava, A., Kaul, S., Badani, K. K., Fumo, M., Bhandari, M., & Peabody, J. O. (2007). Vattikuti Institute prostatectomy: contemporary technique and analysis of results. European Urology, 51(3), 648-57; discussion 657-8.
Menon M, et al. Vattikuti Institute Prostatectomy: Contemporary Technique and Analysis of Results. Eur Urol. 2007;51(3):648-57; discussion 657-8. PubMed PMID: 17097214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vattikuti Institute prostatectomy: contemporary technique and analysis of results. AU - Menon,Mani, AU - Shrivastava,Alok, AU - Kaul,Sanjeev, AU - Badani,Ketan K, AU - Fumo,Michael, AU - Bhandari,Mahendra, AU - Peabody,James O, Y1 - 2006/11/03/ PY - 2006/04/30/received PY - 2006/10/23/accepted PY - 2006/11/14/pubmed PY - 2007/4/11/medline PY - 2006/11/14/entrez SP - 648-57; discussion 657-8 JF - European urology JO - Eur Urol VL - 51 IS - 3 N2 - OBJECTIVES: Contemporary techniques of radical prostatectomy achieve excellent oncologic outcomes; erectile dysfunction is the most common adverse effect. We have modified our technique of robotic radical prostatectomy (Vattikuti Institute prostatectomy [VIP]) in an attempt to minimize decrease of erectile function while maintaining the excellent oncologic outcomes achieved by the radical retropubic prostatectomy. We present our current technique of VIP with preservation of the lateral prostatic fascia ("veil of Aphrodite"). METHODS: A total of 2652 patients with localized carcinoma prostate underwent VIP. The salient features of our current technique are early transection of the bladder neck, preservation of the prostatic fascia, and control of the dorsal vein complex after dissection of the prostatic apex. Oncologic and functional outcomes were obtained through a questionnaire collected by a third party not involved in patient care. RESULTS: Complete follow-up information was obtained in 1142 patients with a minimum follow-up of 12 mo (range: 12-66 mo; median: 36 mo). The actuarial 5-yr biochemical recurrence rate was 8.4% and the actual biochemical recurrence rate was 2.3%. Median duration of incontinence was 4 wk; 0.8% patients had total incontinence at 12 mo. The intercourse rate was 93% in men with no preoperative erectile dysfunction undergoing veil nerve-sparing surgery, although only 51% returned to baseline function. CONCLUSIONS: VIP with veil nerve sparing offers oncologic and continence results that are comparable to the results of conventional nerve-sparing radical prostatectomy. Early potency results are encouraging. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/17097214/Vattikuti_Institute_prostatectomy:_contemporary_technique_and_analysis_of_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(06)01350-9 DB - PRIME DP - Unbound Medicine ER -