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[Vattikuti institute prostatectomy (VIP) and current results].
Arch Esp Urol. 2007 May; 60(4):397-407.AE

Abstract

OBJECTIVES

To describe a technique of Robot Assisted Radical Prostatectomy (RAP) for localized carcinoma of the prostate, the Vattikuti Institute Prostatectomy (VIP) and an innovative incremental nerve preservation technique, the Veil of Aphrodite. We also report complications, oncological and functional outcomes in a cohort of the patient operated during 2001-2006.

METHODS

2,652 patients with localiced carcinoma of prostate underwent VIP at our centre between 2001-2006. Our current technique involves: early division of the bladder neck, preservation of the lateral pelvic fascia and control of the dorsal vein complex after apical dissection of the prostate. Oncological, functional and follow-up information was obtained through "ROBOSURG" data base, which is managed by an independent group not involved in the patient care. VIP, as it has evolved in our hands over a period of 5 years, has given excellent outcomes in terms of cancer control, continence and erectile function. Our modifications of the surgical technique had a singular focus on consistent improvement of the so called "Trifecta", taking radical retropubic prostatectomy (RRP) published data as a reference standard. We present our current technique of VIP with preservation of the lateral prostatic fascia ("Veil of Aphrodite").

RESULTS

In this report we include 2077 patients with follow-up ranging from 4 weeks to 260 weeks (median 68 weeks). We have a low incidence (1.5%) of perioperative complications. 97.6% of our patients had a hospital stay of less than 48 hours. There were 5.8% unscheduled postoperative visits. With the PSA cut-off limit of 0.4 ng/ml, the overall biochemical recurrence rate was 3.9%. Median duration of incontinence was 4 weeks; 0.8% patients had total incontinence at 12 months. The intercourse rate was 93% in men with no pre-operative erectile dysfunction undergoing veil nerve-sparing surgery, although only 51% returned to baseline function.

CONCLUSION

Vattikuti Institute Prostatectomy offers excellent patient recovery with significant reduction in first 30 days morbidity and provides excellent oncological and functional outcomes. The preservation of the "Veil of Aphrodite" helps in postoperative return of erectile function in patients with normal preoperative erectile function.

Authors+Show Affiliations

Vattikuti Urology Institute, Henry Ford Health System, 2799 West Grand Blvd., Detroit, MI 48202, USA. mbhanda1@hfhs.orgNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

17626532

Citation

Bhandari, Mahendra, and Mani Menon. "[Vattikuti Institute Prostatectomy (VIP) and Current Results]." Archivos Espanoles De Urologia, vol. 60, no. 4, 2007, pp. 397-407.
Bhandari M, Menon M. [Vattikuti institute prostatectomy (VIP) and current results]. Arch Esp Urol. 2007;60(4):397-407.
Bhandari, M., & Menon, M. (2007). [Vattikuti institute prostatectomy (VIP) and current results]. Archivos Espanoles De Urologia, 60(4), 397-407.
Bhandari M, Menon M. [Vattikuti Institute Prostatectomy (VIP) and Current Results]. Arch Esp Urol. 2007;60(4):397-407. PubMed PMID: 17626532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Vattikuti institute prostatectomy (VIP) and current results]. AU - Bhandari,Mahendra, AU - Menon,Mani, PY - 2007/7/14/pubmed PY - 2007/8/31/medline PY - 2007/7/14/entrez SP - 397 EP - 407 JF - Archivos espanoles de urologia JO - Arch Esp Urol VL - 60 IS - 4 N2 - OBJECTIVES: To describe a technique of Robot Assisted Radical Prostatectomy (RAP) for localized carcinoma of the prostate, the Vattikuti Institute Prostatectomy (VIP) and an innovative incremental nerve preservation technique, the Veil of Aphrodite. We also report complications, oncological and functional outcomes in a cohort of the patient operated during 2001-2006. METHODS: 2,652 patients with localiced carcinoma of prostate underwent VIP at our centre between 2001-2006. Our current technique involves: early division of the bladder neck, preservation of the lateral pelvic fascia and control of the dorsal vein complex after apical dissection of the prostate. Oncological, functional and follow-up information was obtained through "ROBOSURG" data base, which is managed by an independent group not involved in the patient care. VIP, as it has evolved in our hands over a period of 5 years, has given excellent outcomes in terms of cancer control, continence and erectile function. Our modifications of the surgical technique had a singular focus on consistent improvement of the so called "Trifecta", taking radical retropubic prostatectomy (RRP) published data as a reference standard. We present our current technique of VIP with preservation of the lateral prostatic fascia ("Veil of Aphrodite"). RESULTS: In this report we include 2077 patients with follow-up ranging from 4 weeks to 260 weeks (median 68 weeks). We have a low incidence (1.5%) of perioperative complications. 97.6% of our patients had a hospital stay of less than 48 hours. There were 5.8% unscheduled postoperative visits. With the PSA cut-off limit of 0.4 ng/ml, the overall biochemical recurrence rate was 3.9%. Median duration of incontinence was 4 weeks; 0.8% patients had total incontinence at 12 months. The intercourse rate was 93% in men with no pre-operative erectile dysfunction undergoing veil nerve-sparing surgery, although only 51% returned to baseline function. CONCLUSION: Vattikuti Institute Prostatectomy offers excellent patient recovery with significant reduction in first 30 days morbidity and provides excellent oncological and functional outcomes. The preservation of the "Veil of Aphrodite" helps in postoperative return of erectile function in patients with normal preoperative erectile function. SN - 0004-0614 UR - https://www.unboundmedicine.com/medline/citation/17626532/[Vattikuti_institute_prostatectomy__VIP__and_current_results]_ L2 - https://medlineplus.gov/prostatecancer.html DB - PRIME DP - Unbound Medicine ER -