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Transition from pure laparoscopic to robotic-assisted radical prostatectomy: a single surgeon institutional evolution.
Urol Oncol. 2010 Jan-Feb; 28(1):81-5.UO

Abstract

PURPOSE

To review a single surgeon experience of transitioning to a robotic-assisted laparoscopic prostatectomy program (RALP) with prior pure laparoscopic radical prostatectomy (LRP) experience.

MATERIALS AND METHODS

A retrospective review of surgical results from a single surgeon performing LRP transitioning to RALP was performed. Two hundred five patients undergoing RALP by a single, fellowship-trained, urologic oncologist were analyzed and compared with 45 patients undergoing LRP by the same surgeon. Operative, pathologic, and functional outcomes were evaluated. Validated questionnaires, including the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF), were utilized for assessing urinary and sexual parameters.

RESULTS

Preoperative parameters (age, PSA, Gleason score) were similar in both RALP and LRP groups. Operative time (190 vs. 299 minutes), estimated blood loss (253 vs. 299 ml), and length of stay (1.6 vs. 2.6 days) were reduced in RALP vs. LRP. Although not statistically significant, there was a trend toward fewer transfusions with RALP (2.0% vs. 4.4%) as well as a lower positive margin rate in organ-confined (pT2) disease (9.8%, RALP vs. 20%, LRP). Continence at 12 months was 94% following RALP as opposed to 82% after LRP. In preoperatively potent men undergoing bilateral nerve sparing procedures, RALP conferred 81% potency at 12 months as opposed to only 62% following LRP.

CONCLUSIONS

The transition from LRP to RALP, in concert with an institutional commitment to a successful robotic surgery program, has yielded superior operative, oncologic, and functional results.

Authors+Show Affiliations

Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA. edouard.trabulsi@jefferson.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20123354

Citation

Trabulsi, Edouard J., et al. "Transition From Pure Laparoscopic to Robotic-assisted Radical Prostatectomy: a Single Surgeon Institutional Evolution." Urologic Oncology, vol. 28, no. 1, 2010, pp. 81-5.
Trabulsi EJ, Zola JC, Gomella LG, et al. Transition from pure laparoscopic to robotic-assisted radical prostatectomy: a single surgeon institutional evolution. Urol Oncol. 2010;28(1):81-5.
Trabulsi, E. J., Zola, J. C., Gomella, L. G., & Lallas, C. D. (2010). Transition from pure laparoscopic to robotic-assisted radical prostatectomy: a single surgeon institutional evolution. Urologic Oncology, 28(1), 81-5. https://doi.org/10.1016/j.urolonc.2009.07.002
Trabulsi EJ, et al. Transition From Pure Laparoscopic to Robotic-assisted Radical Prostatectomy: a Single Surgeon Institutional Evolution. Urol Oncol. 2010 Jan-Feb;28(1):81-5. PubMed PMID: 20123354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transition from pure laparoscopic to robotic-assisted radical prostatectomy: a single surgeon institutional evolution. AU - Trabulsi,Edouard J, AU - Zola,Joseph C, AU - Gomella,Leonard G, AU - Lallas,Costas D, PY - 2009/02/13/received PY - 2009/07/03/revised PY - 2009/07/03/accepted PY - 2010/2/4/entrez PY - 2010/2/4/pubmed PY - 2010/5/26/medline SP - 81 EP - 5 JF - Urologic oncology JO - Urol Oncol VL - 28 IS - 1 N2 - PURPOSE: To review a single surgeon experience of transitioning to a robotic-assisted laparoscopic prostatectomy program (RALP) with prior pure laparoscopic radical prostatectomy (LRP) experience. MATERIALS AND METHODS: A retrospective review of surgical results from a single surgeon performing LRP transitioning to RALP was performed. Two hundred five patients undergoing RALP by a single, fellowship-trained, urologic oncologist were analyzed and compared with 45 patients undergoing LRP by the same surgeon. Operative, pathologic, and functional outcomes were evaluated. Validated questionnaires, including the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF), were utilized for assessing urinary and sexual parameters. RESULTS: Preoperative parameters (age, PSA, Gleason score) were similar in both RALP and LRP groups. Operative time (190 vs. 299 minutes), estimated blood loss (253 vs. 299 ml), and length of stay (1.6 vs. 2.6 days) were reduced in RALP vs. LRP. Although not statistically significant, there was a trend toward fewer transfusions with RALP (2.0% vs. 4.4%) as well as a lower positive margin rate in organ-confined (pT2) disease (9.8%, RALP vs. 20%, LRP). Continence at 12 months was 94% following RALP as opposed to 82% after LRP. In preoperatively potent men undergoing bilateral nerve sparing procedures, RALP conferred 81% potency at 12 months as opposed to only 62% following LRP. CONCLUSIONS: The transition from LRP to RALP, in concert with an institutional commitment to a successful robotic surgery program, has yielded superior operative, oncologic, and functional results. SN - 1873-2496 UR - https://www.unboundmedicine.com/medline/citation/20123354/Transition_from_pure_laparoscopic_to_robotic_assisted_radical_prostatectomy:_a_single_surgeon_institutional_evolution_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(09)00202-6 DB - PRIME DP - Unbound Medicine ER -