Transition from pure laparoscopic to robotic-assisted radical prostatectomy: a single surgeon institutional evolution.
Publication/Presentation Date
1-1-2010
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.
Volume
28
Issue
1
First Page
81
Last Page
85
ISSN
1873-2496
Published In/Presented At
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), 81–85. https://doi.org/10.1016/j.urolonc.2009.07.002
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
20123354
Department(s)
Administration and Leadership
Document Type
Article