Evidence-based evolution of our robot-assisted laparoscopic prostatectomy (RALP) technique through 13,000 cases

Bhat, Kulthe Ramesh Seetharam; Moschovas, Marcio Covas; Önol, Fikret Fatih; Rogers, Travis; Reddy, Sunil; Corder, Cathy; Roof, Shannon; Patel, Vipul

doi:10.1007/s11701-020-01157-5

Cited by 24 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the surgical technique, the best series describing potency recovery following radical prostatectomy have never achieved 100% success rates. In this scenario, we have described several technical modifications to improve and maximize functional recovery over the years 7 . In our routine, the NVB preservation is planned according to the preoperative tumoral staging with imaging (MRI) and biopsy report (29).…”

Section: Our Technical Considerations For Ns-rarp After 15000 Casesmentioning

confidence: 99%

“…Recent studies have described that, in addition to the surgical technique, some important factors are associated with erectile dysfunction (ED) following robotic-assisted radical prostatectomy (RARP). These include preoperative Sexual Health Inventory for Men (SHIM) score, age, preoperative Gleason score, and Charlson Comorbidity Index (CCI) (7,8). After performing 15,000 cases, in this article we describe our current RARP technique with details and considerations regarding the optimal approach to neurovascular preservation (9).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurovascular bundle preservation in robotic-assisted radical prostatectomy: How I do it after 15.000 cases

Moschovas¹,

Patel²

2022

Int. braz j urol.

Self Cite

View full text Add to dashboard Cite

Despite the neuroanatomy knowledge of the prostate described initially in the 1980's and the robotic surgery advantages in terms of operative view magnification, potency outcomes following robotic-assisted radical prostatectomy still challenge surgeons and patients due to its multifactorial etiology. Recent studies performed in our center have described that, in addition to the surgical technique, some important factors are associated with erectile dysfunction (ED) following robotic-assisted radical prostatectomy (RARP). These include preoperative Sexual Health Inventory for Men (SHIM) score, age, preoperative Gleason score, and Charlson Comorbidity Index (CCI). After performing 15,000 cases, in this article we described our current Robotic-assisted Radical Prostatectomy technique with details and considerations regarding the optimal approach to neurovascular bundle preservation.

show abstract

Section: Our Technical Considerations For Ns-rarp After 15000 Casesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neurovascular bundle preservation in robotic-assisted radical prostatectomy: How I do it after 15.000 cases

Moschovas¹,

Patel²

2022

Int. braz j urol.

Self Cite

View full text Add to dashboard Cite

show abstract

“…17,19,21 Although minimally invasive techniques such as robotic surgery decrease perioperative impacts, surgical outcomes depend on several different factors, such as preoperative patient characteristics, age, SHIM score, cancer stage, and comorbidities. 10,13,22,23 In addition, surgical technique and nerve-sparing degree also play an important role along with postoperative management and patient follow-up protocols. 8,24 Due to the multifactorial in uence on surgical outcomes, to assess the differences and possible bene ts of the da Vinci SP and Xi robotic platforms, our study compared two groups with similar preoperative demographics (selected with a Propensity Score matching) undergoing robotic radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Comparison between intra and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

Moschovas¹,

Loy²,

Patel³

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Background The new SP robot incorporates a single trocar that houses a flexible camera and three bi-articulated arms, which minimizes the number of incisions needed to assess the surgical site, allowing for a less invasive procedure. Objectives To compare the postoperative pain scale and outcomes in patients with similar demographic characteristics undergoing robotic-assisted radical prostatectomy (RARP) with SP and Xi robots. Material and Methods One hundred consecutive patients undergoing RARP with the SP robot were matched, using a propensity score (PS), with 100 patients from a cohort of 1757 who were operated on with the da Vinci Xi from June 2019 to January 2021. We described and compared the perioperative pain scores and outcomes of both groups. Results The SP group had less blood loss (50cc vs. 62.5cc, P < 0.001) and longer operative time (114 min. vs. 94 min, P < 0.001). The only period we could show a difference in postoperative pain scores was 6 hours after surgery, with a small advantage for the SP (2 vs. 2.5, P < 0.001). Both groups had satisfactory postoperative continence recovery, 91% vs. 90% for the SP and Xi, respectively. The groups had a mean follow-up of 24.5 and 22 months for SP and Xi, respectively. The tumor stage and percentage of positive surgical margins were similar between groups (15% vs. 15%, P = 1). Conclusion Patients undergoing RARP with the SP had longer operative times with less blood loss than the Xi. However, despite the lower number of abdominal incisions on the SP, the groups had similar intraoperative performance, and we were unable to demonstrate clinically significant differences in postoperative pain scores between the groups 6, 12, and 18 hours after surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison between intra- and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

et al. 2023

Self Cite

View full text Add to dashboard Cite

BackgroundThe new SP robot incorporates a single trocar that houses a exible camera and three bi-articulated arms, which minimizes the number of incisions needed to assess the surgical site, allowing for a less invasive procedure. ObjectivesTo compare the postoperative pain scale and outcomes in patients with similar demographic characteristics undergoing robotic-assisted radical prostatectomy (RARP) with SP and Xi robots. Material and MethodsOne hundred consecutive patients undergoing RARP with the SP robot were matched, using a propensity score (PS), with 100 patients from a cohort of 1757 who were operated on with the da Vinci Xi from June 2019 to January 2021. We described and compared the perioperative pain scores and outcomes of both groups. ResultsThe SP group had less blood loss (50cc vs. 62.5cc, P < 0.001) and longer operative time (114 min. vs. 94 min, P < 0.001). The only period we could show a difference in postoperative pain scores was 6 hours after surgery, with a small advantage for the SP (2 vs. 2.5, P < 0.001). Both groups had satisfactory postoperative continence recovery, 91% vs. 90% for the SP and Xi, respectively. The groups had a mean follow-up of 24.5 and 22 months for SP and Xi, respectively. The tumor stage and percentage of positive surgical margins were similar between groups (15% vs. 15%, P = 1). ConclusionPatients undergoing RARP with the SP had longer operative times with less blood loss than the Xi. However, despite the lower number of abdominal incisions on the SP, the groups had similar intraoperative performance, and we were unable to demonstrate clinically signi cant differences in postoperative pain scores between the groups 6, 12, and 18 hours after surgery.

show abstract

Evidence-based evolution of our robot-assisted laparoscopic prostatectomy (RALP) technique through 13,000 cases

Cited by 24 publications

References 26 publications

Neurovascular bundle preservation in robotic-assisted radical prostatectomy: How I do it after 15.000 cases

Neurovascular bundle preservation in robotic-assisted radical prostatectomy: How I do it after 15.000 cases

Comparison between intra and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

Comparison between intra- and postoperative outcomes of the da Vinci SP and da Vinci Xi robotic platforms in patients undergoing radical prostatectomy

Contact Info

Product

Resources

About