Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation

Ahlering, Thomas E.; Eichel, Louis; Chou, David S.; Skarecky, Douglas

doi:10.1016/j.urology.2004.11.023

Cited by 116 publications

(58 citation statements)

References 19 publications

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“…Our surgical technique has been previously described, which includes a running Van Velthoven urethrovesical anastomosis, a cautery-free technique for the prostatic vascular pedicle and neurovascular bundle, Rocco reconstruction, and local endorectal hypothermia. 1,4,10,11 The indwelling catheter was removed on day 7, and cystography was not performed. All men were counseled on how to do routine Kegel exercises.…”

Section: Methodsmentioning

confidence: 99%

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Skarecky

Morales

Chang

et al. 2011

Journal of Endourology

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Background and Purpose: After removal of the Foley catheter after robot-assisted radical prostatectomy (RARP), recovery of continence can take days to months. We sought to identify a simple means to predict time to recovery of postoperative continence. Patients and Methods: Preoperative characteristics on 172 men who were undergoing RARP were entered into an electronic database. All men were queried via telephone and/or returned a 7-day log of pad use. Men without need for pads were excluded (n = 41). At 4 to 7 days, responses were grouped as: one pad (n = 55), two pads (n = 35), or three or more pads (n = 41). Patients returned self-addressed postcards noting the date of 0-pad urinary status. Univariate and multivariate analysis of variables were assessed for ability to predict time to continence. Results: No preoperative factors, such as age, International Index of Erectile Function-5, prostate-specific antigen level, American Urological Association symptom score, body mass index, uroflowmetry, nervesparing status, estimated blood loss, or prostate weight, were found to predict time to continence. Pad use at 4 to 7 days, however, was highly correlated with median time to continence. The median time to continence for men using one pad was 35 days, two pads was 42 days, and for three or more pads was 73 days (P = 0.0001). Conclusions: As has been previously reported, we found no reliable baseline factors that predicted postoperative time to 0-pad continence. We did find that determining pad usage at 4 to 7 days after catheter removal strongly predicted time to pad-free continence. This method is simpler then pad weights, predicts high-and low-risk men for delayed continence, and can be used for counseling/intervention.

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Section: Methodsmentioning

confidence: 99%

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Skarecky

Morales

Chang

et al. 2011

Journal of Endourology

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“…When applied to a bleeding area, the gelatin granules expand to produce a tamponade effect, and the thrombin converts the fibrinogen in the blood to fibrin, which helps produce a blood clot. 12,13 GMHS has been used to stop bleeding in various surgical procedures, including cardiac surgery, vascular surgery, 13 brain surgery 14 and urological surgery, 15 and it was shown to provide immediate and durable intraoperation hemostasis. GMHS is frequently applied to the prostatic fossa, where local recurrence is often observed following RP to control bleeding.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effects of gelatin matrix-embedded IL-12 gene-modified macrophages in a mouse model of residual prostate cancer

Tabata

Watanabe

Naruishi

et al. 2008

Prostate Cancer Prostatic Dis

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We evaluated the potential use of intraoperative gelatin matrix hemostatic sealant (GMHS; FloSeal; Baxter Healthcare) embedded with macrophages (M/) transduced with murine interleukin (IL)-12 recombinant adenoviral vector (G/M//AdmIL-12) for prevention of recurrence of prostate cancer following radical prostatectomy. Application of G/M//AdmIL-12 resulted in significant suppression of tumor growth and spontaneous lung metastases, a statistically significant survival advantage of the G/M//AdmIL-12-treated animals, more efficient trafficking of M/ to lymph nodes draining from the prostate and generation of systemic natural killer cell activity and tumor-specific cytolytic T lymphocyte responses compared to the controls in a preclinical mouse model of residual prostate cancer. Our data recommend this treatment as a novel adjuvant for prevention of local recurrence of prostate cancer following radical prostatectomy.

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“…Los resultados funcionales están aún por ver, al igual que el posible efecto tóxico del Floseal sobre los erectores 39 .…”

Section: Resultados Funcionalesunclassified

Prostatectomía radical laparoscópica: Revisión de la literatura. Nuestra experiencia

et al. 2006

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Introducción: En éste trabajo, hemos revisado las últimas publicaciones que hacen referencia a la Prostatectomía Radical Laparoscópica (PRL) hasta el 2005 y describimos nuestra serie en éste tipo de cirugía.Material y Métodos: Tras realizar una búsqueda en Internet, consultando revistas de reconocido prestigio, hemos seleccionado los artículos que hacen referencia a ésta técnica, resumiendo la actualidad de la PRL.Además, presentamos nuestra serie. Resultados: Los buenos resultados oncológicos y funcionales obtenidos con la PRL, y la posibilidad de realizar hernioplastias al igual que en cirugía abierta, hacen de la técnica, un servicio de calidad para el paciente.Conclusiones: Los avances de la técnica, como la utilización de la robótica, cámaras de 3 CCD y la experiencia del cirujano, hacen de la PRL una técnica segura y de calidad, lo que nos obliga, en la medida de nuestras posibilidades, a ofrecerla al paciente.Palabras clave: Laparoscopia. Cáncer de próstata. Prostatectomía radical. ABSTRACT ANALYSIS OF A LAPAROSCOPIC RADICAL PROSTATECTOMY PROGRAM WITH 544 CASESIntroduction: This article reviews the latest publications that refer to Laparoscopic Radical Prostatectomy (LRP) up to 2005, and describes our series of patients for this type of surgery.Materials and methods: After a search of the Internet and consulting journals of renowned prestige, we selected articles that refer to this technique and we summarise the latest developments in LRP. We also present our series of patients.Results: In view of the good oncologic and functional results obtained with LRP, and the possibility of performing hernioplasty as in open surgery, this technique provides a high quality service for patients.Conclusions: Due to the advances in the safety and quality of this technique, such as the use of robots, 3 CCD cameras, and the surgeon's experience, LRP should be offered to our patients, if it is within our means.

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Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation

Cited by 116 publications

References 19 publications

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Simple Method to Predict Return of Continence After Robot-Assisted Radical Prostatectomy

Therapeutic effects of gelatin matrix-embedded IL-12 gene-modified macrophages in a mouse model of residual prostate cancer

Prostatectomía radical laparoscópica: Revisión de la literatura. Nuestra experiencia

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