Laparoscopic Radical Prostatectomy

Hoznek, Andràs; Salomon, Laurent; Olsson, Leif Eric; Antiphon, Patrick; Saint, F.; Cicco, Antony; Chopin, Dominique; Abbou, Clément‐Claude

doi:10.1159/000049747

Cited by 167 publications

(87 citation statements)

References 29 publications

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“…We also evaluated the learning curve of RALP, comparing these results over time in a single-surgeon patient cohort. The extraperitoneal LRP is now used routinely in our department, since 2000 [2,14]. The extraperitoneal approach is a safe and reproducible procedure, with a fast recovery after surgery [14].…”

Section: Discussionmentioning

confidence: 99%

“…The extraperitoneal LRP is now used routinely in our department, since 2000 [2,14]. The extraperitoneal approach is a safe and reproducible procedure, with a fast recovery after surgery [14]. The first RALP was performed in our department in 2001 [13], but RALP has been used routinely only since 2005 because the robot was not accessible to urologists during this period (2001)(2002)(2003)(2004)(2005).…”

Section: Discussionmentioning

confidence: 99%

“…The surgical technique and the different steps of the surgery were the same as our LRP technique [14]. Two continuous polyglactin sutures were used to make a running vesicourethral anastomosis.…”

Section: Betweenmentioning

confidence: 99%

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Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

et al. 2010

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surgeon were distributed into five groups according to the chronological order of the procedures. The mean follow-up after RALP was 18.3 months. Patient demographics, surgical data and postoperative variables were collected into a prospective database. Data were compared by chronological groups into single-surgeon cohort. RESULTSThe median operative time and blood loss were 140 min and 350 mL, respectively. The complication rate was 8.3%. Cancers were pT3-4 in 34.5%. The mean hospital stay and duration of bladder catheterization were 4.3 and 8.2 days, respectively. The rate of positive surgical margins (PSMs) was 17.2% in pT2 cancers. The recovery rate of continence was 98% at 12 months. Intraoperative time, blood loss and length of hospital stay were significantly improved after a short learning curve. The continence recovery, the rate and the length of PSM were also improved beyond the learning curve, but difference was not statistically significant. CONCLUSIONSRALP is a safe and reproducible procedure and offers a short learning curve for experienced laparoscopic surgeons. Beyond the learning curve, continued experience might also provide further improvements in terms of operative, pathological and functional results. KEYWORDSprostate cancer, radical prostatectomy, robotic assistance, learning curve Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVETo describe our current procedure of robotassisted laparoscopic radical prostatectomy (RALP), and to assess the effect of the learning curve on perioperative data, early oncological outcomes and functional results, as RALP has increasingly become a treatment option for men with localized prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

et al. 2010

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“…This is longer than, but still the same order of magnitude as, the time taken for ORRP. The likelihood of conversion to open surgery and re-operation is clearly related to experience with the procedure (Table 2 [2,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]). …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical prostatectomy: the initial UK series

et al. 2002

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Bilateral neurovascular bundle preservation was attempted in 58% of patients. The transfusion rate was 3%. The conversion and re-intervention rates were 1% and 2%, respectively. There were eight complications, six of which were in the initial 26 cases, i.e. bladder neck stenosis (two), and rectal injury, laparotomy for bleeding, premature drain removal leading to urinary peritonitis, ulnar nerve neuropraxia, port-site hernia and paralytic ileus in one each. The positive surgical margin rate was 16%. All patients had a PSA level of £ 0.1 ng/mL at 3 months. By 1 year 90% of patients were pad-free and 62% operated on using a bilateral nerve-sparing technique had erections. There were no biochemical failures. The mean (range) follow-up was 9.8 (1-24) months. Conclusion The present results are similar to those reported by other centres with greater experience and confirm that LRP is an effective, safe and precise technique. Once intial experience has been gained it offers advantages over open surgery in the form of a dry and magnified operative site, and a lower likelihood of blood transfusion, in addition to the generic advantages of laparoscopy.

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“…The necessity of transfusion varied from 1.6% to 31% among the analyzed series (15,(29)(30)(31)(32), Table-7. A particular area of concern is pulmonary embolism (PE) that is the main cause of death in the 0.5% patients who die perioperatively after cancer surgery (33). The true incidence of symptomatic venous thromboembolism (VTE) in patients undergoing LRP is still unclear.…”

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confidence: 99%

Laparoscopic radical prostatectomy: a review

et al. 2009

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Introduction:We offer an overview of the intra-, peri-and postoperative outcomes of laparoscopic radical prostatectomy (LRP) with the endpoint to evaluate potential advantages of this approach. Materials and Methods:We conducted an extensive Medline literature search (search terms "laparoscopic radical prostatectomy" and "radical prostatectomy") from 1990 until 2007. Only full-length English language articles identified during this search were considered for this analysis. A preference was given to the articles with large series with more than 100 patients. All pertinent articles concerning localized prostate cancer were reviewed. Conclusion: Pure LRP has shown to be feasible and reproducible but it is difficult to learn. Potential advantages over open surgery have to be confirmed by longer-term follow-up and adequately designed clinical studies.

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Laparoscopic Radical Prostatectomy

Cited by 167 publications

References 29 publications

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

Robot‐assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high‐volume laparoscopy reference centre

Laparoscopic radical prostatectomy: the initial UK series

Laparoscopic radical prostatectomy: a review

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