Laparoscopic Radical Prostatectomy With a Remote Controlled Robot

ABBOU, CL??MENT-CLAUDE; Hoznek, A.; Salomon, Laurent; Olsson, Leif Eric; Lobonţiu, Adrian; Saint, F.; Cicco, Antony; Antiphon, Patrick; Chopin, Dominique

doi:10.1097/00005392-200106000-00027

Cited by 149 publications

(80 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After initially embarking into cardiothoracic surgery, the da Vinci robot found popularity within the urological community. From the initial descriptions of RALP in 2000 [10, 11], it has become widely adopted by urologists. By 2008, roughly 80% of RPs in the United States were performed robotically [12].…”

Section: Introductionmentioning

confidence: 99%

Advances in Robotic-Assisted Radical Prostatectomy over Time

2013

View full text Add to dashboard Cite

Since the introduction of robot-assisted radical prostatectomy (RALP), robotics has become increasingly more commonplace in the armamentarium of the urologic surgeon. Robotic utilization has exploded across surgical disciplines well beyond the fields of urology and prostate surgery. The literature detailing technical steps, comparison of large surgical series, and even robotically focused randomized control trials are available for review. RALP, the first robot-assisted surgical procedure to achieve widespread use, has recently become the primary approach for the surgical management of localized prostate cancer. As a result, surgeons are constantly trying to refine and improve upon current technical aspects of the operation. Recent areas of published modifications include bladder neck anastomosis and reconstruction, bladder drainage, nerve sparing approaches and techniques, and perioperative and postoperative management including penile rehabilitation. In this review, we summarize recent advances in perioperative management and surgical technique for RALP.

show abstract

Section: Introductionmentioning

confidence: 99%

Advances in Robotic-Assisted Radical Prostatectomy over Time

2013

View full text Add to dashboard Cite

show abstract

“…The advantages of the multi-armed robotic telemanipulator system in terms of improved dexterity of operation of laparoscopic instruments by increasing articulation and scaling together with the three-dimensional magnified image all set in an ergonomic platform encouraged a number of centers, particularly in the USA, to apply this system to RP. It was also thought that the greater scope for telemedicine mentoring and the ability of the robot to scale surgeon movements and hence reduce unwanted movements such as tremor would widen the group of surgeons who could achieve competency at keyhole prostatectomy [18,19]. …”

Section: Discussionmentioning

confidence: 99%

Developing a Robotic Prostatectomy Service and a Robotic Fellowship Programme - Defining the Learning Curve

et al. 2014

View full text Add to dashboard Cite

Introduction: Robotic radical prostatectomy (RRP) is an established treatment for prostate cancer in selected centres with appropriate expertise. We studied our single-centre experience of developing a RRP service and subsequent training of 2 additional surgeons by the initial surgeon and the introduction of United Kingdom's first nationally accredited robotic fellowship training programme. We assessed the learning curve of the 3 surgeons with regard to peri-operative outcomes and oncological results. Patients and Methods: Three hundred consecutive patients underwent RRP between November 2008 and August 2012. Patients were divided into 3 equal groups (Group 1, case 1-100; Group 2, case 101-200; and Group 3, case 201-300). Age, ASA score, preoperative co-morbidities and indications for laparoscopic radical prostatectomy were comparable for all 3 patient groups. Peri-operative and oncological outcomes were compared across all 3 groups to assess the impact of the learning curve for laparoscopic radical prostatectomy. All surgical complications were classified using the Clavien-Dindo system. Results: The mean age was 60.7 years (range 41-74). There was a significant reduction in the mean console time (p < 0.001), operating time (p < 0.001), mean length of hospital stay (p < 0.001) and duration of catheter (p < 0.001) between the 3 groups as the series progressed. The two most important factors predictive of positive surgical margins (PSM) at RRP were the initial prostate specific antigen (PSA) and tumor stage at diagnosis. The overall PSM rate was 26.7%. For T2/T3 tumors the incidence of PSM reduced as the series progressed (Group 1- 22%, Group 2- 32% and Group 3- 26%). The incidence of major complications i.e. grade Clavien-Dindo system score ≤ III was 2% (6/300). Conclusion: RRP is a safe procedure with low morbidity. As surgeons progress through the learning curve peri-operative parameters and oncological outcomes improve. This learning curve is not affected by the introduction of a fellowship-training programme. Using a carefully structured mentored approach, RRP can be safely introduced as a new procedure without compromising patient outcomes.

show abstract

“…Robotic-assisted laparoscopic radical prostatectomy (RARP) was first reported in 2000 (Abbou et al, 2000). Since then the number of patients undergoing RARP for prostate cancer has steadily increased.…”

Section: Prostatectomymentioning

confidence: 99%