Retzius-Sparing Robot-Assisted Robotic Prostatectomy

Davis, Meghan F.; Egan, Jillian; Marhamati, Shawn; Galfano, Antonio; Kowalczyk, Keith

doi:10.1016/j.ucl.2020.09.012

Cited by 31 publications

(29 citation statements)

References 33 publications

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“…However, when pT stage subgroups were compared, no statistical significance was found (18). Also, many studies comparing Rs-RARP and S-RARP reported similar PSM rate and biochemical recurrence-free survival (8). In our study, in accordance with the literature, there was no significant difference in PSM rate between the groups.…”

Section: Discussionsupporting

confidence: 84%

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Does transition from standard to Retzius-sparing technique in robot-assisted radical prostatectomy affect the functional and oncological outcomes?

Anıl

Karamık

Yıldız

et al. 2021

Arch Ital Urol Androl

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Objective: To appraise the outcomes on the Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) learning curve of a surgeon with previous experience of anterior (standard) RARP. Materials and methods: The first 50 cases during the Rs-RARP learning curve (group 1) and 50 cases after the second 100 cases with the standard approach (group 2) were comprised in the study. Patients who used zero or one safety pads were considered continent. Erectile function recuperation was characterized as the competence to achieve penetrative intercourse without receiving any medication. All patients were reevaluated at two weeks, first, third, sixth, and 12th months after surgery using IIEF-5, PSA level, and continence status. Results: Immediate continence rates following catheter removal were 32/50 (64%) in Rs-RARP group and 26/50 (52%) in S-RARP group (p = 0.224). The continence recovery rate was 48/50 (96%) in Rs-RARP group and 46/50 (92%) in the S-RARP group at 12 months follow-up (p = 0.400). Total nerve-sparing surgery was enforced in 36/50 (72%) patients for group 1 and 35/50 (70%) patients for group 2. Potency recovery was 27/43 (62.8%) in Rs-RARP and 30/44 (68.2%) for S-RARP at 12 months follow up (p = 0.597). Surgical margin positivity was detected in 6/50 (12%) cases in the Rs-RARP group and in 4/50 (8%) cases in the S-RARP (p = 0.444). Conclusions: Functional and oncological results are not negatively affected in the first 50 cases for a surgeon who is experienced in S-RARP before transition to the Rs-RARP method.

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Section: Discussionsupporting

confidence: 84%

“…One-third of men with localized prostate cancer undergo radical prostatectomy (8). Incontinence is an adverse effect faced by patients after radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Does transition from standard to Retzius-sparing technique in robot-assisted radical prostatectomy affect the functional and oncological outcomes?

Anıl

Karamık

Yıldız

et al. 2021

Arch Ital Urol Androl

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“…Continence is one of the most important indicators for patients after radical prostatectomy and is directly related to patient quality of life after radical prostatectomy. The retention of continence mainly depends on the following factors: preservation of the neurovascular bundle, maximum preservation of the bladder neck and urethral length, and preservation of the puboprostatic ligaments [ 16 ]. Approximately 4% of patients who undergo radical prostatectomy need additional surgery to correct incontinence [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

A comparison of the da Vinci Xi vs. da Vinci Si surgical systems for radical prostatectomy

Lei

Xie

et al. 2021

BMC Surg

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Background To compare the perioperative and short-term efficacy and cost of the da Vinci Xi and da Vinci Si surgical systems for radical prostatectomy. Methods We retrospectively analyzed the clinical data of 175 patients with prostate cancer who underwent radical prostatectomy with the da Vinci Si or Xi surgical systems in our hospital from June 2019 to June 2020. Of the 175 patients, 82 underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Xi surgery system, and 93 patients underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Si surgical system. The perioperative outcomes, short-term efficacy and costs were compared between the two groups. Results The anesthesia time, operation time, docking time, indwelling catheter time and postoperative bed rest time in the Xi group were shorter than those in the Si group (respectively, 268.8 min vs. 219.3 min, P = 0.001; 228.2 min vs. 259.6 min, P < 0.001; 7.4 min vs. 12.7 min, P < 0.001; 8.6 d vs. 9.7 d, P = 0.036; 2.2 d vs. 2.6 d, P = 0.002). However, the total cost of hospitalization and the cost of intraoperative consumables in the Xi group were higher than those in the Si group (84,740.7 vs. 76,739.1 ¥, P = 0.003; 13,199.4 vs. 10,823.0 ¥, P = 0.019). Conclusions Although the cost of robot-assisted radical prostatectomy is higher, compared with the Si system, the Xi system has better perioperative outcomes and can provide similar short-term efficacy and oncology outcomes.

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“…Some authors have reported alternative approaches to the robotic retropubic approach, with Retzius‐sparing approach being the most commonly reported. In 2013, Galfano et al reported this technique, whereby the bladder is left suspended to the anterior abdominal wall and access to the prostate is achieved through a peritoneotomy posterior to the bladder and seminal vesicles 18,19 . Initial reports of this technique showed a high T2‐positive margin rate compared with matched traditional robotic prostatectomy.…”

Section: Robotic Radical Prostatectomymentioning

confidence: 99%