Total extra-peritoneal (TEP) access for robotic-assisted laparoscopic radical prostatectomy (RARP) in patients with prior major abdominal surgeries: A step-by-step approach

Lim, Ee Jean; Chen, K.; Ng, Tze Kiat; Tay, Kae Jack; Ho, Henry; Yuen, J.S.P.

doi:10.1016/j.urolvj.2020.100056

Cited by 2 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although there is a learning curve involved in the TEP approach to RARP, fortunately, it is a consistently reproducible surgical method of access to the prostate, even in patients with a past history of laparotomy. 16 It is already a preferred surgical approach for laparoscopic radical prostatectomy; hence, a wider adoption by robotic surgeons is possible. Furthermore, the technique is well-described with a step-by-step video illustration previously described.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory robot‐assisted laparoscopic radical prostatectomy with extended recovery by total extraperitoneal approach

et al. 2021

View full text Add to dashboard Cite

Objective: To evaluate the feasibility of performing robot-assisted laparoscopic radical prostatectomy in an ambulatory with extended recovery setting by using a total extraperitoneal approach. Methods: Patients with low-to intermediate-risk, prostate cancer were prospectively recruited in the ambulatory robot-assisted laparoscopic radical prostatectomy with extended recovery by total extraperitoneal approach group (n = 30), and a matched-pair inpatient surgery control group by total extraperitoneal approach (n = 20). Objective discharge criteria were based on the postanesthesia discharge scoring system. All patients underwent preoperative counseling on preoperative preparation and postoperative care. Results: There were no statistically significant differences between the ambulatory with extended recovery-total extraperitoneal approach and inpatient-total extraperitoneal approach groups in patient factors (age, body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index), disease factors (prostate-specific antigen, clinical T stage, biopsy Gleason score, prostate volume) and peri-operative parameters (operative time, blood loss, Trendelenburg angle). All total extraperitoneal robot-assisted laparoscopic radical prostatectomy patients (ambulatory with extended recovery and inpatient surgery groups) met the postanesthesia discharge scoring system discharge criteria ≤23 h from admission. The mean hospital stays for ambulatory with extended recovery-total extraperitoneal and inpatient-total extraperitoneal groups were 20.3 and 52.4 h, respectively (P < 0.001). A total of 29 of 30 patients (97%) in the ambulatory with extended recovery-total extraperitoneal group were discharged ≤23 h of admission. Conclusions: This is the first prospective evaluation of robot-assisted laparoscopic radical prostatectomy by the total extraperitoneal approach, showing that the short-stay ambulatory with extended recovery approach is safe, feasible and with a high success rate. Total extraperitoneal surgical approach is a critical factor for the success of the ambulatory with extended recovery protocol.

show abstract

Section: Discussionmentioning

confidence: 99%