Update on Robotic Laparoscopic Radical Prostatectomy

Matsunaga, Garrett S.; Ahlering, Thomas E.; Skarecky, Douglas

doi:10.1100/tsw.2006.394

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…7,8 Ahlering et al also reported that a laparoscopically naïve yet experienced open surgeon using a robotic interface successfully transferred open surgical skills to a laparoscopic environment in 8-12 cases. 3 These reports, however, were based on operations carried out by well experienced open surgeons.…”

Section: Discussionmentioning

confidence: 99%

Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload

et al. 2015

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Objectives: To compare perioperative, oncological and functional outcomes of robotassisted radical prostatectomy between experienced and novice open radical prostatectomy surgeons in a laparoscopically naïve center with a limited caseload. Methods: Six surgeons carried out robot-assisted radical prostatectomy in 154 patients, which were divided into the following three groups: group 1 (n = 90), including patients operated on by a surgeon with experience in both open radical prostatectomy and robot-assisted radical prostatectomy; group 2 (n = 36), including patients operated on by two surgeons with experience in open radical prostatectomy only; and group 3 (n = 28), including patients operated on by three surgeons with limited experience in both open radical prostatectomy or robot-assisted radical prostatectomy. Results: Groups 2 and 3 did not differ significantly in their median values of external blood loss (P = 0.165) or console time (P = 0.103). Positive surgical margin rates for pT2 patients were also similar in these two groups: 21.2% (7/33) in group 2 and 22.7% (5/22) in group 3 (P = 0.894). Kaplan-Meier analysis showed that 12 months after robot-assisted radical prostatectomy the prostate-specific antigen-free rate for pT2 patients was 96.0% in group 2 and 100% in group 3, but the pad-free continence rate was just 91.0% in group 1, 88.0% in group 2 and 75.5% in group 3 (group 1 vs group 3, P = 0.037; group 2 vs group 3, P = 0.239). The major complication rate after robot-assisted radical prostatectomy was 3.3% (3/90) in group 1, 11.1% (4/36) in group 2 and 17.9% (5/28) in group 3 (group 1 vs group 3, P = 0.008; group 2 vs group 3; P = 0.441). Conclusions: Robot-assisted radical prostatectomy offers satisfactory postoperative outcomes even when carried out by surgeons with limited experience in open radical prostatectomy.

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Section: Discussionmentioning

confidence: 99%

Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload

et al. 2015

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“…Matsunaga et al. [13] reported that the initial experience and training seemed to be accelerated in the case of experienced open surgeons and that robotic assistance enabled both laparoscopically skilled and naive surgeons to achieve operative times similar to an accomplished standard laparoscopist within ≈20 cases.…”

Section: Discussionmentioning

confidence: 99%

Robotic vs open prostatectomy in a laparoscopically naive centre: a matched‐pair analysis

et al. 2009

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. All patients were operated by the same laparoscopically naive surgeons. The comparison was by matched-pair analysis. RESULTSThe baseline characteristics of the two groups were equivalent, although there was a higher percentage of patients with pT3/pT4 disease in the RRP group. As a proxy for oncological outcome, positive surgical margins were equivalent in the two groups (22% RARP vs 25% RRP, P = 0.77). The overall mean (range) surgical duration was significantly longer in RARP group, at 215 (165-450) min vs 160 (90-240) min in the RRP group ( P < 0.001). However, RARP had a statistically significant advantage over RRP for estimated blood loss, of 200 vs 800 mL ( P < 0.001), duration of catheterization (6 vs 7 days P < 0.001) and length of stay (3 vs 6 days, P < 0.001) The 3, 6 and 12-month continence rates were 70%, 93% and 97% vs 63%, 83% and 88% after RARP and RRP, respectively ( P = 0.15, 0.011 and 0.014). The 3, 6 and 12 month overall potency recovery rate was 31%, 43% and 61% vs 18%, 31% and 41%, after RARP and RRP, respectively ( P = 0.006, 0.045 and 0.003). CONCLUSIONOur initial experience showed the feasibility of RARP in a laparoscopically naive centre. RRP seems to be a faster procedure, whereas RARP provided better results in terms of estimated blood loss, hospitalization and functional results. The early oncological outcome seemed to be equivalent in the two groups.

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“…In urology, most of the reports demonstrated easy adaptation and shorter learning curve in robot-assisted surgery compared with laparoscopic surgery [16][17][18]. Robotic assistance allowed suturing and dexterity skills to be performed faster than laparoscopic assistance.…”

Section: Discussionmentioning

confidence: 99%

Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases

et al. 2009

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Update on Robotic Laparoscopic Radical Prostatectomy

Cited by 15 publications

References 26 publications

Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload

Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload

Robotic vs open prostatectomy in a laparoscopically naive centre: a matched‐pair analysis

Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases

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