Vattikuti Institute Prostatectomy: Technical Modifications in 2009

Menon, Mani; Shrivastava, Aviral; Bhandari, Mahendra; Satyanarayana, Ramgopal; Siva, Siddharth; Agarwal, Piyush K.

doi:10.1016/j.eururo.2009.04.032

Cited by 142 publications

(74 citation statements)

References 24 publications

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“…When these anatomic boundaries are respected, PLND usually retrieves ≥10 lymph nodes [ 21 ]. Freicke et al [ 22 ], Ham et al [ 23 ], and Menon et al [ 24 ] reported the feasibility of an extended lymph node dissection in course of RARP, including external iliac, internal iliac, and obturator lymph nodes. They obtained mean numbers of nodes ranging from 12 to 19 and positive node rates ranging from 11 to 24 %, according to the different patient characteristics [ 25 ].…”

Section: Robot-assisted Lymph Node Dissectionmentioning

confidence: 98%

Robot-Assisted Radical Prostatectomy

Rocco

Coelho

Cozzi

et al. 2014

Minimally Invasive Urology

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In the field of oncologic urologic surgery, robot-assisted radical prostatectomy (RARP) represents the main application of the robotic approach. RARP is currently the leading urologic use of the da Vinci system, and more than 80 % of the radical prostatectomies performed in the USA in 2011 were carried out by robot-assisted surgery. Indications for RARP are the same with those for radical retropubic prostatectomy (RRP), and RARP has also been described as a salvage surgical treatment after radiotherapy (RT), brachytherapy, and high-intensity focused ultrasound. Under an oncological point of view, RARP offers at least the same results of RRP also in higher-risk patients. Extended lymph node dissection yielding a reasonably high number of lymph nodes is feasible during RARP. The mean complication rate of RARP is 9 % (range, 3–26 %). Twelve-month urinary incontinence rates after RARP range from 4 to 31 %, with significant advantage in favor of RARP in comparison with RRP and laparoscopic radical prostatectomy. RARP is associated with an incidence of 12- and 24-month erectile dysfunction ranging from 10 to 46 % and from 6 to 37 %, respectively. A significant advantage in favor of RARP in comparison with RRP in terms of 12 months’ potency rates has been observed. Concomitant good oncological, continence, and potency outcomes define the concept of “trifecta.”\ud This chapter presents the technique for RARP described by Patel, which introduces some differences from the standard laparoscopic and robotic technique described previously

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Section: Robot-assisted Lymph Node Dissectionmentioning

confidence: 98%

Robot-Assisted Radical Prostatectomy

Rocco

Coelho

Cozzi

et al. 2014

Minimally Invasive Urology

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“…Insgesamt kann man sagen, dass die Potenzraten für die RALP bei bilateralem Nerverhalt mit >75% nach 12 Monaten (mit/ohne PDE-5-Inhibitoren) sehr gut sind [25,26]. Technische Modifikationen mit einer Extension der nervenerhaltenden Präpa-ration nach ventral bis 1 und 11 Uhr ("superveil") ermöglichen sogar Potenzraten von >90% für selektionierte, junge Patienten mit einem durchschnittlichen Patientenalter von 55 (40-72) Jahren [28].…”

Section: Potenzerhaltungunclassified

Radikale Prostatektomie – pro robotisch

Gillitzer

2012

Urologe

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Anatomical radical prostatectomy was introduced in the early 1980s by Walsh and Donker. Elucidation of key anatomical structures led to a significant reduction in the morbidity of this procedure. The strive to achieve similar oncological and functional results to this gold standard open procedure but with further reduction of morbidity through a minimally invasive access led to the establishment of laparoscopic prostatectomy. However, this procedure is complex and difficult and is associated with a long learning curve. The technical advantages of robotically assisted surgery coupled with the intuitive handling of the device led to increased precision and shortening of the learning curve. These main advantages, together with a massive internet presence and aggressive marketing, have resulted in a rapid dissemination of robotic radical prostatectomy and an increasing patient demand. However, superiority of robotic radical prostatectomy in comparison to the other surgical therapeutic options has not yet been proven on a scientific basis. Currently robotic-assisted surgery is an established technique and future technical improvements will certainly further define its role in urological surgery. In the end this technical innovation will have to be balanced against the very high purchase and running costs, which remain the main limitation of this technology.

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“…Prospektiv randomisierte Studien zu "offen vs. Da Vinci" sind wahrscheinlich nicht mehr durchsetzbar. Fazit: Das Marketing war schneller als die Wissenschaft (s. auch Ash Tewari auf iclinics.org, 2010; [9,10]). …”

Section: Operationstechnikunclassified

Prostatakarzinom: ein Update

Hohenfellner

2010

Urologe

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2009 Has been a year of high profile publishing about prostate cancer (PCa): To call in the first instance the S3 guideline and the ERSPC. The ERSPC especially as the basis for that in addition to the detection of prostate cancer, the treatment must be differentiated; overtreatment in particular may be avoided through the implementation of active surveillance protocols. In radical prostatectomy (RPx), increasingly the therapeutic value of lymphadenectomy is detected. Current issues in radiation oncology concern the efficacy and indications of brachytherapy, dose escalation with external beam radiotherapy and the differential indication of adjuvant vs. salvage radiotherapy after RPx. Similarly, the indication for salvage RPx after primary radiotherapy. To mention in systemic therapy are the GnRH antagonists, the so-called super-antiandrogens and the different approaches to immunotherapy of prostate cancer.

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Vattikuti Institute Prostatectomy: Technical Modifications in 2009

Cited by 142 publications

References 24 publications

Robot-Assisted Radical Prostatectomy

Robot-Assisted Radical Prostatectomy

Radikale Prostatektomie – pro robotisch

Prostatakarzinom: ein Update

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