Korean J Urol.  2008 Mar;49(3):215-220. 10.4111/kju.2008.49.3.215.

Robot-Assisted Laparoscopic Radical Prostatectomy: Clinical Experience of 200 Cases

• Park SY
• Ham WS
• Choi YD
• Rha KH

• KMID: 1204622
• DOI: http://doi.org/10.4111/kju.2008.49.3.215

Abstract

PURPOSE: We report the initial functional and surgical results of 200 robot-assisted laparoscopic radical prostatectomies performed at our hospital, and evaluate the efficacy and safety of this surgery.
MATERIALS AND METHODS
Between July 2005 and July 2007, 200 patients underwent robot-assisted laparoscopic radical prostatectomy(RLRP). All cases were performed using the four-arm da Vinci(TM) robot system (Intuitive Surgical, Mountain View, CA USA). RLRP was performed by two surgeons. All operations were approached transperitoneally. We studied the perioperative parameters and early surgical outcome retrospectively.
RESULTS
The mean age at surgery was 64+/-8.2 years. The median preoperative prostate-specific antigen level was 8.24 ng/ml(range, 1.37-726.60 ng/ml) and the mean preoperative Gleason score was 6.5(range, 4-9). The median total operative time was 215 min(range, 140-418 min) and the median estimated blood loss was 300ml(range, 50-2,700ml). A positive surgical margin was found in 64 patients(32.0%). A normal diet was started 2.3 days after surgery and the median hospital stay was 5 days(range, 2-26 days). Among 71 patients with over 6 months follow-up, 69 patients (97.2%) were completely continent at 6 months after surgery and 29 patients(40.8%) were completely continent at catheter removal. In 58 patients who were younger than 65 years, potent preoperatively, and received a nerve sparing procedure, 31 patients(53.4%) were potent at 6 months after surgery.
CONCLUSIONS
We were able to verify the feasibility and safety of RLRP in the management of prostate cancer. A longer follow-up of the data and larger prospective studies are necessary to confirm these results.

Keyword

Robotics; Prostatectomy; Prostate neoplasms

Figure

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  Fig. 1. Port placement for robot-assisted laparoscopic radical prostatectomy (six-port technique).

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  Fig. 2. Dissection of the bladder neck.

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  Fig. 3. Veil of Aphrodite technique.

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  Fig. 4. Urethrovesical anastomosis.

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