Single-Port Robot-Assisted Perineal Radical Prostatectomy: Our Initial Experience

Abstract Purpose: To evaluate the clinical value of robot-assisted perineal radical prostatectomy (RPRP) in the treatment of early localized prostate cancer.Methods: We retrospectively analyzed 3 consecutive patients diagnosed with prostate cancer from January 2020 to May 2020 who received RPRP in our center. The main outcomes assessed were operating time, perioperative complications and need for conversion to open surgery. Results: 3 patients successfully underwent RPRP with no conversion to open surgery. No intra-operative complications were seen. Average operative time was 201.67±61.53 min, console time was131.67±32.53 min, with an estimated blood loss of 183.33±28.87mL. 2 patients were discharged within 10 days postoperatively with perineal drainages removed. The Foley catheter was removed 2 weeks after surgery. One patient had a positive surgical margin (33.3%). 2 patients were continent immediately after removal of the Foley catheter, 1 patient was continent 1 month postoperatively. The sexual function of 2 patients recovered within 1 month and 1 patient recovered within 3 months. The PSA reexamination was 0-0.1µg/L one month after operation.Conclusion: For patients with early localized prostate cancer, robot-assisted perineal radical prostatectomy is a safe and effective method, and has outstanding advantages in radical tumor resection and postoperative urine control.

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Retzius-sparing robot-assisted radical prostatectomy: initial experience and surgical technique

Urologicheskie vedomosti ◽

10.17816/uroved9419-24 ◽

2020 ◽

Vol 9 (4) ◽

pp. 19-24

Author(s):

Dmitry M. Ilin ◽

Bahman G. Guliev

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Surgical Technique ◽

Intraoperative Complications ◽

Surgical Margin ◽

Operation Time ◽

Localized Prostate Cancer ◽

Positive Surgical Margin ◽

Initial Experience ◽

Robot Assisted

To present own initial experience of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) and surgical technique. In OctoberNovember 2019 on the basis of the Urological Department and the Center for Robotic Surgery of City Mariinsky Hospital (Saint Petersburg, Russia) five patients with localized prostate cancer were treated with RS-RARP. The operation time was from 140 to 205 min. The blood loss volume was from 50 to 250 ml. No conversions and intraoperative complications were recorded. Nervous-saving RS-RARP was performed in three patients. No blood transfusions were performed. Two patients faced Clavien Grade I postoperative complications. Immediate continence after removal of the urethral catheter was noted in 3 out of 5 patients. All the patients became continent for 2 weeks. One extraprostatic positive surgical margin was recorded. RS-RARPis an accessible technique for treating patients with localized prostate cancer, which allows achieving high early results. It is necessary to accumulate more experience of such surgeries to assess the distant outcomes and compare them with the data of the robot-assisted radical prostatectomies performed by other approaches.

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Transvesical Versus Posterior Approach to Retzius-Sparing Robot-Assisted Radical Prostatectomy: A Retrospective Comparison With a 12-Month Follow-Up

Frontiers in Oncology ◽

10.3389/fonc.2021.641887 ◽

2021 ◽

Vol 11 ◽

Author(s):

Wen Deng ◽

Cheng Zhang ◽

Hao Jiang ◽

Yulei Li ◽

Ke Zhu ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Erectile Function ◽

Localized Prostate Cancer ◽

Robot Assisted ◽

Open Conversion ◽

Estimated Blood Loss ◽

Before And After ◽

Grade Ii

ObjectivesTo assess the perioperative, functional, and oncological outcomes of transvesical robot-assisted radical prostatectomy (T-RARP) and posterior robot-assisted radical prostatectomy (P-RARP) for localized prostate cancer.Materials and MethodsWe analyzed the data of 96 patients who underwent T-RARP or P-RARP for localized prostate cancer between January 2017 and June 2019 in a retrospective fashion.ResultsNo significant differences in the baseline characteristics existed between the T-RARP and P-RARP arms. Both interventions were successfully performed without open conversion in either group. T-RARP was associated with a slightly more operative time (135.3 vs. 127.3 min) and estimated blood loss (105.2 vs. 94.2 mL) than P-RARP, but the differences were not significant (both p > 0.05). The likelihood of transfusion, ≤Grade II, and >Grade II postoperative complications, pT3a disease and positive surgical margins in the T-RARP group was comparable with that in the P-RARP group. No significant differences were noted between these two arms in terms of UC at the removal of catheter and nocturia (p = 0.750 and p = 0.684, respectively), and all included patients recovered UC at 3 months postoperatively. The median International Index of Erectile Function-5 score in both groups remains comparable before and after RARP. The patients in the T-RARP and P-RARP groups had a similar biochemical recurrence-free survival (p = 0.387).ConclusionsBoth T-RARP and P-RARP by experienced hands are feasible for well-selected patients with prostate cancer, obtaining similar outcomes in terms of perioperative results, UC and erectile function, and oncological control within short-term follow-up.

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Comparison of Treatment Outcomes between Laparoscopic and Robot-Assisted Laparoscopic Radical Prostatectomy in Clinically Localized Prostate Cancer, A Single-Surgeon Experience

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.12.11113 ◽

2020 ◽

Vol 103 (12) ◽

pp. 1300-1308

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Laparoscopic Radical Prostatectomy ◽

Localized Prostate Cancer ◽

Robot Assisted ◽

Oncological Outcomes ◽

Estimated Blood Loss ◽

Surgeon Experience ◽

Potency Rate

Objective: To compare the treatment outcomes between laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP) in clinically localized prostate cancer in a tertiary care hospital in Thailand by a single-surgeon experience. Materials and Methods: Between January 2013 and June 2019, 171 patients with clinically localized prostate cancer underwent minimally invasive radical prostatectomy. These were LRP in 62 patients and RALP in 109 patients. All clinical data were retrospectively reviewed. Patient demographic data, perioperative parameters, pathological reports, oncological outcomes, and functional outcomes including continence and potency rate at 1, 3, 6, and 12 months were compared between groups. Results: Patients in the RALP group were significantly younger (p=0.03) and had a shorter follow-up period (p=0.004). The estimated blood loss was significantly lower in the RALP group (p=0.001). There were no significant differences in intraoperative and 30-day postoperative complications. Pathological results and overall positive surgical margin rate (PSM) were not significantly different. In pT3 patients, PSM was significantly lower in the RALP group (p=0.045). Oncological outcomes were not different in term of biochemical recurrence (BCR) rate (p=0.3), median time to BCR (p=0.45), BCR-free survival (p=0.81), and overall survival (p=0.99). The continence rate was significantly better in the RALP group in every period after surgery (p=0.01, <0.001, 0.001, and p=0.02 at 1, 3, 6 and 12 months, respectively). The potency rate who performed bilateral neurovascular bundles sparing was not different between groups. Conclusion: RALP provided a significant improvement of continence recovery and PSM rate in non-organ confined disease. Estimated blood loss was significantly lower among the RALP patient. Larger numbers of patients with longer follow-up will justify proofing these findings. Keywords: Laparoscopic surgery, Robot-assisted surgery, Radical prostatectomy, Prostate cancer

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Comparison of functional and oncological outcomes of innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy in patients with prostate cancer

BMC Urology ◽

10.1186/s12894-021-00787-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ben Xu ◽

Si-da Cheng ◽

Yi-ji Peng ◽

Qian Zhang

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Biochemical Recurrence ◽

Laparoscopic Radical Prostatectomy ◽

Positive Surgical Margin ◽

Oncological Outcomes ◽

Estimated Blood Loss ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background To compare the functional and oncological outcomes between innovative “three-port” and traditional “four-port” laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). Methods We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. Results There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. Conclusions Innovative “three-port” LRP can significantly shorten the OT and reduce the EBL compared with the traditional “four-port” LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. “Three-port” LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

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Re: Safety and Feasibility of Robot-Assisted Radical Prostatectomy for Clinically Localized Prostate Cancer in Elderly Japanese Patients

The Journal of Urology ◽

10.1016/j.juro.2018.03.046 ◽

2018 ◽

Vol 199 (6) ◽

pp. 1375-1376

Author(s):

Tomas L. Griebling

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Japanese Patients ◽

Localized Prostate Cancer ◽

Robot Assisted ◽

Elderly Japanese ◽

Elderly Japanese Patients

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Single plus one port robotic radical prostatectomy (SPORP); Initial experience

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.3.178 ◽

2017 ◽

Vol 89 (3) ◽

pp. 178 ◽

Cited By ~ 4

Author(s):

Volkan Tugcu ◽

Abdulmuttalip Simsek ◽

Ismail Evren ◽

Kamil Gokhan Seker ◽

Ramazan Kocakaya ◽

...

Keyword(s):

Prostate Cancer ◽

Postoperative Complications ◽

Radical Prostatectomy ◽

Serum Level ◽

Blood Loss ◽

Clinical Stage ◽

Operating Time ◽

Positive Surgical Margin ◽

Robotic Radical Prostatectomy ◽

Postoperative Continence

Objective: This article reports on patients with early stage prostate cancer treated with single plus one port robotic radical prostatectomy (SPORP). Materials and methods: Since January 2014, we performed SPORP in 8 patients with localized prostate cancer. Age of patients, clinical stage, operation time, intraoperative and postoperative complications, blood loss, histopathological evaluation, postoperative continence, serum level of PSA were evaluated. Results: Mean age of the 8 patients was 59.85 years. All operations were completed without conversion to standard robotic procedure or open surgery. No intra operative complications occurred. Mean operating time was 143 minutes; prostate excision 123 minutes and urethrovesical anastomosis 20 minutes. Mean blood loss was 45 ml. Preoperative Gleason scores were (3 + 4) in one patient and (3 + 3) in 7 patients. Postoperative Gleason scores were (3 + 4) in 2 patients, and (3 + 3) in 6 patients. All these 8 cases were in T1c clinical stage. Early postoperative complications were drain leakage (n = 1), atelectasis (n = 1), wound infection (n = 1) and fever (n = 1). There was no positive surgical margin. The serum level of PSA was less than 0.2 ng/ml and no other complications happened during the 4 to 12 months follow-up period. Postoperative continence and cosmetic results were excellent. Conclusions: It is relatively easy for urologists who are skilled in traditional laparoscopic and robotic surgeries to master SPORP. However long-term outcomes of this surgery need further investigations.

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Robotic Management of Localized Adenocarcinoma Prostate with Large Vesical Calculus: A Report of Two Cases

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1190 ◽

2016 ◽

Vol 50 (1) ◽

pp. 36-38 ◽

Cited By ~ 1

Author(s):

Girdhar Singh Bora ◽

Prem Nath Dogra ◽

Prabhjot Singh

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Bladder Outlet Obstruction ◽

Outlet Obstruction ◽

Perioperative Period ◽

Localized Prostate Cancer ◽

Special Group ◽

Robot Assisted ◽

Vesical Calculus ◽

Bladder Calculi

ABSTRACT Introduction Bladder outlet obstruction (BOO) accounts for more than 75% of cases of vesical calculi in patients aged above 50 years. There are special group of patients who have large vesical calculus with localized adenocarcinoma prostate requiring treatment for both bladder calculi and malignancy. We are sharing our technique of extraperitoneal robot-assisted radical prostatectomy (RRP) and removal of vesical calculus in two patients of localized adenocarcinoma prostate with large vesical calculus (≥ 4 cm). Two patients with localized prostate cancer with large vesical stone underwent simultaneous cystolithotomy and extraperitoneal radical prostatectomy. Their perioperative period was uneventful. Large vesical stones with localized prostate cancer can be easily managed simultaneously by an experienced robotic surgeon. How to cite this article Bora GS, Dogra PN, Singh P. Robotic Management of Localized Adenocarcinoma Prostate with Large Vesical Calculus: A Report of Two Cases. J Postgrad Med Edu Res 2016;50(1):36-38.

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