BACKGROUND: We examined the patient characteristics, operative proceedings and the outcomes of the initial series of 125 cases of robot-assisted laparoscopic radical prostatectomy (RALRP) in an independent hospital in Ireland, performed by two surgeons using the da Vinci(®) surgical system. MATERIALS AND METHODS: The series data were gathered prospectively in a consecutive series. Focus was given to the outcome trifecta of oncological control, urinary continence and erectile function. We also report on complications reported using the Clavien-Dindo classification. RESULTS: Mean patient age was 58.86 years, with a range between 47 and 71 years. Positive surgical margin rates were 11.3% overall (n = 14); 7.8% (n = 8) in the pT2 group (n = 101) and 30% (n = 6) in the pT3/pT4 (n = 20) group. 93% (n = 125) of patients are continent at 6 months. Biochemical recurrence-free survival was 92.4%. 72% (n = 43) of patients under the age of 65 with normal preoperative erectile function are potent at 1 year post-operatively. No patient in this series required a blood transfusion. Some form of relatively minor complication occurred in 12.8% (n = 16) of cases; there was no mortality rate, and no complication was life-threatening or resulted in single-organ or multiple-organ failure. CONCLUSIONS: With a combination of high-level fellowship training of surgeons, a co-operative and combined approach to cases between surgeons, institutional support, and enthusiasm, encouragement and dedication from ancillary staff and colleagues, we have shown that a programme can be established with excellent levels of safety and efficacy.
BACKGROUND: We examined the patient characteristics, operative proceedings and the outcomes of the initial series of 125 cases of robot-assisted laparoscopic radical prostatectomy (RALRP) in an independent hospital in Ireland, performed by two surgeons using the da Vinci(®) surgical system. MATERIALS AND METHODS: The series data were gathered prospectively in a consecutive series. Focus was given to the outcome trifecta of oncological control, urinary continence and erectile function. We also report on complications reported using the Clavien-Dindo classification. RESULTS: Mean patient age was 58.86 years, with a range between 47 and 71 years. Positive surgical margin rates were 11.3% overall (n = 14); 7.8% (n = 8) in the pT2 group (n = 101) and 30% (n = 6) in the pT3/pT4 (n = 20) group. 93% (n = 125) of patients are continent at 6 months. Biochemical recurrence-free survival was 92.4%. 72% (n = 43) of patients under the age of 65 with normal preoperative erectile function are potent at 1 year post-operatively. No patient in this series required a blood transfusion. Some form of relatively minor complication occurred in 12.8% (n = 16) of cases; there was no mortality rate, and no complication was life-threatening or resulted in single-organ or multiple-organ failure. CONCLUSIONS: With a combination of high-level fellowship training of surgeons, a co-operative and combined approach to cases between surgeons, institutional support, and enthusiasm, encouragement and dedication from ancillary staff and colleagues, we have shown that a programme can be established with excellent levels of safety and efficacy.
Authors: Vincenzo Ficarra; Giacomo Novara; Walter Artibani; Andrea Cestari; Antonio Galfano; Markus Graefen; Giorgio Guazzoni; Bertrand Guillonneau; Mani Menon; Francesco Montorsi; Vipul Patel; Jens Rassweiler; Hendrik Van Poppel Journal: Eur Urol Date: 2009-01-25 Impact factor: 20.096
Authors: Declan G Murphy; Anders Bjartell; Vincenzo Ficarra; Markus Graefen; Alexander Haese; Rodolfo Montironi; Francesco Montorsi; Judd W Moul; Giacomo Novara; Guido Sauter; Tullio Sulser; Henk van der Poel Journal: Eur Urol Date: 2009-12-28 Impact factor: 20.096
Authors: Stefan Carlsson; Andreas E Nilsson; Martin C Schumacher; Martin N Jonsson; Daniela S Volz; Gunnar Steineck; Peter N Wiklund Journal: Urology Date: 2010-05 Impact factor: 2.649
Authors: Jim C Hu; Xiangmei Gu; Stuart R Lipsitz; Michael J Barry; Anthony V D'Amico; Aaron C Weinberg; Nancy L Keating Journal: JAMA Date: 2009-10-14 Impact factor: 56.272
Authors: Rafael F Coelho; Sanket Chauhan; Kenneth J Palmer; Bernardo Rocco; Manoj B Patel; Vipul R Patel Journal: BJU Int Date: 2009-10-05 Impact factor: 5.588