OBJECTIVES: To report our surgical technique and outcomes after extraperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP). MATERIALS AND METHODS: At Henri Mondor's Hospital, we performed the first RALRP in 2001 and started to perform routinely RALRP since 2006. Preoperative characteristics, perioperative parameters, functional and oncological outcomes were collected in a prospective database and studied. All parameters were tested in patients undergoing RALRP beyond the learning curve of each surgeon. The overall cohort included 792 patients. RESULTS: RALRP offers interesting results in terms of hospital stay, operative time, and blood loss. The overall rate of complications was low, especially concerning the rates of anastomosis' complications. An extraprostatic extension was seen in 42.8 % of specimens. The overall rate of positive margins was 30.7 % of specimens. In our cohort, after a mean follow-up of 19 months, 8.7 % of PSA failure has been reported. The rate of continence was 77.4 % at 6 months and 96.8 % at 2 years. The rate of potency was 17 % at 3 months and 60.9 % at 2 years. The 2-year rate was 86.7 % in case of intrafascial dissection. A trifecta outcome was achieved in 44 and 53 % of men at 12 and 24 months, respectively. CONCLUSIONS: The extraperitoneal approach confers interesting results in terms of perioperative parameters as previously described in series using a transperitoneal approach. Functional outcomes in terms of continence and potency recovery after extraperitoneal seem equivalent to those reported after transperitoneal RALRP. Longer follow-up is warranted to confirm our favorable mid-term oncologic outcomes.
OBJECTIVES: To report our surgical technique and outcomes after extraperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP). MATERIALS AND METHODS: At Henri Mondor's Hospital, we performed the first RALRP in 2001 and started to perform routinely RALRP since 2006. Preoperative characteristics, perioperative parameters, functional and oncological outcomes were collected in a prospective database and studied. All parameters were tested in patients undergoing RALRP beyond the learning curve of each surgeon. The overall cohort included 792 patients. RESULTS: RALRP offers interesting results in terms of hospital stay, operative time, and blood loss. The overall rate of complications was low, especially concerning the rates of anastomosis' complications. An extraprostatic extension was seen in 42.8 % of specimens. The overall rate of positive margins was 30.7 % of specimens. In our cohort, after a mean follow-up of 19 months, 8.7 % of PSA failure has been reported. The rate of continence was 77.4 % at 6 months and 96.8 % at 2 years. The rate of potency was 17 % at 3 months and 60.9 % at 2 years. The 2-year rate was 86.7 % in case of intrafascial dissection. A trifecta outcome was achieved in 44 and 53 % of men at 12 and 24 months, respectively. CONCLUSIONS: The extraperitoneal approach confers interesting results in terms of perioperative parameters as previously described in series using a transperitoneal approach. Functional outcomes in terms of continence and potency recovery after extraperitoneal seem equivalent to those reported after transperitoneal RALRP. Longer follow-up is warranted to confirm our favorable mid-term oncologic outcomes.
Authors: Bernardo Rocco; Gabriele Cozzi; Matteo G Spinelli; Rafael F Coelho; Vipul R Patel; Ashutosh Tewari; Peter Wiklund; Markus Graefen; Alex Mottrie; Franco Gaboardi; Inderbir S Gill; Francesco Montorsi; Walter Artibani; Francesco Rocco Journal: Eur Urol Date: 2012-05-30 Impact factor: 20.096
Authors: Vincenzo Ficarra; Giacomo Novara; Thomas E Ahlering; Anthony Costello; James A Eastham; Markus Graefen; Giorgio Guazzoni; Mani Menon; Alexandre Mottrie; Vipul R Patel; Henk Van der Poel; Raymond C Rosen; Ashutosh K Tewari; Timothy G Wilson; Filiberto Zattoni; Francesco Montorsi Journal: Eur Urol Date: 2012-06-01 Impact factor: 20.096
Authors: Jens-Uwe Stolzenburg; Robert Rabenalt; Minh Do; Michael C Truss; Martin Burchardt; Thomas R Herrmann; Thilo Schwalenberg; Panagiotis Kallidonis; Evangelos N Liatsikos Journal: World J Urol Date: 2007-03-02 Impact factor: 4.226
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: Vincenzo Ficarra; Giacomo Novara; Raymond C Rosen; Walter Artibani; Peter R Carroll; Anthony Costello; Mani Menon; Francesco Montorsi; Vipul R Patel; Jens-Uwe Stolzenburg; Henk Van der Poel; Timothy G Wilson; Filiberto Zattoni; Alexandre Mottrie Journal: Eur Urol Date: 2012-06-01 Impact factor: 20.096
Authors: Matthew T Gettman; András Hoznek; Laurent Salomon; Ran Katz; Tomasz Borkowski; Patrick Antiphon; Adrian Lobontiu; Clément-Claude Abbou Journal: J Urol Date: 2003-08 Impact factor: 7.450