OBJECTIVES: To report our initial experience and technique of performing robot-assisted laparoscopic radical prostatectomy (RALP) with the extraperitoneal approach. MATERIALS AND METHODS: Twenty-seven patients, between September 2010 to January 2012, were included in the study. All patients underwent extraperitoneal robot-assisted radical prostatectomy. Patients were placed supine with only 10-15(0) Trendelenburg tilt. The extraperitoneal space was developed behind the posterior rectus sheath. A five-port technique was used. After incision of endopelvic fascia and ligation of the deep venous complex, the rest of the procedure proceeded along the lines of the transperitoneal approach. RESULTS: The mean patient age, prostate size and Gleason score were 67 ± 1.8 years, 45 ± 9.55 g and 6, respectively. The mean prostate-specific antigen (PSA) was 6.50 ng/mL. The mean time required for creating extraperitoneal space, docking of robot and console time were 22, 7 and 94 min, respectively. The mean time to resume full oral feeds was 22 ± 3.45 h. There were no conversions from extraperitoneal to transperitoneal or open surgery in our series. Pathological stage was pT1, pT2a and pT3b in 11 (40.74%), 14 (51.85%) and two (7.4%) patients, respectively. Two patients had positive surgical margins and two had biochemical recurrence at the last follow-up. Our mean follow-up was 12 ± 3.30 (2-17) months. The overall continence rate was 83.33% and 92.4% at 6 and 12 months, respectively. CONCLUSIONS: Extraperitoneal RALP is an efficacious, minimally invasive approach for patients with localized carcinoma of the prostate.
OBJECTIVES: To report our initial experience and technique of performing robot-assisted laparoscopic radical prostatectomy (RALP) with the extraperitoneal approach. MATERIALS AND METHODS: Twenty-seven patients, between September 2010 to January 2012, were included in the study. All patients underwent extraperitoneal robot-assisted radical prostatectomy. Patients were placed supine with only 10-15(0) Trendelenburg tilt. The extraperitoneal space was developed behind the posterior rectus sheath. A five-port technique was used. After incision of endopelvic fascia and ligation of the deep venous complex, the rest of the procedure proceeded along the lines of the transperitoneal approach. RESULTS: The mean patient age, prostate size and Gleason score were 67 ± 1.8 years, 45 ± 9.55 g and 6, respectively. The mean prostate-specific antigen (PSA) was 6.50 ng/mL. The mean time required for creating extraperitoneal space, docking of robot and console time were 22, 7 and 94 min, respectively. The mean time to resume full oral feeds was 22 ± 3.45 h. There were no conversions from extraperitoneal to transperitoneal or open surgery in our series. Pathological stage was pT1, pT2a and pT3b in 11 (40.74%), 14 (51.85%) and two (7.4%) patients, respectively. Two patients had positive surgical margins and two had biochemical recurrence at the last follow-up. Our mean follow-up was 12 ± 3.30 (2-17) months. The overall continence rate was 83.33% and 92.4% at 6 and 12 months, respectively. CONCLUSIONS: Extraperitoneal RALP is an efficacious, minimally invasive approach for patients with localized carcinoma of the prostate.
Authors: Andrs Hoznek; Patrick Antiphon; Tomasz Borkowski; Matthew T Gettman; Ran Katz; Laurent Salomon; Safwat Zaki; Alexandre de la Taille; C lment-Claude Abbou Journal: Urology Date: 2003-03 Impact factor: 2.649
Authors: Fatih Atug; Erik P Castle; Michael Woods; Sudesh K Srivastav; Raju Thomas; Rodney Davis Journal: Urology Date: 2006-11-07 Impact factor: 2.649
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