Urol Ann. 2014 Apr;6(2):130-4. doi: 10.4103/0974-7796.130555.
Extraperitoneal robot-assisted laparoscopic radical prostatectomy: Initial experience.
Urology annals
Prem Nath Dogra, Ashish Kumar Saini, Prabhjot Singh, Girdhar Bora, Brusabhanu Nayak
Affiliations
Affiliations
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
PMID: 24833824
PMCID: PMC4021652 DOI: 10.4103/0974-7796.130555
Abstract
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.
Keywords: Carcinoma prostate; extraperitoneal; prostatectomy; robotics
References
- J Urol. 2003 Aug;170(2 Pt 1):416-9 - PubMed
- BJU Int. 2001 Mar;87(4):408-10 - PubMed
- J Urol. 2004 Feb;171(2 Pt 1):714-6 - PubMed
- J Endourol. 2004 Sep;18(7):611-9; discussion 619 - PubMed
- Can J Urol. 2008 Apr;15(2):3994-9 - PubMed
- Urology. 2005 Nov;66(5 Suppl):101-4 - PubMed
- J Endourol. 2010 Apr;24(4):577-82 - PubMed
- Urology. 2006 Nov;68(5):1077-81 - PubMed
- Urology. 2002 Oct;60(4):569-72 - PubMed
- Minerva Urol Nefrol. 2008 Mar;60(1):31-9 - PubMed
- J Endourol. 2009 Sep;23(9):1467-72 - PubMed
- Curr Treat Options Oncol. 2007 Jun;8(3):197-210 - PubMed
- Urology. 2005 Nov;66(5 Suppl):83-94 - PubMed
- Surg Endosc. 1998 Oct;12(10):1264-7 - PubMed
- J Urol. 2005 Jul;174(1):269-72 - PubMed
- J Urol. 2006 Mar;175(3 Pt 1):945-50; discussion 951 - PubMed
- J Endourol. 2001 May;15(4):441-5; discussion 447-8 - PubMed
- BJU Int. 2010 Apr;105(8):1155-60 - PubMed
- Urology. 1997 Dec;50(6):849-53 - PubMed
- Urology. 2003 Mar;61(3):617-22 - PubMed
Publication Types