TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: We describe our experience with robotic-assisted laparoscopic simple prostatectomy (RALSP), and compare the results to a matched cohort of patients undergoing OSP during the same time period from a single institution.
Methods: A retrospective review of our institutional database identified all patients undergoing RALSP procedures, which were performed by 2 high-volume robotic prostate cancer surgeons. Operative approach to RALSP is identical to robotic assisted radical prostatectomy in terms of patient positioning and port placement. Perioperative and postoperative data were collected and analyzed. Statistical analysis was used to compare the open and robotic cohorts where appropriate.
Results: 20 patients underwent RALSP for symptomatic, large-gland BPH at our institution. Median preoperative gland size was 125 gm and the majority of patients (65%) had a history of urinary retention. Two patients had prior failed outlet surgery. Median operative time was 176 minutes and EBL was 225 ml. 1 patient (5%) needed a blood transfusion. 3 patients had bladder pathology that was simultaneously treated. Median pathologic gland weight was 87 grams. 1 patient had a Clavien >2 complications (bleeding requiring fulguration). Comparing this data with a matched cohort undergoing OSP, EBL and length of stay significantly favored the RALSP group.
Conclusions: RALSP is safe and feasible in patients with symptomatic large-gland BPH. Blood loss and length of stay appear to be improved compared to the open operation. Surgeons with significant robotic experience, especially with radical prostatectomy, may consider utilizing this approach for their patients with large-gland BPH.
Source of Funding: None
|Listen to an interview with Misop Han, one of the authors of this study.|
Presented by Misop Han, Gautam Jayram, Mark Ball, and Christian Pavlovich at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
Johns Hopkins Hospital, Baltimore, MD USA