Our study demonstrated that pelvic visceral fat (PVF) and working space (WS) in the pelvic cavity are factors that significantly affect operative time in robot-assisted radical prostatectomy (RARP). Diverse space volumes were measured using the Synapse Vincent® (FUJIFILM, Tokyo) 3D image analysis software. This technology allows calculation of the volume of any space using magnetic resonance imaging (MRI) or computed tomography (CT) scan images. Working space is the area in the pelvis in which surgeons work during RARP. PVF and WS only can be measured using specific software. Therefore, we explored the measurement of pelvic width (PW) and body mass index (BMI) as practical alternatives. BMI and PW were correlated with PVF and WS, respectively.
We concluded that increased PVF (BMI) and a narrower WS (PW) increase operative difficulty, leading to postoperative complications such as urine leakage from anastomoses. In this study, the cohort included only Asians (Japanese). The USA or European countries are multi-ethnic. Therefore, results from a similar analysis might be different because the pelvis is wider in Caucasians than in Asians. A study including individuals of other races may show interesting results.
Written by: Takato Uchida, Taro Higure, Masayoshi Kawakami, Mayura Nakano, Nobuyuki Nakajima, Hakushi Kim, Masahiro Nitta, Masanori Hasegawa, Yoshiaki Kawamura, Sunao Shoji, Akira Miyajima
Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan., Department of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan. .
Read the Abstract