Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted

Frota, Rodrigo; Turna, Burak; Barros, Rodrigo; Gill, Inderbir S.

doi:10.1590/s1677-55382008000300002

Cited by 73 publications

(60 citation statements)

References 40 publications

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“…Therefore, we believe that this surgical technique is both feasible and reproducible, since residents could complete it even in their first procedures supervised by a professor with an average surgical time of 145.5 minutes. This result is comparable to other series reporting mean procedure times of 181 minutes for RRP, 219 minutes for LRP, and 179.5 minutes for RARP [16]. The ease of the procedure reported here is an advantage compared to video-assisted surgery, for which surgeons typically require more than 200 procedures to reach a plateau in the learning curve [16].…”

Section: Discussionsupporting

confidence: 84%

“…The operations were executed by second-year residents of our hospital's urology program, aided by one of the authors, who is a senior surgeon. All surgeries were performed as planned, without conversion to the Walsh technique, and had a similar duration to other RRP techniques [5,16]. Therefore, we believe that this surgical technique is both feasible and reproducible, since residents could complete it even in their first procedures supervised by a professor with an average surgical time of 145.5 minutes.…”

Section: Discussionmentioning

confidence: 99%

“…The development and improvement of surgical technique achieved by LRP and RARP may not be entirely due to their technological advances. The enhanced vision associated with a convenient sitting position, wider operative field, and ability for more precise movements are advantages of robotic-assisted surgery, and are part of evolution in surgical techniques toward better visualization of pelvic anatomical structures such as the cavernous nerve fibers within the periprostatic tissue, seminal vesicles, prostatic pedicle, apex, and urethra [1,2,5,[15][16][17][18]. This advancement has allowed for the development of a new method to perform an anterograde anatomical dissection technique that is more precise and less invasive than the classical open RRP described in 1983 by Walsh et al [2,5,6,[9][10][11]15,17,18].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Description of the Open Anterograde Anatomic Radical Retropubic Prostatectomy Technique

Bc¹,

Ronaldo²,

E³

et al. 2017

Surgery Curr Res

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Description of the Open Anterograde Anatomic Radical Retropubic Prostatectomy Technique

Bc¹,

Ronaldo²,

E³

et al. 2017

Surgery Curr Res

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“…With respect to blood loss, it appears that RALP is superior to open and laparoscopic RP (Frota et al, 2008). While early results are promising, some studies have reported higher complication rates with RALP compared with open RP: Hu et al (2008) showed an anastomotic stricture rate of 15.2% in the RALP group, compared with 12% in the open group.…”

Section: Results Of Different Types Of Rpmentioning

confidence: 99%

Robotic-assisted laparoscopic prostatectomy

2009

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Prostate cancer remains a significant health problem worldwide and is the second highest cause of cancer-related death in men. While there is uncertainty over which men will benefit from radical treatment, considerable efforts are being made to reduce treatment related side-effects and in optimising outcomes. This article reviews the development and introduction of robotic-assisted laparoscopic radical prostatectomy (RALP), the results to date, and the possible future directions of RALP. Prostate cancer remains a significant health problem worldwide and is the most common cancer affecting men in the United Kingdom, with over 34 000 cases diagnosed in 2005. It is the second leading cause of cancer-related death among men in the UK and the lifetime risk of being diagnosed with prostate cancer is around one in ten. In contrast, in the United States, it is the third commonest cause of cancer-related death among men and the lifetime risk of being diagnosed is one in six, which largely is the consequence of higher rates of PSA testing and screening.Conventional treatment options include radical prostatectomy (RP), external beam radical radiotherapy, brachytherapy and active monitoring or surveillance with or without regular biopsy. More recently, focal therapies such as cryoablation and highintensity focused ultrasound have been introduced, but their oncological effectiveness remains uncertain. Radical prostatectomy is an established and accepted treatment for localised and more recently, for locally advanced prostate cancer. Overall 10-year PSA progression rates after RP are around 30%. Recurrence rates are increased in men with a higher pre-operative PSA, Gleason grade, or tumour stage and if there are positive margins in the pathological specimen.Surgery can be performed by traditional open surgery, or laparoscopically -with or without robotic assistance. This article reviews the development and introduction of robotic-assisted laparoscopic RP (RALP), the results to date, and the possible future directions. In order to concentrate on outcomes when the learning curve has been passed, we have for the purposes of this review included studies where 500 or more cases of RALP have been reported plus other selected references. HISTORY OF RADICAL PROSTATECTOMYThe first perineal prostatectomy was performed by Proust in France in 1901, followed by Young in 1905 in the United States of America who performed the surgery on men with prostate cancer. During the early years, there was significant mortality and morbidity, with some surgeons reporting up to 30% mortality rates. Improvements in technique were made, and Millin's retropubic prostatectomy was used for patients with prostate cancer by Memmelaar and others from the late 1940's. It was not until 1983 that the operation was refined by Walsh who also reported the use of a nerve-sparing procedure to improve postprostatectomy potency rates. The first laparoscopic RP was performed in 1991 by Schuessler and, as with open surgery, advances have been made to improve outcomes, inc...

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“…Because the urologists always seek less invasive and less morbid therapeutic options and the financial sources supplying health worldwide tend Clinical Urolo�y Clinical Urolo�y doi: 10.1590/S1677-55382010000600007 to support therapeutic modalities resulting in shorter hospitalization and early recovery, interest in radical perineal prostatectomy (RPP) has increased again in recent years (1,2). When compared to radical retropubic prostatectomy (RRP), laparoscopic or roboticassisted procedures have advantageous outcome data regarding duration of hospitalization, loss of blood, time needed to recover from the disease, and return to normal daily life (3). However, these advantages may also be offered by RPP, which additionally has some advantages such as lesser cost and shorter duration of operation (1,4).…”

Section: Introductionmentioning

confidence: 99%

Radical perineal prostatectomy and early continence: outcomes after 120 cases

Albayrak¹,

Cangüven²,

Göktaş³

et al. 2010

Int. braz j urol.

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Purpose: Evaluate the results of urinary continence on patients who had undergone radical perineal prostatectomy (RPP) for clinically localized prostate cancer. Materials and Methods:We analyzed the continence data of 120 patients with pathology of cT1-cT2N0M0 prostate cancer and who had undergone RPP. Continence was assessed on the day of catheter removal, at the end of the first and third month, and the first year postoperatively. The patients who were continent immediately after catheter removal were classified in the group of "immediately continent" while the patients who became continent during the 3 postoperative months were classified as "early continent." Results: Mean duration of catheterization was 10 (10-25) days. Of 120 patients, 44 (36.7%) were immediately continent. At the end of the first and third months, 65 (54.1%) and 87 (72.5%), respectively, were early continent. At the one-year follow-up, 95.3% of 107 cases whose one-year follow-up data were available were continent. When the relationship between patients' age and continence was analyzed, it was found that the early continence rates were 77.7% (7/9), 73.3% (33/45), 73.4% (36/49), and 64.7% (11/17) in the groups of ≤ 49, 50-59, 60-69, and ≥ 70 years, respectively (p = 0.68). Conclusions: The majority of patients who underwent RPP rapidly regained continence within 3 months. RPP is an exceptional alternative approach for radical surgery in the treatment of localized prostate cancer.

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Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted

Cited by 73 publications

References 40 publications

Description of the Open Anterograde Anatomic Radical Retropubic Prostatectomy Technique

Description of the Open Anterograde Anatomic Radical Retropubic Prostatectomy Technique

Robotic-assisted laparoscopic prostatectomy

Radical perineal prostatectomy and early continence: outcomes after 120 cases

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