Randomised Controlled Trial Comparing Laparoscopic and Robot-assisted Radical Prostatectomy

Porpiglia, Francesco; Morra, Ivano; Chiarissi, Marco Lucci; Manfredi, Matteo; Mele, F.; Grande, Susanna; Ragni, F.; Poggio, M.; Fiori, Cristian

doi:10.1016/j.eururo.2012.07.007

Cited by 207 publications

(158 citation statements)

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“…Martis et al [21] reported that the mean amount of blood loss in open RRP was 200 cc. In a study by Porpiglia et al [22] , the average amount of bleeding in robot-assisted laparoscopic transperitoneal RP was reported as 200 cc, whereas the amount of bleeding in laparoscopic extraperitoneal RP was reported as 234 cc. The mean amount of bleeding in our series was 62.9±18.5 cc.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted radical perineal prostatectomy: first experience of 15 cases

Tuğcu

Akça

Şimşek

et al. 2017

Turkish Journal of Urology

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Objective: Minimally invasive techniques are increasingly evolving and preferred to reduce surgical induced morbidity and mortality and minimize the challenges of surgical techniques. Especially radical perineal prostatectomy (RPP) includes some challenges like working in a deep and narrow space and challenging ergonomics for the surgeons. Because of these issues open RPP is still performed in experienced centers. In order to reduce these difficulties, robot-assisted radical perineal prostatectomy (r-RPP) is developed. In this study, we report our first clinical results for r-RPP. Material and methods:Between November 2016 and February 2017, 15 patients underwent r-RPP in our center. Multiparametric magnetic resonance imaging was performed for all patients to exclude locally advanced disease. The patients with chronic obstructive pulmonary disease and locally advanced prostate cancer were not chosen for r-RPP method. The patient was positioned in the exaggerated lithotomy with 15 degrees of Trendelenburg position. After incision and dissection of subcutaneous tissue, dissection was advanced to the margin of posterior recto-urethral muscle fibers. Then a GelPOINT ® device was placed and robotic system was docked. Results:The mean age of the patients was 60.2±7.8 years. The mean body mass index of the patients was 28.8±1.9 kg/m 2 . Four patients had previous major abdominal surgeries. Preoperative mean prostate specific antigen value was 7.3±2.4 ng/mL. The mean prostate volume was 40.8±12.4 cc. Mean perineal dissection time was 60±10.1 minutes. Mean console time and total operation time was 95±11.3 and 167±37.4 minutes, respectively. The mean time of postoperative catheterization was 8.3±1.7 days. Early continence rate was 40% after urethral catheter removal and at 3rd month of the surgery mean continence rate was 94% for all patients. Conclusion:We demonstrate that r-RPP is a feasible and efficient method. But still this method needs for further studies in this area.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted radical perineal prostatectomy: first experience of 15 cases

Tuğcu

Akça

Şimşek

et al. 2017

Turkish Journal of Urology

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“…Two RCTs comparing laparoscopic surgery and RAS found that, although there was no difference in oncological outcomes, RAS offered health-related quality-of-life benefits for patients, in terms of higher rates of continence and sexual function. 17,18 As a consequence of this, in July 2015, NHS England recommended that RAS should be offered as a choice, alongside open and laparoscopic surgery, and when considered clinically appropriate, to all patients with localised prostate cancer. 19 Given the high costs of RAS, with the cost-effectiveness of RAS depending on the number of operations for which the da Vinci robot is used, 20 it could be anticipated that NHS trusts that have purchased a da Vinci robot would be seeking to maximise its use.…”

Section: Implications For Practicementioning

confidence: 99%

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/04. The contractual start date was in September 2013. The final report began editorial review in September 2016 and was accepted for publication in February 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department...

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“…The oncological outcome was same in many reports, including the two past randomized control trials (RCTs) [23,24]. These RCTs compared LRP with RARP and reported that PRM was 10.0 to 20.0% in LRP and 15.4 to 26.6% on RARP.…”

Section: Discussionmentioning

confidence: 80%