Robot-Assisted Simple Prostatectomy by an Extraperitoneal Approach

Stolzenburg, Jens‐Uwe; Kallidonis, Panagiotis; Kyriazis, Iason; Kotsiris, Dimitrios; Ntasiotis, P.; Liatsikos, Evangelos

doi:10.1089/end.2017.0714

Cited by 15 publications

(6 citation statements)

References 15 publications

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“…As a minimal invasive alternative to OSP, robot-assisted simple prostatectomy (RASP) was first described by Sotelo et al in 2008 [4]. Since then, different transperitoneal and extraperitoneal approaches have been developed [5][6][7]. Efficacy and safety of RASP have been investigated in different noncomparative studies and a multinational analysis.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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Purpose Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP. Methods In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSP patients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed. Results Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions. Conclusion Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.

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Section: Introductionmentioning

confidence: 99%

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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“…Several centers worldwide have reported small case series with perioperative and functional results similar to HoLEP and OP. [ 16 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 ] [ Table 3 ]…”

Section: Discussionmentioning

confidence: 99%

“…Our mean pathology specimen weight was 82.8 g, with other series reporting between 46 g and 162 g on an average. [ 16 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 ] “Trifecta” arbitrarily included (a) no perioperative complications, (b) postoperative IPSS <8, and (c) postoperative Qmax > 15 ml/s. [ 27 ] Although it needs external validation, many researchers[ 27 38 ] recognized that this might be a simple way to define successful outcomes.…”

Section: Discussionmentioning

confidence: 99%

Robotic Freyer's prostatectomy

Waigankar

Yuvaraja

Dev

et al. 2021

Indian Journal of Urology

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Introduction: Transurethral resection of prostate replaced open surgery and remained the gold standard in surgical management of benign prostatic hyperplasia (BPH). Holmium laser enucleation and bipolar resection of prostate managed even larger glands. Open simple prostatectomy remains an option for large glands and concurrent pathologies. Minimally invasive laparoscopic simple prostatectomy lacks general acceptance. Surgeons have now started exploring the robotic platform due to its advantages. Herein, we present the technique and initial outcomes of robotic Freyer's prostatectomy (RFP). Materials and Methods: Thirteen transperitoneal RFPs were performed using the DaVinci Xi platform. We evaluated perioperative characteristics and functional outcomes. Results: Median patient age was 67.8 years and the mean prostate volume was 105.8 ml. The median International Prostate Symptom Score (IPSS) and American Urological Association quality of life (AUA-QoL) score was 19.6 and 5.3. There were no intraoperative complications or conversion to open surgery. The mean console time and estimated blood loss were 107.30 min and 92.5 ml, respectively. One patient required redo-surgery by robotic technique due to urine leak (Clavien-Dindo Grade 3b complication). Mean hospital stay and catheter duration were 4.9 days and 5.2 days, respectively. Change (preoperative vs. postoperative) in IPSS (19.6 vs. 4.67 points), maximum flow rate (6.8 vs. 15.1 ml/s), AUA-QoL score (5.3 vs. 2.2 points) and PVR (179.4 vs 7.1 ml) were significant ( P < 0001). Conclusions: RFP is a safe and effective option for managing BPH, especially for large glands. It confers minimally invasive surgery benefits with good functional outcomes.

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“…The surgical technique of RSP essentially reproduces OSP, with the principal difference being that the basic approach of RSP is transperitoneal. Recently, however, Stolzenburg et al [15] reported a case of RSP using an extraperitoneal approach. There are 2 ways to resect an adenoma: the transvesical approach and the transcapsular approach.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The preperitoneal space is prepared with finger dissection and balloon insufflation. After all trocars are inserted, a cystotomy incision is made longitudinally from the anterior bladder wall to the bladder neck, and the adenoma is removed in a similar way as in the transperitoneal approach [15].…”

Section: Extraperitoneal Approachmentioning

confidence: 99%

Robotic Simple Prostatectomy: Why and How?

2020

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Increasingly many studies have presented robotic simple prostatectomy (RSP) as a surgical treatment option for large benign prostatic hyperplasia (BPH) weighing 80–100 g or more. In this review, some frequently used RSP techniques are described, along with an analysis of the literature on the efficacy and complications of RSP and differences in treatment results compared with other surgical methods. RSP has the advantage of a short learning curve for surgeons with experience in robotic surgery. Severe complications are rare in patients who undergo RSP, and RSP facilitates the simultaneous treatment of important comorbid diseases such as bladder stones and bladder diverticula. In conclusion, RSP can be recommended as a safe and effective minimally invasive treatment for large BPH.

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Robot-Assisted Simple Prostatectomy by an Extraperitoneal Approach

Cited by 15 publications

References 15 publications

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

Robotic Freyer's prostatectomy

Robotic Simple Prostatectomy: Why and How?

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