“Robotic fatigue?” – The impact of case order on positive surgical margins in robotic-assisted laparoscopic prostatectomy

Bukavina, Laura; Mishra, Kirtishri; Mahran, Amr; Fernstrum, Austin; Ray, Al; Markt, Sarah C.; Schumacher, Fredrick R.; Conroy, Britt; Abouassaly, Robert; MacLennan, Gregory T.; Smith, Garrett; Ferry, Elizabeth; Wong, Daniel; Lotan, Yair; Chaparala, Hemant; Sharp, David; Alazem, Kareem; Moinzadeh, Alireza; Adamic, Brittany; Zagaja, Gregory P.; Kang, Puneet; Lawry, Holly; Lee, Benjamin; Calaway, Adam; Ponsky, Lee

doi:10.1016/j.urolonc.2020.10.071

Cited by 4 publications

(2 citation statements)

References 26 publications

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“…In contrast, Bukavina et al recently analysed a multi-institutional retrospective cohort aimed to determine whether the outcomes of RARP differed when two RARP interventions were performed one after another by the same team. In their hands, case sequence was found not associated with operative time, positive margins, and lymph-nodes yield ( 14 ). Similarly, Bagrodia et al reported that performance of several consecutive complex urological procedures (including RARP) was not associated with the worsening of outcomes ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

"Single-Surgeon" versus "Dual-Surgeon" Robot-Assisted Radical Prostatectomy and Pelvic Lymph-nodes Dissection: Comparative Analysis of Perioperative Outcomes

Bertolo,

Carilli,

Antonucci

et al. 2023

Int. braz j urol.

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Purpose: To compare the perioperative outcomes of robot-assisted radical prostatectomy (RARP) with pelvic lymph-nodes dissection (PLND) when the same surgeon performs RARP and PLND versus one surgeon performs RARP and another surgeon performs PLND. Materials and Methods: From January 2022 to March 2023, data of consecutive patients who underwent RARP with PLND were prospectively collected. The surgeries were performed by two "young" surgeons with detailed profi le. Specifi cally for the study purpose, one surgeon performed RARP, and the other surgeon performed PLND. A set of surgeries performed according to the standard setup (i.e., the same surgeon performing both RARP and PLND) was retrieved from the institutional database and used as comparator arm. To test the study hypothesis, patients were divided into two groups: "dual-surgeon" versus "single-surgeon". Results: Fifty patients underwent RARP and PLND performed according to dual-surgeon setup and were compared to the last 50 procedures performed according to the standard single-surgeon setup. Patients in the groups had comparable baseline characteristics. Dual-surgeon interventions had signifi cantly shorter median total operative versus 174 ] minutes, p<0.001) and console time versus 154 [IQR 129-170] minutes, p<0.001). No signifi cant differences were found in terms of blood loss, intraoperative complications, postoperative outcomes, and fi nal pathology results. Conclusions: The present analysis found that when RARP and PLND are split onto two surgeons, the operative time is shorter by 20 minutes compared to when a single surgeon performs RARP and PLND. This is an interesting fi nding that could sponsor further studies.

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Section: Discussionmentioning

confidence: 99%

"Single-Surgeon" versus "Dual-Surgeon" Robot-Assisted Radical Prostatectomy and Pelvic Lymph-nodes Dissection: Comparative Analysis of Perioperative Outcomes

Bertolo,

Carilli,

Antonucci

et al. 2023

Int. braz j urol.

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“…The choice of the appropriate extension of RP depends primarily on the preoperative prediction of the pT3 stage. NVB sparing surgery in the presence of EPE is associated with an increased risk of positive SM in postoperative specimens [27][28][29][30]. Positive SMs are associated with an increased risk of BCR [31].…”

Section: Discussionmentioning

confidence: 99%

Prostate Magnetic Resonance Imaging Analyses, Clinical Parameters, and Preoperative Nomograms in the Prediction of Extraprostatic Extension

Majchrzak¹,

Cieśliński²,

Głyda

et al. 2021

Clinics and Practice

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Introduction: Proper planning of laparoscopic radical prostatectomy (RP) in patients with prostate cancer (PCa) is crucial to achieving good oncological results with the possibility of preserving potency and continence. Aim: The aim of this study was to identify the radiological and clinical parameters that can predict the risk of extraprostatic extension (EPE) for a specific site of the prostate. Predictive models and multiparametric magnetic resonance imaging (mpMRI) data from patients qualified for RP were compared. Material and methods: The study included 61 patients who underwent laparoscopic RP. mpMRI preceded transrectal systematic and cognitive fusion biopsy. Martini, Memorial Sloan-Kettering Cancer Center (MSKCC), and Partin Tables nomograms were used to assess the risk of EPE. The area under the curve (AUC) was calculated for the models and compared. Univariate and multivariate logistic regression analyses were used to determine the combination of variables that best predicted EPE risk based on final histopathology. Results: The combination of mpMRI indicating or suspecting EPE (odds ratio (OR) = 7.49 (2.31–24.27), p < 0.001) and PSA ≥ 20 ng/mL (OR = 12.06 (1.1–132.15), p = 0.04) best predicted the risk of EPE for a specific side of the prostate. For the prediction of ipsilateral EPE risk, the AUC for Martini’s nomogram vs. mpMRI was 0.73 (p < 0.001) vs. 0.63 (p = 0.005), respectively (p = 0.131). The assessment of a non-specific site of EPE by MSKCC vs. Partin Tables showed AUC values of 0.71 (p = 0.007) vs. 0.63 (p = 0.074), respectively (p = 0.211). Conclusions: The combined use of mpMRI, the results of the systematic and targeted biopsy, and prostate-specific antigen baseline can effectively predict ipsilateral EPE (pT3 stage).

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A Study on the VR Goggle-based Vision System for Robotic Surgery

Kim

Mun

Kim

et al. 2022

Int. J. Control Autom. Syst.

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“Robotic fatigue?” – The impact of case order on positive surgical margins in robotic-assisted laparoscopic prostatectomy

Cited by 4 publications

References 26 publications

"Single-Surgeon" versus "Dual-Surgeon" Robot-Assisted Radical Prostatectomy and Pelvic Lymph-nodes Dissection: Comparative Analysis of Perioperative Outcomes

"Single-Surgeon" versus "Dual-Surgeon" Robot-Assisted Radical Prostatectomy and Pelvic Lymph-nodes Dissection: Comparative Analysis of Perioperative Outcomes

Prostate Magnetic Resonance Imaging Analyses, Clinical Parameters, and Preoperative Nomograms in the Prediction of Extraprostatic Extension

A Study on the VR Goggle-based Vision System for Robotic Surgery

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