Total Extraperitoneal Robot-Assisted Laparoscopic Radical Prostatectomy: Step-by-Step Approach

ChenKenneth,; Yang, Xin Yan; SimKarine,; MohammadMahmood, B; Jack, TayKae; SimAllen,; YuenJohn, S P

doi:10.1089/vid.2018.0036

Cited by 2 publications

(3 citation statements)

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“…Furthermore, the technique is well-described with a step-by-step video illustration previously described. 12 Second, although as far as we know this is the largest study on AXR-RARP by the TEP approach, the sample size remained small. Thus, the outcome of the study would most appropriately be treated as a proof-of-concept rather than a conclusion leading to a practice-changing recommendation.…”

Section: Discussionmentioning

confidence: 91%

“…The preservation of the peritoneal cavity without exposure of the gastrointestinal tract to fluids (blood, urine and irrigation fluids), direct pneumo-peritoneum pressure and operative maneuvers resulted in no reported cases of postoperative ileus, abdominal distension and PONV, as we previously reported. 12 In addition, the TEP approach allows a lesser degree of peri-operative Trendelenburg tilt (mean 16°), which resulted in lesser respiratory pressure requirements and negligible postoperative orbital edema. These had contributed to improved overall postoperative wellness for the patients.…”

Section: Discussionmentioning

confidence: 99%

“…The TEP technique developed for RARP used in the study was previously described. 12 A small Redivac drain was placed in the pelvis at the end of the surgery.…”

Section: Methodsmentioning

confidence: 99%

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Ambulatory robot‐assisted laparoscopic radical prostatectomy with extended recovery by total extraperitoneal approach

et al. 2021

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Objective: To evaluate the feasibility of performing robot-assisted laparoscopic radical prostatectomy in an ambulatory with extended recovery setting by using a total extraperitoneal approach. Methods: Patients with low-to intermediate-risk, prostate cancer were prospectively recruited in the ambulatory robot-assisted laparoscopic radical prostatectomy with extended recovery by total extraperitoneal approach group (n = 30), and a matched-pair inpatient surgery control group by total extraperitoneal approach (n = 20). Objective discharge criteria were based on the postanesthesia discharge scoring system. All patients underwent preoperative counseling on preoperative preparation and postoperative care. Results: There were no statistically significant differences between the ambulatory with extended recovery-total extraperitoneal approach and inpatient-total extraperitoneal approach groups in patient factors (age, body mass index, American Society of Anesthesiologists score, Charlson Comorbidity Index), disease factors (prostate-specific antigen, clinical T stage, biopsy Gleason score, prostate volume) and peri-operative parameters (operative time, blood loss, Trendelenburg angle). All total extraperitoneal robot-assisted laparoscopic radical prostatectomy patients (ambulatory with extended recovery and inpatient surgery groups) met the postanesthesia discharge scoring system discharge criteria ≤23 h from admission. The mean hospital stays for ambulatory with extended recovery-total extraperitoneal and inpatient-total extraperitoneal groups were 20.3 and 52.4 h, respectively (P < 0.001). A total of 29 of 30 patients (97%) in the ambulatory with extended recovery-total extraperitoneal group were discharged ≤23 h of admission. Conclusions: This is the first prospective evaluation of robot-assisted laparoscopic radical prostatectomy by the total extraperitoneal approach, showing that the short-stay ambulatory with extended recovery approach is safe, feasible and with a high success rate. Total extraperitoneal surgical approach is a critical factor for the success of the ambulatory with extended recovery protocol.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%