Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases

Menon, Mani; Tewari, Ashutosh; Peabody, James O.; Shrivastava, Aviral; Kaul, Sanjeev; Bhandari, Akshay; Hemal, Ashok K.

doi:10.1016/j.ucl.2004.06.011

Cited by 292 publications

(170 citation statements)

References 44 publications

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“…RARP was performed by three surgeons and RRP by 17, using modified variations of previously reported techniques [4,8]. Most RARP procedures were done by one surgeon (M.T.G.)…”

Section: Methodsmentioning

confidence: 99%

“…At present there are several definitive surgical options for managing clinically localized prostate cancer, including radical retropubic prostatectomy (RRP), laparoscopic RP (LRP), and robot-assisted RP (RARP) [1][2][3][4][5][6][7][8][9][10][11][12]. Given the novelty and interest in minimally invasive/ minimal access options, studies comparing the laparoscopic approaches to RRP have been published [5,7,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

et al. 2009

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OBJECTIVETo assess the perioperative complications and early oncological results in a comparative study matching open radical retropubic (RRP) and robot‐assisted radical prostatectomy (RARP) groups.PATIENTS AND METHODSFrom August 2002 to December 2005 we identified 294 patients undergoing RARP for clinically localized prostate cancer. A comparison RRP group of 588 patients from the same period was matched 2:1 for surgical year, age, preoperative prostate‐specific antigen level, clinical stage and biopsy Gleason grade. Perioperative complications were compared. Patients completed a standardized quality‐of‐life questionnaire. Pathological features were assessed and Kaplan‐Meier estimates of biochemical progression‐free survival (PFS) were compared.RESULTSThere was no significant difference in overall perioperative complications between the RARP and RRP groups (8.0% vs 4.8%, P = 0.064). Wound herniation was more common after RARP (1.0% vs none, P = 0.038), and development of bladder neck contracture was more common after RRP (1.2% vs 4.6%; P < 0.018). The hospital stay was less after RARP (29.3% vs 19.4%, P = 0.004, for a stay of 1 day). At the 1‐year follow‐up there was no significant difference in continence (RARP 91.8%, RRP 93.7%, P = 0.344) or potency (RARP 70.0%, RRP 62.8%, P = 0.081) rates. The biochemical PFS was no different between treatments at 3 years (RARP 92.4%, RRP 92.2%; P = 0.69).CONCLUSIONThere was no significant difference in overall early complication, long‐term continence or potency rates between the RARP and RRP techniques. Furthermore, early oncological outcomes were similar, with equivalent margin positivity and PFS between the groups.

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“…RARP was performed by three surgeons and RRP by 17, using modified variations of previously reported techniques [4,8]. Most RARP procedures were done by one surgeon (M.T.G.)…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

et al. 2009

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“…Originally introduced by Terrence Millin in 1945 and then significantly refined by Patrick Walsh and colleagues in the 1980s, open radical retropubic prostatectomy (ORP) has long been considered the gold-standard treatment of clinically localized prostate cancer[5,6]. The past 2 decades have ushered in minimally invasive surgical approaches, and urologists have embraced these technological advances and refined approaches for pure laparoscopic and robotic-assisted laparoscopic radical prostatectomy (RALP) with the hope of improving patient outcomes[7,8]. …”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

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“…However, nodal yield, which may serve as a surrogate for adequacy of dissection, was not reported. 50 An updated report from the same group's experience in 2007, which comprised 2766 patients, cited a total of 20 positive nodes. However, total number of patients undergoing PLND, anatomic extent, and nodal yield were not reported.…”

Section: Large Seriesmentioning

confidence: 99%

Lymph node dissection during robot-assisted radical prostatectomy: where do we stand?

Silberstein

Derweesh

Kane

2009

Prostate Cancer Prostatic Dis

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Since the initial report of robot-assisted laparoscopic prostatectomy (RALP) in 2001, the technique has gained rapid acceptance and utilization. When compared with more traditional forms of surgical intervention, there is still much debate with respect to cost, and impact on potency and continence. Less often is the focus on oncologic outcomes. Pelvic lymph node dissection (PLND) at the time of prostatectomy is an important part of the surgical intervention for prostate cancer and is currently underreported during robotic procedures. Herein, we review the current controversies on the value and extent of PLND and the status of emerging data regarding robot-assisted PLND. IntroductionRadical prostatectomy has undergone an evolution in technique over many decades with older procedures being largely replaced by newer ones due to perceived superiority of oncologic outcomes or diminution of operative morbidity. [1][2][3] In the United States, da Vinci robot-assisted laparoscopic prostatectomy (RALP) has gained rapid popularity because of the facility with which it allows laparoscopic skills to be transferred to even non-laparoscopically trained surgeons. 4 Thus, the benefits of laparoscopy, enhanced optical magnification, decreased blood loss, and minimal incisions can be obtained without prolonged learning curves. Any time a new technique is introduced, it must be compared with current methods to ascertain at least equivalent outcomes, in addition to assessment of benefits, and limitations. To this end, there have been recent publications from the centers of excellence attempting to compare RALP to radical retropubic and pure laparoscopic techniques. 5,6 However, there has been a paucity of literature addressing pelvic lymph node dissection (PLND) at the time of RALP. This is not the case with all urologic robot-assisted procedures; recent literature on robot-assisted radical cystectomy has specifically focused on feasibility and adequacy of robot-assisted PLND. 7 Thus, the lack of literature on robot-assisted PLND at RALP may reflect that PLND at the time of prostatectomy performed through open technique (or otherwise) is a controversial topic. Important questions remain regarding patient selection, potential benefit and anatomic extent of the dissection, nodal yield, and complication rates. We will review these controversies and the state of the literature regarding RALP PLND in this context. Ongoing controversies in PLNDIn the United States, prostate cancer is the most commonly diagnosed noncutaneous cancer and the second-leading cause of cancer death among men. In 2008, 186 320 men were diagnosed with, and 28 660 men died of, prostate cancer in the United States. 8 The advent of prostate-specific antigen (PSA) screening has led to a profound stage migration such that men diagnosed in the PSA era are younger and have lower clinical and pathologic stage and lower mortality rates, and when treated they have improved margin-free status and biochemical progression-free survival and decreased extracapsular extension a...

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Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases

Cited by 292 publications

References 44 publications

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lymph node dissection during robot-assisted radical prostatectomy: where do we stand?

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