Robot-Assisted Laparoscopic Radical Prostatectomy: Perioperative Outcomes of 1500 Cases

2008 ◽  
Vol 22 (10) ◽  
pp. 2299-2306 ◽  
Author(s):  
Vipul R. Patel ◽  
Kenneth J. Palmer ◽  
Geoff Coughlin ◽  
Srinivas Samavedi
Keyword(s):  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted

scholarly journals Morbid obesity is adversely associated with perioperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy

2020 ◽  
Vol 14 (11) ◽  
Author(s):  
Hedong Han ◽  
Yingyi Qin ◽  
Yiming Ruan ◽  
Jia He ◽  
Zhexu Cao ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Laparoscopic Radical Prostatectomy ◽  
Class I ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Obesity Class ◽  
Propensity Score Weighting

Introduction: Robot-assisted laparoscopic radical prostatectomy (RALRP) may be more challenging in obese individuals. This study aimed to evaluate whether obesity had an adverse effect on perioperative outcomes following RALRP. Methods: Hospitalized patients who underwent RALRP from 2008–2014 were identified using the National Inpatient Sample database. We grouped RALRP patients into non-obese, obesity class I–II and obesity class III (morbid obesity). Rates of blood transfusion, intraoperative and postoperative complications, in-hospital mortality, prolonged length of stay, and total costs were compared among the three groups by univariate regression, multivariate regression, and propensity score weighting analysis. Results: Of 53 301 patients identified, 48 725 were non-obese, 3572 were diagnosed with obesity class I–II, and 1004 were diagnosed with morbid obesity. Compared to non-obesity (7.62%), overall postoperative complications were commonly observed in obesity class I–II (10.55%) and morbid obesity (17.11%). Multivariable analyses suggested that morbid obesity was associated with increased overall postoperative (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.65–2.42), cardiac (OR 1.63; 95% CI 1.03–2.58), respiratory (OR 4.03; 95% CI 3.04–5.36), genitourinary (OR 1.77; 95% CI 1.08–2.90), miscellaneous medical (OR 1.94; 95% CI 1.58–2.39) complications, prolonged hospitalization (OR 1.86; 95% CI 1.57–2.21), and 12% higher total cost. Propensity score weighting analysis yielded similar results. Adequate covariate balance was achieved for all variables after weighting. Conclusions: Morbid obesity is adversely associated with perioperative outcomes in RALRP. Close management is required in patients undergoing RALRP with morbid obesity for potential worse prognosis.

scholarly journals A comparison of the da Vinci Xi vs. da Vinci Si surgical systems for radical prostatectomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun-Yang Lei ◽  
Wen-Jie Xie ◽  
Sheng-Qiang Fu ◽  
Ming Ma ◽  
Ting Sun
Keyword(s):  
Radical Prostatectomy ◽  
Da Vinci ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Da Vinci Xi ◽  
Robot Assisted ◽  
Short Term ◽  
Term Efficacy ◽  
Da Vinci Si ◽  
The Cost

Abstract Background To compare the perioperative and short-term efficacy and cost of the da Vinci Xi and da Vinci Si surgical systems for radical prostatectomy. Methods We retrospectively analyzed the clinical data of 175 patients with prostate cancer who underwent radical prostatectomy with the da Vinci Si or Xi surgical systems in our hospital from June 2019 to June 2020. Of the 175 patients, 82 underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Xi surgery system, and 93 patients underwent robot-assisted laparoscopic radical prostatectomy with the da Vinci Si surgical system. The perioperative outcomes, short-term efficacy and costs were compared between the two groups. Results The anesthesia time, operation time, docking time, indwelling catheter time and postoperative bed rest time in the Xi group were shorter than those in the Si group (respectively, 268.8 min vs. 219.3 min, P = 0.001; 228.2 min vs. 259.6 min, P < 0.001; 7.4 min vs. 12.7 min, P < 0.001; 8.6 d vs. 9.7 d, P = 0.036; 2.2 d vs. 2.6 d, P = 0.002). However, the total cost of hospitalization and the cost of intraoperative consumables in the Xi group were higher than those in the Si group (84,740.7 vs. 76,739.1 ¥, P = 0.003; 13,199.4 vs. 10,823.0 ¥, P = 0.019). Conclusions Although the cost of robot-assisted radical prostatectomy is higher, compared with the Si system, the Xi system has better perioperative outcomes and can provide similar short-term efficacy and oncology outcomes.

scholarly journals Perioperative outcomes of robot-assisted laparoscopic radical prostatectomy (RALRP) and LRP in patients with prostate cancer based on risk groups

2020 ◽  
Vol 18 (3) ◽  
pp. 187-193
Author(s):  
Napat Amornratananont ◽  
Kun Sirisopana ◽  
Suchin Worawichawong ◽  
Panas Chalermsanyakorn ◽  
Premsant Sangkum ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Groups ◽  
Laparoscopic Radical Prostatectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted

scholarly journals Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a multi-institutional comparative study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Amr A. Faddan ◽  
Mahmoud M. Shalaby ◽  
Mohamed Gadelmoula ◽  
Younis Alshamsi ◽  
Daniar K. Osmonov ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Statistical Significance ◽  
Operating Time ◽  
Perioperative Outcomes ◽  
Academic Institutions ◽  
Robot Assisted ◽  
Surgical Specimen ◽  
Significant Difference

Abstract Background The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and finally robot-assisted techniques. Herein, we compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions. Methods A total of 394 patients underwent RP between January 2016 and December 2018 in four academic institutions; their records were reviewed. We recorded the patient age, BMI, PSA level, Gleason score and TNM stage, type of surgery, the pathological data from the surgical specimen, the perioperative complications, unplanned reoperating, and readmission rates within 3 months postoperatively. Statistical significance was set at (P < 0.05). All reported P values are two-sided. Results A total of 123 patients underwent RALRP, 220 patients underwent RRP, and 51 underwent LRP. There was no statistically significant difference between the three groups regarding age, BMI, prostatic volume, and preoperative PSA. However, there were statistically significant differences between them regarding the operating time (P < .0001), catheterization period (P < .001), hospital stay (P < .0001), and overall complications rate (P = .023). Conclusions The minimally invasive procedures (RALRP and LRP) are followed by a significantly lower complication rate. However, the patients’ factors and surgical experience likely impact perioperative outcomes and complications.

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