Outcomes of lateral approach in robot-assisted radical prostatectomy: insights from a single-surgeon experience.

Journal: Journal of robotic surgery
PMID:

Abstract

In the era of robotic prostate surgery, various techniques have been developed to improve functional outcomes. Urinary continence has shown satisfactory results, but the preservation of lateral nerves to the periprostatic capsule is only achievable by sparing the pubovesical complex. This study aims to present the first cases of lateral-approach robot-assisted radical prostatectomy (LRRP) performed by a novice surgeon. We conducted a retrospective analysis of 70 prostate cancer patients who underwent LRRP between October 2019 and September 2021, analyzing the perioperative and functional outcomes. The median operative time and intraoperative blood loss were 102 (92-108) minutes and 150 (130-180) mL, respectively. Five minor postoperative complications were reported, and the median hospital stay was 2 (1-2) days. Eleven positive surgical margins occurred. Potency and urinary continence recovery were achieved in 59 (84%) and 66 (94%) patients, respectively, 12 months after surgery. Our analysis shows that LRRP is a safe and effective procedure for prostate cancer surgery. Continence and potency recovery required a short learning curve, with an acceptable recovery rate even in the initial cases.

Authors

  • Carlo Giulioni
    Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy.
  • Daniele Castellani
    Endourology Section, European Association of Urology, Arnhem, The Netherlands.
  • Nam-Son Vuong
    Department of Urology, Bordeaux University Hospital, Bordeaux, France - dr.nsvuong@gmail.com.
  • Julien Riviere
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Julie Piechaud-Kressmann
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Laurent Hugo Lopez
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Thierry Piechaud
    Department of Urology, Clinique Saint Augustin, Bordeaux, France.
  • Jean-Baptiste Roche
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Jean Rouffilange
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Jean-Luc Hoepffner
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Andrea Benedetto Galosi
    Urology Unit, Faculty of Medicine, School of Urology, Azienda Ospedaliera Universitaria Delle Marche, 60127 Ancona, Italy.
  • Richard Pierre Gaston
    Urology Department, Clinique Saint Augustin, Bordeaux, France.
  • Grégory Pierquet
    Urology Department, Clinique Saint Augustin, Bordeaux, France.