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World Journal of Urology

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01-06-2013 | Topic paper

Extraperitoneal robot-assisted laparoscopic radical prostatectomy: a single-center experience beyond the learning curve

Authors: Guillaume Ploussard, Laurent Salomon, Bastien Parier, Claude Clément Abbou, Alexandre de la Taille

Published in: World Journal of Urology | Issue 3/2013

Abstract

Objectives

To report our surgical technique and outcomes after extraperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP).

Materials and methods

At Henri Mondor’s Hospital, we performed the first RALRP in 2001 and started to perform routinely RALRP since 2006. Preoperative characteristics, perioperative parameters, functional and oncological outcomes were collected in a prospective database and studied. All parameters were tested in patients undergoing RALRP beyond the learning curve of each surgeon. The overall cohort included 792 patients.

Results

RALRP offers interesting results in terms of hospital stay, operative time, and blood loss. The overall rate of complications was low, especially concerning the rates of anastomosis’ complications. An extraprostatic extension was seen in 42.8 % of specimens. The overall rate of positive margins was 30.7 % of specimens. In our cohort, after a mean follow-up of 19 months, 8.7 % of PSA failure has been reported. The rate of continence was 77.4 % at 6 months and 96.8 % at 2 years. The rate of potency was 17 % at 3 months and 60.9 % at 2 years. The 2-year rate was 86.7 % in case of intrafascial dissection. A trifecta outcome was achieved in 44 and 53 % of men at 12 and 24 months, respectively.

Conclusions

The extraperitoneal approach confers interesting results in terms of perioperative parameters as previously described in series using a transperitoneal approach. Functional outcomes in terms of continence and potency recovery after extraperitoneal seem equivalent to those reported after transperitoneal RALRP. Longer follow-up is warranted to confirm our favorable mid-term oncologic outcomes.

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Title: Extraperitoneal robot-assisted laparoscopic radical prostatectomy: a single-center experience beyond the learning curve
Authors: Guillaume Ploussard
Laurent Salomon
Bastien Parier
Claude Clément Abbou
Alexandre de la Taille
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 3/2013
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-012-1014-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extraperitoneal robot-assisted laparoscopic radical prostatectomy: a single-center experience beyond the learning curve

Abstract

Objectives

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

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