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Robotic radical prostatectomy

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https://www.readbyqxmd.com/read/28097262/lessons-learned-over-a-decade-of-pediatric-robotic-ureteral-reimplantation
#1
REVIEW
Minki Baek, Chester J Koh
The da Vinci robotic system has improved surgeon dexterity, ergonomics, and visualization to allow for a minimally invasive option for complex reconstructive procedures in children. Over the past decade, robot-assisted laparoscopic ureteral reimplantation (RALUR) has become a viable minimally invasive surgical option for pediatric vesicoureteral reflux (VUR). However, higher-than-expected complication rates and suboptimal reflux resolution rates at some centers have also been reported. The heterogeneity of surgical outcomes may arise from the inherent and underestimated complexity of the RALUR procedure that may justify its reclassification as a complex reconstructive procedure and especially for robotic surgeons early in their learning curve...
January 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28089387/treatment-of-men-with-high-risk-prostate-cancer-based-on-race-insurance-coverage-and-access-to-advanced-technology
#2
Robert Steven Gerhard, Dattatraya Patil, Yuan Liu, Kenneth Ogan, Mehrdad Alemozaffar, Ashesh B Jani, Omer N Kucuk, Viraj A Master, Theresa W Gillespie, Christopher P Filson
PURPOSE: We characterized factors related to nondefinitive management (NDM) of patients with high-risk prostate cancer and assessed impact from race, insurance status, and facility-level volume of technologically advanced prostate cancer treatments (i.e., intensity-modulated radiation therapy, robotic-assisted laparoscopic radical prostatectomy) on this outcome. METHODS: We identified men with high-risk localized prostate cancer (based on D׳Amico criteria) in the National Cancer Database (2010-2012)...
January 12, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28081352/removing-the-specimen-with-traction-during-robotic-radical-prostatectomy-does-not-cause-a-positive-surgical-margin
#3
Serkan Altınova, Abidin Egemen İşgören, Ziya Akbulut, Muhammet Fuat Özcan, Abdullah Erdem Canda, Ali Fuat Atmaca, Mevlana Derya Balbay
BACKGROUND/AIM: The aim of this study was to gauge whether removal of a specimen with traction during robot-assisted laparoscopic radical prostatectomy causes a positive surgical margin or not. MATERIALS AND METHODS: One hundred and sixty-nine patients with localized prostate cancer who underwent robot-assisted laparoscopic radical prostatectomy from 2009 to 2011 were included in the study. After dividing the patients into two groups, we recorded their characteristics and pre-op/post-op evaluations...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28078524/vesico-urethral-anastomosis-vua-evaluation-of-short-and-long-term-outcome-after-robot-assisted-laparoscopic-radical-prostatectomy-rarp-selective-cystogram-to-improve-outcome
#4
C Tillier, H A M van Muilekom, J Bloos-van der Hulst, N Grivas, H G van der Poel
The role of a cystogram to assess the vesico-urethral anastomosis (VUA) after robot-assisted laparoscopic radical prostatectomy (RARP) has been debated. Early catheter removal without cystogram was reported to be associated with a trend towards an increased risk of acute urinary retention (AUR). In two cohorts we studied the effects of VUA leakage on cystogram and functional outcome after RARP. Cohort A contained 1390 consecutive men that routinely underwent a cystogram after RARP. Transurethral catheter (TUC) was removed in the absence of VUA leakage or minimal leakage on subsequent repeat cystogram...
January 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28078523/simple-vs-six-branches-autologous-suburethral-sling-during-robot-assisted-radical-prostatectomy-to-improve-early-urinary-continence-recovery-prospective-randomized-study
#5
Andrea Cestari, Matteo Ferrari, Mattia Sangalli, Matteo Zanoni, Massimo Ghezzi, Fabio Fabbri, Francesco Sozzi, Carolina Lolli, Vincenzo Dell'Acqua, Patrizio Rigatti
We have recently described the use of a retropubic suburethral autologous sling created and placed during robotic radical prostatectomy (RARP). In this study, we assess the effectiveness of newly designed six-branches compared to two-branches suburethral autologous sling in improving early urinary continence (UC) recovery. 120 patients submitted to RARP were prospectively randomized according to the intraoperative positioning of six-branches (group 1, n = 60) or two-branches autologous sling (group 2, n = 60) obtained by different configuration of a same tract of vas deferens removed...
January 11, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28075516/quantifying-severe-urinary-complications-after-radical-prostatectomy-the-development-and-validation-of-a-surgical-performance-indicator-using-hospital-administrative-data
#6
A Sujenthiran, S C Charman, M Parry, J Nossiter, A Aggarwal, P Dasgupta, H Payne, N W Clarke, P Cathcart, J van der Meulen
OBJECTIVES: To develop and validate a surgical performance indicator based on severe urinary complications that require an intervention within two years after radical prostatectomy (RP) identified in hospital administrative data. PATIENTS AND METHODS: Men who underwent RP between 2008 and 2012 in England were identified using hospital administrative data. A transparent coding-framework based on procedure codes was developed to identify severe urinary complications which were grouped into "stricture", "incontinence" and "other"...
January 11, 2017: BJU International
https://www.readbyqxmd.com/read/28075160/can-we-accomplish-better-oncological-results-with-robot-assisted-radical-prostatectomy
#7
Ali Riza Kural, Can Obek, Tünkut Doğanca
Surgical removal with radical prostatectomy has been a cornerstone for the treatment of prostate cancer and is associated with level one evidence for survival advantage compared to watchful waiting. Since the first structured robotic program was launched in 2000, robot-assisted radical prostatectomy (RARP) has had a rapid diffusion and surpassed its open (ORP) and laparoscopic (LRP) counterparts in the United States and is progressively expanding in other countries. Interestingly, this common acceptance of RARP was initially driven in the paucity of robust clinical evidence...
January 11, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28073298/extraperitoneal-vs-transperitoneal-robot-assisted-radical-prostatectomy-in-the-setting-of-prior-abdominal-or-pelvic-surgery
#8
David Horovitz, Changyong Feng, Edward M Messing, Jean Volny Joseph
INTRODUCTION: During Robotic-Assisted Radical Prostatectomy (RARP), the prostate may be approached extraperiteoneally (eRARP) or transperitoneally (tRARP). The former avoids the abdominal cavity which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique. METHODS: A retrospective review of patients treated with RARP from July 1, 2003-Dec. 31, 2014 with a minimum follow-up of 3 months was undertaken...
January 10, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28070166/biochemical-recurrence-prediction-in-high-risk-prostate-cancer-patients-following-robot-assisted-radical-prostatectomy
#9
Noriya Yamaguchi, Tetsuya Yumioka, Hideto Iwamoto, Toshihiko Masago, Shuichi Morizane, Masashi Honda, Takehiro Sejima, Atsushi Takenaka
BACKGROUND: High-risk prostate cancer treatment has been controversial. Some high-risk prostate cancer patients fail to respond to radical prostatectomy only. Thus, we aimed to investigate the predictive factors for biochemical recurrence (BCR) and identify patients who could achieve sufficient therapeutic effect by radical prostatectomy only. METHODS: Of 264 medical records reviewed, 141 low-intermediate-risk and 100 high-risk prostate cancer patients, excluding those who had received neoadjuvant hormone therapy, were analyzed...
December 2016: Yonago Acta Medica
https://www.readbyqxmd.com/read/28056561/survey-of-abdominal-access-and-associated-morbidity-for-robot-assisted-radical-prostatectomy-rarp-does-palmer-s-point-warrant-further-awareness-and-study
#10
William K Johnston Iii, Susan Linsell, David Christopher Miller, Khurshid R Ghani
INTRODUCTION: Laparoscopic access for RARP is often initiated in the peri-umbilical location. Palmer's Point, located in the left upper quadrant, has been reported as an alternative access site for pelvic laparoscopy to reduce morbidity, but not widely reported among urologists. To better understand surgeons' preferences for access and its associated morbidity during RARP, we surveyed surgeons from two urological organizations. METHODS: An anonymous online questionnaire that assessed training, experience, and preferences for RARP was emailed in December 2014 to members of the Endourology Society (ES) and the Michigan Urological Society Improvement Collaborative (MUSIC) ...
January 5, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28054309/the-effect-of-evolving-strategies-in-the-surgical-management-of-organ-confined-prostate-cancer-comparison-of-data-from-2005-to-2014-in-a-multicenter-setting
#11
Margit Pohle, Ahmed Magheli, Tom Fischer, Carsten Kempkensteffen, Jonas Busch, Hannes Cash, Kurt Miller, Stefan Hinz
INTRODUCTION: The objective of this study was to evaluate changes of patient characteristics and surgical techniques in radical prostatectomy in Germany within the last decade. METHODS: Data from 44 German prostate cancer centers were included in the study. Patients' characteristics (age, initial PSA value), surgical techniques (open vs. minimally invasive approaches), perioperative parameters (operating time, rate of nerve-sparing (NS) radical prostatectomies (RPs), hospitalization time, catheter indwelling time, surgical margin status, number of dissected lymph nodes (LN)), and pathological findings (tumor stage, Gleason score) were analyzed...
January 4, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28012768/laparoscopic-radical-prostatectomy-with-a-remote-controlled-robot
#12
Clément-Claude Abbou, András Hoznek, Laurent Salomon, Leif Eric Olsson, Adrian Lobontiu, Fabien Saint, Antony Cicco, Patrick Antiphon, Dominique Chopin
PURPOSE: Robotics in surgery is a recent innovation. This technology offers a number of attractive features in laparoscopy. It overcomes the difficulties with fixed port sites by restoring all 6 degrees of freedom at the instrument tips, provides new possibilities for miniaturization of surgical tasks and allows remote controlled surgery. We investigated the applicability of remote controlled robotic surgery to laparoscopic radical prostatectomy. MATERIALS AND METHODS: Our previous experience with laparoscopic prostatectomy served as a basis for adapting robotic surgery to this procedure...
December 21, 2016: Journal of Urology
https://www.readbyqxmd.com/read/28009151/comparing-conventional-laparoscopic-to-robotic-assisted-extended-pelvic-lymph-node-dissection-in-men-with-intermediate-and-high-risk-prostate-cancer-a-matched-pair-analysis
#13
Simone Albisinni, Fouad Aoun, Dam LE Dinh, Marc Zanaty, Eric Hawaux, Alexandre Peltier, Roland VAN Velthoven
BACKGROUND: In intermediate and high-risk prostate cancer patients, a robotic-assisted approach is increasingly being used for prostatectomy and extended pelvic lymph node dissection (ePLND). This is reducing the number of conventional laparoscopic radical prostatectomies (LR P) and laparoscopic ePLNDs for prostate cancer in Europe. Aim of this study is to compare laparoscopic ePLND to robotic-assisted ePLND in a cohort of patients with intermediate and high risk prostate cancer. METHODS: We performed a matched-pair analysis matching 1:1 70 patients who underwent LRP+ePLND (2004-2009) to 70 who underwent RAR P+ePLND (2010-2014)...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28009149/robotic-assisted-laparoscopic-radical-prostatectomy-following-transrectal-compared-to-transperineal-prostate-biopsy-surgical-oncological-and-functional-outcomes
#14
Karan Wadhwa, Giulio Patruno, Andrew Patterson, Tristan Barrett, Chandni Dalia, Brendan C Koo, Ferdia A Gallagher, Eva Serrao, Anne Warren, Vincent Gnanapragasam, Nimish Shah, Andrew Doble, Christof Kastner
BACKGROUND: To assess if transperineal prostate (TP) biopsy affects th e outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to perioperative complications, oncological results and functional outcomes in the early postoperative setting. METHODS: We identified 61 men who had undergone RALP after TP biopsies, from June 2012 to June 2014 and a control group of 120 men who had undergone RALP after conventional TRUS biopsy in the same period...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28009147/ten-year-experience-of-robot-assisted-radical-prostatectomy-the-road-from-cherry-picking-to-standard-procedure
#15
Jonas Schiffmann, Alexander Haese, Katharina Boehm, Georg Salomon, Thomas Steuber, Hans Heinzer, Hartwig Huland, Markus Graefen, Pierre I Karakiewicz
BACKGROUND: Patients treated with robot-assisted radical prostatectomy (RARP) are frequently selected according to more favorable characteristics. Such patient selection might decrease according to increasing experience. METHODS: We relied on the Martini Clinic Prostate Cancer Center database and focused on patients treated with RARP between 2004 and 2013. Differences in clinical, pathological and surgical characteristics at RARP over time (2004-2010, 2011-2012 and 2013) were assessed...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28009146/positive-surgical-margins-and-early-oncological-outcomes-of-robotic-vs-open-radical-prostatectomy-at-a-medium-case-load-institution
#16
Alessandro Antonelli, Mario Sodano, Angelo Peroni, Irene Mittino, Carlotta Palumbo, Maria Furlan, Francesca Carobbio, Regina Tardanico, Simona Fisogni, Claudio Simeone
BACKGROUND: The aim of this study was to analyze the rates of positive surgical margins (PSM) after radical prostatectomy in patients undergoing robotic surgery (robot assisted laparoscopic prostatectomy [RALP]) compared with those undergoing open surgery (radical retropubic prostatectomy [RRP]), at an institution with medium case load. METHODS: Retrospective consultation of a perspectively-maintained database that stores the data of all the patients submitted to radical prostatectomy at our institution since 1/2008...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28009145/predicting-the-risk-of-positive-surgical-margins-following-robotic-assisted-radical-prostatectomy
#17
David R Alchin, Declan Murphy, Nathan Lawrentschuk
INTRODUCTION: The number of men receiving radical prostatectomy (RP) in Victoria, Australia, increased seven-fold in the period 1993-2010, and increasingly robotic-assisted radical prostatectomy (RARP) is being utilized over the open and laparoscopic approaches. The longer-term oncological outcomes of RARP are beginning to be reported in the literature. The objective of this review was to determine whether any preoperative variables may be associated with the occurrence of positive surgical margins (PSMs) following RARP and how these may translate into subsequent risk of biochemical recurrence (BCR)...
February 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28006957/the-role-of-robot-assisted-radical-prostatectomy-in-high-risk-prostate-cancer
#18
Victor Srougi, Rafael R Tourinho-Barbosa, Igor Nunes-Silva, Mohammed Baghdadi, Silvia Garcia-Barreras, Gregory Rembeyo, Sophie S Eiffel, Eric Barret, Francois Rozet, Marc Galiano, Rafael Sanchez-Salas, Xavier Cathelineau
Prostate cancer (PCa) is stratified into different risk categories based on the patient's prognosis. High-risk disease was formerly characterized by an increased risk of metastasis and lethality, requiring complex treatments. Surgery was recently highlighted to have a pivotal role for the treatment of such cases, even as monotherapy. In the past, open radical prostatectomy was performed for most patients with high-risk PCa; however, robot-assisted radical prostatectomy (RARP) emerged as a reasonable option because it provided optimal outcomes for low- and intermediate-risk PCa...
January 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/27995221/nerve-sparing-techniques-and-results-in-robot-assisted-radical-prostatectomy
#19
REVIEW
Hasan Hüseyin Tavukçu, Omer Aytac, Fatih Atug
Nerve-sparing techniques in robot-assisted radical prostatectomy (RARP) have advanced with the developments defining the prostate anatomy and robotic surgery in recent years. In this review we discussed the surgical anatomy, current nerve-sparing techniques and results of these operations. It is important to define the right and key anatomic landmarks for nerve-sparing in RARP which can demonstrate individual variations. The patients' risk assessment before the operation and intraoperative anatomic variations may affect the nerve-sparing technique, nerve-sparing degree and the approach...
December 2016: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/27995220/standardized-4-step-technique-of-bladder-neck-dissection-during-robot-assisted-radical-prostatectomy
#20
REVIEW
Mansour Alnazari, Marc Zanaty, Emad Rajih, Assaad El-Hakim, Kevin C Zorn
Bladder neck (BN) dissection is considered one of the most challenging steps during robot-assisted radical prostatectomy. Better understanding of the BN anatomy, coupled with a standardized approach may facilitate dissection while minimizing complications. We describe in this article the 4 anatomic spaces during standardized BN dissection, as well other technical maneuvers of managing difficult scenarios including treatment of a large median lobe or patients with previous transurethral resection of the prostate...
December 2016: Investigative and Clinical Urology
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