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Robotic radical prostatectomy

Melinda Wolboldt, Barbara Saltzman, Patrick Tenbrink, Khaled Shahrour, Samay Jain
INTRODUCTION: With healthcare reform, cost and patient satisfaction will directly affect hospital reimbursement. We present data on same day discharge (SDD) for patients who underwent robot assisted laparoscopic radical prostatectomy (RALP). METHODS: Patient data were gathered in an IRB approved database. In April 2015, surgeon (SJ) began SDD. The SDD protocol for RALP includes multimodal anesthesia/analgesia and extended recovery. Interim analysis revealed that government insurance (CMS) refused hospital reimbursement for SDD...
October 19, 2016: Journal of Endourology
Gabriel Ogaya-Pinies, Yash Kadakia, Hariharan Palayapalayam-Ganapathi, Tracey Woodlief, Cathy Jenson, Vipul Patel
BACKGROUND: One of the key factors contributing to morbidity associated with salvage radical prostatectomy is a significant vesicourethral anastomosis (VUA) disruption or postoperative tissue dehiscence in the region of the distal bladder neck that causes a large prolonged urinary leak, perineal pain, and delayed catheter removal. OBJECTIVE: To describe our surgical technique using a urinary bladder extracellular matrix (UB-ECM) scaffold incorporated into the base of the VUA and the distal bladder neck during salvage robot-assisted radical prostatectomy (sRARP) and to assess outcomes and safety...
October 14, 2016: European Urology
Roberto Bianchi, Gabriele Cozzi, Giuseppe Petralia, Sarah Alessi, Giuseppe Renne, Danilo Bottero, Antonio Brescia, Antonio Cioffi, Giovanni Cordima, Matteo Ferro, Deliu Victor Matei, Federica Mazzoleni, Gennaro Musi, Francesco Alessandro Mistretta, Alessandro Serino, Valeria Maria Lucia Tringali, Ioan Coman, Ottavio De Cobelli
To evaluate the role of multiparametric magnetic resonance imaging (mpMRI) in predicting upgrading, upstaging, and extraprostatic extension in patients with low-risk prostate cancer (PCa). MpMRI may reduce positive surgical margins (PSM) and improve nerve-sparing during robotic-assisted radical prostatectomy (RARP) for localized prostate cancer PCa.This was a retrospective, monocentric, observational study. We retrieved the records of patients undergoing RARP from January 2012 to December 2013 at our Institution...
October 2016: Medicine (Baltimore)
Hung-Jui Tan, Siwei Xiong, Aaron A Laviana, Ryan J Chuang, Eric Treat, Patrick C Walsh, Jim C Hu
INTRODUCTION: Postprostatectomy incontinence significantly impairs quality of life. Although bladder neck intussusception has been reported to accelerate urinary recovery after open radical retropubic prostatectomy, its adaption to robotic surgery has not been assessed. Accordingly, we describe our technique and compare outcomes between men treated with and without bladder neck intussusception during robot-assisted laparoscopic prostatectomy. MATERIALS AND METHODS: We performed a comparative trial of 48 men undergoing robot-assisted laparoscopic prostatectomy alternating between bladder neck intussusception (n = 24) and nonintussusception (n = 24)...
October 12, 2016: Urologic Oncology
Xixue Zhang, Jionglin Wei, Xiaoxing Song, Yuhao Zhang, Weiqing Qian, Lu Sheng, Zhoujun Shen, Lvjun Yang, Rong Dong, Weidong Gu
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy and robot-assisted radical cystectomy have gradually become the preferred choices for urologists as they allow surgeons to perform complex procedures more precisely and effectively. The pneumoperitoneum, which is normally applied in these surgeries to provide visual clarity and space to perform the procedure, may cause hemodynamic disturbance, potentially myocardial injury. Thus surgeons have recently considered opting for the low-pressure pneumoperitoneum to lower this negative impact...
October 10, 2016: Trials
Jim H Hu, Padraic O'Malley, Bilal Chughtai, Abby Isaacs, Jialin Mao, Jason D Wright, Dawn Hershman, Art Sedrakyan
PURPOSE: Robot-assisted surgery has been rapidly adopted in the U.S. for prostate cancer. Its adoption has been driven by market forces and patient preference, and debate continues regarding whether it offers improved outcomes to justify the higher cost relative to open surgery. We examined the comparative effectiveness of robot-assisted vs open radical prostatectomy in cancer control and survival in a nationally representative population. MATERIALS AND METHODS: This population based observational cohort study of patients with prostate cancer undergoing robot-assisted radical prostatectomy and open radical prostatectomy during 2003 to 2012 used data captured in the SEER (Surveillance, Epidemiology, and End Results)-Medicare linked database...
October 5, 2016: Journal of Urology
Virginia Becerra, Mónica Ávila, Jorge Jimenez, Laura Cortes-Sanabria, Yolanda Pardo, Olatz Garin, Angels Pont, Jordi Alonso, Francesc Cots, Montse Ferrer
BACKGROUND: Our objective was to assess the efficiency of treatments in patients with localized prostate cancer, by synthesizing available evidence from European economic evaluations through systematic review. METHODS: Articles published 2000-2015 were searched in MEDLINE, EMBASE and NHS EED (Prospero protocol CRD42015022063). Two authors independently selected studies for inclusion and extracted the data. A third reviewer resolved discrepancies. We included European economic evaluations or cost comparison studies, of any modality of surgery or radiotherapy treatments, regardless the comparator/s...
October 3, 2016: BMC Health Services Research
Matthew J Maurice, Hui Zhu, Simon P Kim, Robert Abouassaly
INTRODUCTION: New technologies may limit access to treatment. We investigated radical prostatectomy (RP) access over time since robotic introduction and the impact of robotic use on RP access relative to other approaches in the modern era. METHODS: Using the National Cancer Data Base, RPs performed during the eras of early (2004-2005) and late (2010-2011) robotic dissemination were identified. The primary endpoints, patient travel distance and treatment delay, were compared by era, and for 2010-2011, by surgical approach...
May 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Abdullah M Alenizi, Kevin C Zorn, Marc Bienz, Emad Rajih, Pierre Alain Hueber, Naif Al-Hathal, Serge Benayoun, Thierry Lebeau, Assaad El-Hakim
INTRODUCTION: To evaluate erectile function recovery following robotic-assisted radical prostatectomy (RARP) according to preoperative sexual health inventory for men (SHIM) score stratification. MATERIALS AND METHODS: We prospectively collected data on 250 consecutive patients who underwent RARP by a single surgeon between October 2006 and October 2012. Thirty-six patients were excluded because of lack of preoperative SHIM score. All patients had a minimum follow up of 2 years...
October 2016: Canadian Journal of Urology
Myoung Jin Ko, Yong Han Kim, Eunsu Kang, Byeong-Cheol Lee, Sujung Lee, Jae-Wook Jung
A 76-year-old man with no notable medical history was scheduled for a robot-assisted radical prostatectomy. After the operation, he was given sugammadex. Two minutes later, ventricular premature contraction bigeminy began, followed by cardiac arrest. Cardiac arrest occurred three times and cardiopulmonary resuscitation was done. The patient recovered after the third cardiopulmonary resuscitation and was transferred to the intensive care unit. Coronary angiography was done on postoperative day 1. The patient was diagnosed with variant angina and discharged uneventfully on postoperative day 8...
October 2016: Korean Journal of Anesthesiology
Johan Stranne, Evelina Stranne
No abstract text is available yet for this article.
October 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Fuminori Sato, Ken Nakagawa, Akihiro Kawauchi, Akio Matsubara, Takatsugu Okegawa, Tomonori Habuchi, Koji Yoshimura, Akio Hoshi, Hidefumi Kinoshita, Akira Miyajima, Yasuyuki Naitoh, Shogo Inoue, Naoshi Itaya, Shintaro Narita, Kazuya Hanai, Kazutoshi Okubo, Masaaki Yanishi, Tadashi Matsuda, Toshiro Terachi, Hiromitsu Mimata
OBJECTIVE: To report on a multi-institutional series of non-robotic urological laparoendoscopic single-site surgery in Japan. METHODS: Consecutive cases of laparoendoscopic single-site surgery carried out between February 2009 and December 2012 at nine academic institutions were included. We examined the surgical outcomes, including conversion and complications rates. RESULTS: Four hundred and sixty-nine cases were included in the analysis...
October 4, 2016: International Journal of Urology: Official Journal of the Japanese Urological Association
Hao G Nguyen, Sanoj Punnen, Janet E Cowan, Michael Leapman, Clint Cary, Christopher Welty, Vivian Weinberg, Matthew R Cooperberg, Maxwell V Meng, Kirsten L Greene, Maurice Garcia, Peter R Carroll
PURPOSE: We evaluated whether placement of a retropubic urethral sling fashioned from autologous vas deferens during robotic-assisted radical prostatectomy (RARP) improved recovery of continence. MATERIALS AND METHODS: In a phase-2, single-blinded trial, age-stratified patients were randomized to undergo RARP by multiple surgeons with or without sling placement. Outcomes were complete continence (0 urinary pads of any type) and near continence (0, occasional or 1 pad per day) at 6 months, assessed with Fisher's exact test and logistic regression...
September 27, 2016: Journal of Urology
Nikolas Katelaris, Declan Murphy, Nathan Lawrentschuk, Athos Katelaris, Daniel Moon
BACKGROUND: Cytoreductive surgery for metastatic prostate cancer is an emerging area of interest with a potential upside that includes local control, delayed initiation of hormone therapy, and possibly improved cancer specific survival. In order for radical prostatectomy to be an effective treatment option for men in this group, the benefits must outweigh the surgical morbidity. The aim of this study was to present a case series and assess the literature feasibility of cytoreductive surgery for men with metastatic prostate cancer...
September 2016: Prostate International
Yun S Ha, Dong J Bak, Jae W Chung, Jun N Lee, Se Y Kwon, Seock H Choi, Tae G Kwon, Tae H Kim
BACKGROUND: Postoperative cystogram has been used to identify clinically significant leaks before catheter removal after radical prostatectomy (RP). The aim of the present study was to investigate the relationship between cystogram findings after RP and early urinary incontinence. METHODS: From January 2011 to February 2015, 417 patients who had undergone a cystography after RP at our hospital were retrospectively analyzed. The ratio dividing the length from the upper part of the pubic symphysis to the neck of the bladder with the length of the total pubic symphysis height [bladder neck pubic symphysis ratio (BNPSR)] was measured and urinary incontinence was assessed by the subjects' use of a pad...
September 29, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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 the outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to peri-operative complications, oncological results and functional outcomes in the early post operative 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...
September 29, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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(3), 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)...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Masashi Honda, Bunya Kawamoto, Shuichi Morizane, Katsuya Hikita, Kuniyasu Muraoka, Takehiro Sejima, Atsushi Takenaka
BACKGROUND: The aim of this study is to develop a novel prognostic model for estimating the risk of postoperative urinary incontinence (UI) after robot-assisted radical prostatectomy (RARP). METHODS: Participants comprised 131 men who underwent RARP at our hospital from 2011 to 2013. Cox regression analyses were performed to evaluate associations between UI and preoperative factors including filling cystometry and pressure-flow study results and magnetic resonance imaging...
September 27, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Ja Yoon Ku, Chan Ho Lee, Jeong Zoo Lee, Hong Koo Ha
AIM: To compare the functional outcomes after laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RARP). METHODS: Between September 2008 and January 2016, 712 patients underwent radical prostatectomy (RP; 614 LRP and 98 RARP). Recovery of incontinence was evaluated through a 24-h pad test. Urinary and erectile function was evaluated using the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function-5...
September 26, 2016: Asia-Pacific Journal of Clinical Oncology
Mark William Louie-Johnsun, Marcus M Handmer, Ross John Spero Calopedos, Charles Chabert, Ronald J Cohen, Troy R J Gianduzzo, Paul A Kearns, Daniel A Moon, Jason Ooi, Tom Shannon, David Sofield, Andrew H H Tan
OBJECTIVES: To analyse the Australian experience of high-volume Fellowship-trained Laparoscopic Radical Prostatectomy (LRP) surgeons. MATERIALS AND METHODS: 2943 LRP cases were performed by nine Australian surgeons. The inclusion criteria were a prospectively collected database with a minimum of 100 consecutive LRP cases. The surgeons' LRP experience commenced at various times from July 2003 to September 2009. Data were analysed for demographic, peri-operative, oncological and functional outcomes...
September 23, 2016: BJU International
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