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Robotic prostatectomy

A Sujenthiran, J Nossiter, M Parry, S C Charman, A Aggarwal, H Payne, P Dasgupta, N W Clarke, J van der Meulen, P Cathcart
OBJECTIVES: Despite the rapid adoption of robot-assisted radical prostatectomy (RARP), there is little evidence about the occurrence of medium-term urinary complications with this type of surgery compared to laparoscopic (LRP) or retropubic open radical prostatectomy (ORP). The aim of this study was to evaluate the occurrence of severe urinary complications within two years of surgery in men undergoing RARP, LRP or ORP. PATIENTS AND METHODS: Population-based cohort study of men who underwent RARP (n=4,947), LRP (n= 5,479), or ORP (n=6,873) between 2008 and 2012 in the English National Health Service (NHS) using national cancer registry records linked to Hospital Episodes Statistics - an administrative database of admissions to NHS hospitals...
October 15, 2017: BJU International
Aldo Brassetti, Riccardo Lombardo, Paolo Emiliozzi, Antonio Cardi, De Vico Antonio, Iannello Antonio, Scapellato Aldo, Riga Tommaso, Pansadoro Alberto, D'Elia Gianluca
OBJECTIVES: To analyse the performance of Prostate specific antigen density (PSAD) as a predictor of upstaging and Prognostic Grade Group (PGG) upgrading. METHODS: we retrospectively evaluated data on men with prostate PCa treated with robotic radical prostatectomy (RALP) at our center in 2014-2015. Preoperative PSAD was calculated. Bioptic and pathologic PGGs were also considered in the analysis. We defined upgrading any increase in PGG after RALP; upstaging was the pathological diagnosis of a pT≥3a PCa clinically unsuspected...
October 12, 2017: Urology
Kelly A Chiles, Ilene Staff, Kelly Johnson-Arbor, Alison Champagne, Tara McLaughlin, R James Graydon
PURPOSE: To evaluate the efficacy and safety of hyperbaric oxygenation therapy (HBO2T) in the preservation of erectile function (EF) as part of penile rehabilitation (PR) after robot assisted bilateral nerve sparing radical prostatectomy for prostate cancer. MATERIALS AND METHODS: A prospective, randomized double-blind study was conducted from January, 2009 to April, 2013. Men (40-65 years old) who underwent robot assisted bilateral nerve sparing radical prostatectomy were randomized 1:1 to either the control or treatment group...
October 12, 2017: Journal of Urology
Karin Stinesen Kollberg, Thordis Thorsteinsdottir, Ulrica Wilderäng, Jonas Hugosson, Peter Wiklund, Anders Bjartell, Stefan Carlsson, Johan Stranne, Eva Haglind, Gunnar Steineck
OBJECTIVE: Studies indicate that social constraints (barriers to emotional expression) may be a risk factor for psychological morbidity. We aimed to investigate the association between prostate cancer- related social constraints and psychological well-being following prostate cancer surgery. METHODS: In a group of 3478 partnered patients, participating in the Laparoscopic Prostatectomy Robot Open (LAPPRO) trial, a prospective multicenter comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer, we used log-binomial regression analysis to investigate the links between prostate cancer-related social constraints at 3 months after surgery and psychological well-being at 12 and 24 months...
October 12, 2017: Psycho-oncology
Shu-Chi Wang, Cheng-Che Chen, Cheng-Kuang Yang, Siu-Wan Hung, Yee-Jee Jan, Yen-Chuan Ou
BACKGROUND: In order to prevent over treatment of prostate cancer and significant adverse effects after surgical intervention, active surveillance was suggested in low risk or very low risk patients. This study aimed to retrospectively analyze the adverse pathological results of candidates eligible for active surveillance. METHODS: A total of 904 patients underwent robot-assisted laparoscopic radical prostatectomy in this single institute, from 2005 to April 2014...
October 2, 2017: Journal of the Chinese Medical Association: JCMA
Lars A R Reisæter, Jurgen J Fütterer, Are Losnegård, Yngve Nygård, Jan Monssen, Karsten Gravdal, Ole J Halvorsen, Lars A Akslen, Martin Biermann, Svein Haukaas, Jarle Rørvik, Christian Beisland
PURPOSE: To improve preoperative risk stratification for prostate cancer (PCa) by incorporating multiparametric MRI (mpMRI) features into risk stratification tools for PCa, CAPRA and D'Amico. METHODS: 807 consecutive patients operated on by robot-assisted radical prostatectomy at our institution during the period 2010-2015 were followed to identify biochemical recurrence (BCR). 591 patients were eligible for final analysis. We employed stepwise backward likelihood methodology and penalised Cox cross-validation to identify the most significant predictors of BCR including mpMRI features...
October 6, 2017: European Radiology
Ajay Aggarwal, Daniel Lewis, Malcolm Mason, Arnie Purushotham, Richard Sullivan, Jan van der Meulen
BACKGROUND: There is a scarcity of evidence about the role of patient choice and hospital competition policies on surgical cancer services. Previous evidence has shown that patients are prepared to bypass their nearest cancer centre to receive surgery at more distant centres that better meet their needs. In this national, population-based study we investigated the effect of patient mobility and hospital competition on service configuration and technology adoption in the National Health Service (NHS) in England, using prostate cancer surgery as a model...
October 3, 2017: Lancet Oncology
Gunilla Högnäs, Kati Kivinummi, Heini M L Kallio, Reija Hieta, Pekka Ruusuvuori, Antti Koskenalho, Juha Kesseli, Teuvo L J Tammela, Jarno Riikonen, Joanna Ilvesaro, Saara Kares, Pasi P Hirvikoski, Marita Laurila, Tuomas Mirtti, Matti Nykter, Paula M Kujala, Tapio Visakorpi, Teemu Tolonen, G Steven Bova
Advances in prostate cancer biology and diagnostics are dependent upon high-fidelity integration of clinical, histomorphologic, and molecular phenotypic findings. In this study, we compared fresh frozen, formalin-fixed paraffin-embedded (FFPE), and PAXgene-fixed paraffin-embedded (PFPE) tissue preparation methods in radical prostatectomy prostate tissue from 36 patients and performed a preliminary test of feasibility of using PFPE tissue in routine prostate surgical pathology diagnostic assessment. In addition to comparing histology, immunohistochemistry, and general measures of DNA and RNA integrity in each fixation method, we performed functional tests of DNA and RNA quality, including targeted Miseq RNA and DNA sequencing, and implemented methods to relate DNA and RNA yield and quality to quantified DNA and RNA picogram nuclear content in each tissue volume studied...
October 3, 2017: American Journal of Surgical Pathology
Matthew J Maurice, Daniel Ramirez, Emre Gorgun, Georges-Pascal Haber
OBJECTIVE: To describe our technique for robotic total pelvic exenteration with intracorporeal sigmoid conduit and colostomy using the da Vinci Si robot. METHODS: Three 8-mm robotic ports and two 12-mm laparoscopic ports are placed in a "W" configuration, approximately 2-3 cm more cephalad than for radical prostatectomy (Fig. 1). The robot is docked between the legs with the patient in steep Trendelenburg. The ureters are dissected out from the iliac vessels to the rectovesical pouch, where they are clipped and transected...
July 2017: Urology
Kyoichi Mizumoto, Masahiko Gosho, Masayoshi Iwaki, Masahiro Zako
PURPOSE: Intraocular pressure (IOP) increases in patients in a steep Trendelenburg position during robotic-assisted laparoscopic radical prostatectomy (RALP). We hypothesized that a steep Trendelenburg position during RALP, an unusual systemic condition involving a transiently increased IOP, may induce ocular pathology that can be detected by detailed evaluations long after the surgery. This study aims to explore ocular structural and functional parameters in patients before and in the long term after the surgery...
2017: Clinical Ophthalmology
Takeshi Hashimoto, Kunihiko Yoshioka, Tatsuo Gondo, Kazuki Hasama, Yosuke Hirasawa, Jun Nakashima, Masaaki Tachibana, Yoshio Ohno
Objective Urinary incontinence is one of the most bothersome adversities after robot-assisted radical prostatectomy (RARP). The aim of the present study was to investigate the urinary continence recovery and the effect of various surgical techniques. Materials and Methods We previously reported that posterior rhabdosphincter reconstruction and nerve-sparing were independent predictors of urinary continence recovery 1 month after catheter removal in 199 patients who underwent RARP. Retrospectively, we further reviewed those 199 patients for urinary continence recovery at 3 months or later after RARP...
October 5, 2017: Journal of Endourology
Alejandro Garcia-Segui
OBJECTIVE: Laparoscopic adenomectomy (LA) is an effective procedure for the treatment of benign prostatic hyperplasia (BPH), which reproduces the surgical steps of the open adenomectomy (OA) by a minimally invasive approach to obtain the favorable results of open surgery in combination with the benefits offered by laparoscopic techniques. We performed a comprehensive bibliographic review of the technique and its current results in order to describe the evolution of the surgical technique and present the current evidence on the LA...
October 2017: Archivos Españoles de Urología
Douglas W Skarecky
No abstract text is available yet for this article.
October 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
Patrick Harrison, Nicholas Raison, Takashige Abe, William Watkinson, Faizan Dar, Ben Challacombe, Henk Van Der Poel, Muhammad Shamim Khan, Prokar Dasgupa, Kamran Ahmed
OBJECTIVE: To perform the first validation of a full procedural virtual reality robotic training module and analysis of novice surgeon's learning curves. DESIGN: Participants completed the bladder neck dissection task and urethrovesical anastomosis task (UVA) as part of the prostatectomy module. Surgeons completed feedback questionnaires assessing the realism, content, acceptability and feasibility of the module. Novice surgeons completed a 5.5-hour training programme using both tasks...
September 30, 2017: Journal of Surgical Education
Yosuke Hirasawa, Makoto Ohori, Toru Sugihara, Takeshi Hashimoto, Naoya Satake, Tatsuo Gondo, Yoshihiro Nakagami, Kazunori Namiki, Kunihiko Yoshioka, Jun Nakashima, Masaaki Tachibana, Yoshio Ohno
Purpose: To investigate the impact of the time interval (TI) between prostate biopsy and robot-assisted radical prostatectomy (RARP) on the risk of biochemical recurrence (BCR). Methods: We retrospectively reviewed the medical records of 793 consecutive patients who were treated with RARP at our institution. Patients were divided into three groups, according to TI, to compare BCR-free survival (BCRFS) rates: Group 1 (n = 196), TI < 3 months; Group 2 (n = 513), 3 ≤ TI < 6 months; Group 3 (n = 84), TI ≥ 6 months...
September 8, 2017: Japanese Journal of Clinical Oncology
Robert Qi, Wen-Chi Foo, Michael N Ferrandino, Leah G Davis, Sitharthan Sekar, Thomas A Longo, Ghalib Jibara, Tracy Han, Ilhan Gokhan, Judd W Moul
INTRODUCTION: Contemporary clinical guidelines utilize the highest Gleason sum (HGS) in any one core on prostate biopsy to determine prostate cancer treatment. Here, we present a large discrepancy between prostate cancer risk stratified as high risk on biopsy and their pathology after radical prostatectomy. MATERIALS AND METHODS: We retrospectively reviewed 1424 men who underwent either open or robotic-assisted prostatectomy between 2004 and 2015. We analyzed 148 men who were diagnosed with HGS 8 on prostate biopsy...
October 2017: Canadian Journal of Urology
Ashwin Sachdeva, Rajan Veeratterapillay, Antonia Voysey, Katherine Kelly, Mark I Johnson, Jonathan Aning, Naeem A Soomro
BACKGROUND: Positive surgical margins are a strong prognostic marker of disease outcome following radical prostatectomy, though prior evidence is largely from a PSA-screened population. We therefore aim to evaluate the biochemical recurrence in men with positive surgical margins (PSM) after minimally-invasive radical prostatectomy (MIRP) in a UK tertiary centre. METHODS: Retrospective study of men undergoing laparoscopic or robotic-assisted radical prostatectomy between 2002 and 2014...
October 2, 2017: BMC Urology
Volkan Tugcu, Abdulmuttalip Simsek, Ismail Evren, Kamil Gokhan Seker, Ramazan Kocakaya, Bugra Dogukan Torer, Arda Atar, Ali Ihsan Tasci
OBJECTIVE: This article reports on patients with early stage prostate cancer treated with single plus one port robotic radical prostatectomy (SPORP). MATERIALS AND METHODS: Since January 2014, we performed SPORP in 8 patients with localized prostate cancer. Age of patients, clinical stage, operation time, intraoperative and postoperative complications, blood loss, histopathological evaluation, postoperative continence, serum level of PSA were evaluated. RESULTS: Mean age of the 8 patients was 59...
October 3, 2017: Archivio Italiano di Urologia, Andrologia
Ram A Pathak, Manish Patel, Ashok Hemal
Port placement for robotic-assisted laparoscopic urologic surgery can be critical to successful completion of the minimally invasive procedure. An ideal port template would allow unhampered access to all critical structures during surgery, easy access for the bedside assistant, and minimization of arm collision with the fewest ports necessary to minimize cosmetic impact. We present a comprehensive plan for the placement of ports across different procedures for a variety of upper tract (radical/partial nephrectomy, retroperitoneal radical/partial nephrectomy, and pyeloplasty), lower tract (prostatectomy, and cystectomy), combined upper/lower tract (nephroureterectomy, retroperitoneal lymph node dissection), and female pelvic surgeries...
October 1, 2017: Journal of Endourology
Pier Andrea Della Camera, Simone Morselli, Gianmartin Cito, Giovanni Tasso, Nicola Laruccia, Andrea Cocci, Antonio Ruffo, Mauro Gacci, Sergio Serni, Marco Carini, Alessandro Natali
OBJECTIVE: The aim of the study is the evaluation of the efficacy and safety of the treatment with topical alprostadil (Vitaros©) in post-robot assisted radical prostatectomy (RARP) rehabilitation therapy of patients with erectile dysfunction (ED). METHODS: Seventy-four patients were enrolled and underwent non-nerve-sparing RARP. Inclusion criteria: age <75, preoperatively International Index of Erectile Function (IIEF-5) >16, erection hardness score (EHS) ≥2, weekly sexual intercourse ≥1, affirmative answers to Sexual Encounter Profile Question (SEP-Q) 2 and SEP-Q3, Charlson Comorbidity Index (CCI) ≤5, Eastern Cooperative Oncology Group (ECOG) performance status ≤1, no moderate/severe cardiovascular disease...
September 22, 2017: Urologia
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