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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)
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
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
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
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
Marcos Tobias-Machado, Igor Nunes-Silva, Alexandre Kiyoshi Hidaka, Leticia Lumy Kanawa Sato, Roberto Almeida, Jose Roberto Colombo, Hamilton de Campos Zampolli, Antonio Carlos Lima Pompeo
INTRODUCTION: Retzus-sparing robotic-assisted radical prostatectomy(RARP) is a newly approach that preserve the Retzus structures and provide better recovery of continence and erectile function. In Brazil, this approach has not yet been pre¬viously reported. OBJECTIVE: Our goal is to describe Step-by-Step the Retzus-sparing RARP surgical technique and report our first Brazilian experience. METHODS: We present a case of a 60-year-old white man with low risk prostate cancer...
September 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Yen-Chuan Ou, Wei-Chun Weng, Kuangh-Si Chang, Cheng-En Mei, Chun Kuang Yang, Siu-Wan Hung, John Wang, Min-Che Tung
BACKGROUND/AIM: Expanded indications are not yet reported for robotic-assisted laparoscopic radical prostatectomy (RARP) performed by experienced surgeons for patients with preoperative suspicion of prostate cancer. We report our experience with 55 cases of prophylactic RARP for preoperative suspicion of prostate cancer, including postoperative pathological characteristics and outcomes. PATIENTS AND METHODS: This retrospective study reviewed data of a subset of 55 consecutive patients among 1,060 patients who underwent RARP for preoperative suspicion of prostate cancer...
September 2016: Anticancer Research
Hiroyuki Momozono, Hideaki Miyake, Masato Fujisawa
INTRODUCTION: The aim of this study was to investigate the effect of periurethral inflammation on the continence status after robot-assisted radical prostatectomy (RARP). METHODS: This study included 101 consecutive prostate cancer patients treated with RARP. To evaluate the status of periurethral inflammation, most apical urethral tissues in RARP specimens from these patients were immunohistochemically stained with antibodies for tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β)...
October 3, 2016: Journal of Endourology
Homayoun Zargar, Alistair D Lamb, Bernardo Rocco, Francesco Porpiglia, Evangelos Liatsikos, John Davis, Rafael F Coelho, Julio M Pow-Sang, Vipul R Patel, Declan G Murphy
INTRODUCTION: The published data on salvage robot assisted radical prostatectomy (sRARP) is limited. Our aim was to perform a systematic review of the literature on sRARP after radiation failure in patients with prostate cancer and systematically analyse the available evidence for operative and oncological outcomes. EVIDENCE ACQUISITION: A systematic review of the literature using Pubmed, Scopus, Cochrane library and ScienceDirect databases was performed in June 2016 using medical subject headings and free-text protocol...
August 31, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sophie Plagakis, Darren Foreman, Peter Sutherland, Andrew Fuller
We highlight two cases of transperitoneal robot-assisted radical prostatectomy (RARP) in patients with pelvic kidneys because of congenital development and renal transplant. These uncommon cases present a challenge to the surgeon contemplating surgery because of access and anomalous vascular and ureteral anatomy. We describe the technical considerations that are paramount in effectively completing transperitoneal RARP, and believe it should be considered as a treatment option in men with pelvic kidneys.
2016: J Endourol Case Rep
S S Goonewardene, D Cahill
The da Vinci Xi robot has been introduced as the successor to the Si platform. The promise of the Xi is to open the door to new surgical procedures. For robotic-assisted radical prostatectomy (RARP)/pelvic surgery, the potential is better vision and longer instruments. How has the Xi impacted on operative and pathological parameters as indicators of surgical performance? This is a comparison of an initial series of 42 RARPs with the Xi system in 2015 with a series using the Si system immediately before Xi uptake in the same calendar year, and an Si series by the same surgeon synchronously as the Xi series using operative time, blood loss, and positive margins as surrogates of surgical performance...
August 19, 2016: Journal of Robotic Surgery
Noah E Canvasser, Aaron H Lay, Ersin Koseoglu, Monica S C Morgan, Jeffrey A Cadeddu
PURPOSE: Early urinary control is a major goal for patients undergoing robot-assisted radical prostatectomy (RARP). We report our technique of posterior urethral suspension (PUS) performed at the time of urethrovesical anastomosis. PATIENTS AND METHODS: We prospectively followed men with localized prostate cancer undergoing RARP by a single surgeon from August 2012 to October 2015. Patients before April 2014 underwent only bladder neck preservation (controls), while patients after April 2014 also underwent PUS...
October 2016: Journal of Endourology
Masaki Shimbo, Fumiyasu Endo, Kazuhito Matsushita, Toshihisa Iwabuchi, Akiko Fujisaki, Yoko Kyono, Kohsuke Hishiki, Osamu Muraishi, Kazunori Hattori
INTRODUCTION: To evaluate the incidence and risk factors for postoperative inguinal hernia (IH) after robot-assisted radical prostatectomy (RARP) and to assess whether a newly developed prevention technique reduces the incidence of IH after RARP. METHODS: We included 161 consecutive patients (322 groins) who underwent RARP between September 2011 and October 2013. The prevention technique was as follows: (1) sufficient incision of peritoneum around the internal inguinal ring; (2) separation of spermatic vessels; (3) dissection of vas deferens...
August 6, 2016: Urologia Internationalis
Denny Yu, Cem Dural, Melissa M B Morrow, Liyun Yang, Justin W Collins, Susan Hallbeck, Magnus Kjellman, Mikael Forsman
BACKGROUND: The introduction of robotic technology has revolutionized radical prostatectomy surgery. However, the potential benefits of robotic techniques may have trade-offs in increased mental demand for the surgeon and the physical demand for the assisting surgeon. This study employed an innovative motion tracking tool along with validated workload questionnaire to assess the ergonomics and workload for both assisting and console surgeons intraoperatively. METHODS: Fifteen RARP cases were collected in this study...
August 5, 2016: Surgical Endoscopy
Takehiro Sejima, Shuichi Morizane, Kazunori Fujiwara, Keigo Ashida, Hiroaki Saito, Yuji Taniguchi, Hiroshige Nakamura, Atsushi Takenaka
BACKGROUND: To ensure safe performance in robotic surgery, the Minimal Invasive Surgery Center (MISC) is composed of the anesthesiology department, five surgery departments and co-medical staff in our institution. The objective of this study was to evaluate the outcomes of different types of robotic surgeries for cancer treatment (n = 326) from different surgery departments in the MISC. METHODS: The outcomes of robot-assisted radical prostatectomy (RARP), partial nephrectomy (RAPN), transoral robotic surgery (TORS) for pharyngeal cancer, and robotic surgery for lung, gastric and rectal cancer were evaluated using the similar concept of pentafecta in RARP...
June 2016: Yonago Acta Medica
Jonas Schiffmann, Alessandro Larcher, Maxine Sun, Zhe Tian, Jérémie Berdugo, Ion Leva, Hugues Widmer, Jean-Baptiste Lattouf, Kevin Zorn, Alexander Haese, Shahrokh F Shariat, Fred Saad, Francesco Montorsi, Markus Graefen, Pierre I Karakiewicz
OBJECTIVE: To examine characteristics of robot-assisted (RARP) and open radical prostatectomy (ORP) patients. PATIENTS AND METHODS: We relied on the Surveillance, Epidemiology, and End Results-Medicare-linked database and focused on prostate cancer patients between 2008 and 2009. In multivariable logistic regression analyses, we predicted RARP. RESULTS: Of 5,915 patients, 3,476 (58.8%) underwent RARP and 2,439 (41.2%) ORP. Patients within intermediate (OR 1...
August 4, 2016: Urologia Internationalis
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