Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases

Eur Urol. 2007 Sep;52(3):746-50. doi: 10.1016/j.eururo.2007.02.029. Epub 2007 Feb 20.

Abstract

Objective: To evaluate the initial functional and oncologic results of 184 robot-assisted radical prostatectomies performed at our hospital.

Methods: A retrospective study was made of the first 184 consecutive robot-assisted radical prostatectomies performed at our hospital between February 2003 and December 2005. The procedures were performed by two surgeons who used the da Vinci robot with three robot arms. A transperitoneal approach was used in all patients. All patients had clinically organ-confined prostate cancer (< or =cT2c). The median follow-up was 6 mo.

Results: A positive surgical margin was found in 29 of the 184 patients (mean: 15.7%). The percentage positive surgical margins for the organ-confined (pT2) and non-organ-confined prostate cancers (pT3) were 2.5% and 38%, respectively. Ninety-five percent of patients were completely continent or wore one safety liner. Forty-three percent of the continent patients achieved complete continence within 28 d. Eighty-one percent of the patients who were younger than 60 yr and received a nerve-sparing procedure were potent and able to perform sexual intercourse. This percentage dropped to 51% in patients older than 60 yr. No major complications were encountered.

Conclusions: The functional and oncologic results of this minimally invasive procedure seem very promising. Longer follow-up of the data and larger prospective studies are necessary to confirm these promising results.

MeSH terms

  • Follow-Up Studies
  • Humans
  • Infertility, Male / etiology
  • Infertility, Male / prevention & control
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Penile Erection / physiology*
  • Prostatectomy / methods*
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / surgery*
  • Retrospective Studies
  • Robotics / methods*
  • Treatment Outcome
  • Urinary Incontinence / etiology
  • Urinary Incontinence / prevention & control