Improvements in robot-assisted prostatectomy: the effect of surgeon experience and technical changes on oncologic and functional outcomes

Journal of Endourology
David B SamadiHugh J Lavery

Abstract

To assess the effect of surgeon experience and technical modifications on functional and oncologic outcomes after robot-assisted laparoscopic prostatectomy (RALP). Data were available for 1181 of 1420 consecutive patients undergoing RALP by a single surgeon (DBS). Three techniques were evaluated. The "initial" technique included incision of the lateral endopelvic fascia, suture ligation of the dorsal venous complex (DVC), and anterior tennis-racquet bladder neck reconstruction (n = 590 procedures). The "intermediate" technique included a modified "curtain" nerve-sparing technique and incision of the DVC without previous ligation (n = 170). The "current" technique uses a posterior tennis-racquet bladder neck reconstruction (n = 421). Outcomes included continence and potency recovery and the presence of pT(2) surgical margins assessed in continuous fashion. Validated questionnaires were used to assess baseline and postoperative functional outcomes. Continence rates improved between techniques at all evaluated time points, with 1-year continence rates of 88%, 93%, and 96% in the initial, intermediate, and current technique groups, respectively (Ptrend <0.001). One-year potency rates, however, remained similar among the groups, wit...Continue Reading

References

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Citations

Feb 14, 2014·Der Urologe. Ausg. A·R MagerA Haferkamp
Nov 8, 2014·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Patrick WhelanAjay Nehra
Jan 5, 2013·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·N DeffarL Cormier
Nov 30, 2012·Urologic Oncology·Hugh J LaveryDavid B Samadi
Oct 24, 2014·International Journal of Urology : Official Journal of the Japanese Urological Association·Takeshi HashimotoMasaaki Tachibana
Sep 17, 2016·Expert Review of Anticancer Therapy·Paolo CapogrossoXavier Cathelineau
Jan 9, 2019·Journal of Comparative Effectiveness Research·Kumar Mukherjee, Khalid M Kamal
Jul 25, 2018·Minerva chirurgica·Clément C Abbou, Ahmed Abdelbary
Jun 17, 2020·Annals of the Royal College of Surgeons of England·A TamhankarN Vasdev
Jun 1, 2013·Journal of Robotic Surgery·Adrien N BernsteinDavid B Samadi
Nov 25, 2016·Case Reports in Medicine·Johnson F TsuiDavid B Samadi
Apr 17, 2020·Minerva urologica e nefrologica = The Italian journal of urology and nephrology·Jae W ChungEun S Yoo
Jan 29, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Tomoyuki TatenumaMasahiro Yao
Apr 26, 2021·Journal of Robotic Surgery·Mihir ShahRene Sotelo
Jul 6, 2021·Sexual Medicine Reviews·Irene E JuManish I Patel

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