Robot-assisted laparoscopic prostatectomy: a 2010 update.

AIM: To build on the previous article and further explore the safety and efficacy of robotic-assisted laparoscopic prostatectomy (RALP) in the first 100 cases from a single institution in New Zealand. METHOD: A prospective database was created to monitor perioperative and postoperative outcomes of men undergoing RALP for clinically localised carcinoma of the prostate. RESULTS: The first 100 cases were followed prospectively with a mean follow-up of 13.9 months. There were no conversions to open surgery, or re-operations. Average blood loss was 281 ml, and there was only one blood transfusion. Mean hospital stay was 1.1 nights. Mean console time improved from 251.4 minutes over the first 10 cases to 104.6 minutes over the last 10. The overall positive margin rate was 18%. The positive margin rate from pT2 tumours was 8%. The majority of patients had well-differentiated, organ-confined disease. Postoperatively, five have a detectable PSA level. 68% use no incontinence pads at 12 months. At one year, 12% of the men who were previously fully potent have achieved full potency again without assistance CONCLUSION: The results further support RALP as a safe, effective, and well tolerated procedure for the management of carcinoma of the prostate. The early local experience compares favourably with other published early series.

Robot-assisted laparoscopic radical prostatectomy (RALP)--a new surgical treatment for cancer of the prostate.

AIM: To examine the safety and efficacy of robotic-assisted laparoscopic prostatectomy (RALP) in the early cases of this new technique from a single institution. METHOD: A prospective database was created to monitor perioperative and postoperative outcomes of men undergoing RALP for clinically localised carcinoma of the prostate. RESULTS: The first 30 consecutive cases were followed prospectively. There were no conversions to open surgery, perioperative transfusions, re-operations, or major complications. The mean operating time was 280 minutes, with reductions in time between cases 1-10 and 10-20, and a smaller improvement between cases 10-20 and 20-30. The mean hospital stay was 1.4 days. There was one delayed discharge (4 days) due to an acute anxiety event. One patient required readmission for severe bladder spasm, and one patient had a failed trial of removal of catheter requiring re-catheterisation. One patient had a minor wound infection. The majority of patients had moderately-well differentiated, organ-confined disease on specimen histology. CONCLUSION: The early results suggest that RALP is a safe and oncologically effective procedure. The local results are at least comparable with other early series in the literature. It is an important addition to the armamentarium available for treating prostate cancer in New Zealand.