The impact of transition from conventional robot-assisted radical prostatectomy to retzius sparing robot-assisted radical prostatectomy: A retrospective multivariate analysis.

INTRODUCTION: To assess the outcomes of Retzius sparing robotic-assisted radical prostatectomy (RS-RARP) in comparison with the conventional RARP. MATERIALS AND METHODS: A retrospective analysis of 320 cases of RARP, performed from 2014 April to 2019 April, was performed. The predictor variables included age, body mass index, clinical stage, prostate-specific antigen, Gleason score category in biopsy, D'Amico risk category, presence of the median lobe, prior transurethral resection of the prostate, and the ability to perform the RS-RARP. The outcome variables included console time, blood loss, blood transfusion, nerve sparing, bladder neck sparing, positive surgical margins (PSM), number and the site of PSMs, extracapsular invasion, seminal vesicle involvement, complications, continence, erectile function, biochemical recurrence, and adjuvant treatment. Regression analysis was performed using the linear regression for the continuous variables and binary logistic regression for the categorical variables with two levels. RESULTS: Three hundred and twenty patients underwent radical prostatectomy from 2014 April to 2019 April. We started the RS-RARP program in December 2016. Twenty-three patients who did not meet the inclusion criteria were excluded and a total of 297 patients were studied. Multivariate analysis demonstrated that RS-RARP was a strong positive independent predictor for continence recovery at 3 months, 6 months, and 12 months. RS-RARP was an independent predictor of reduced console time and increased probability of bladder neck sparing. RS-RARP was also independently associated with increased PSM in the posterolateral, anterolateral, and the apical regions. CONCLUSION: RS-RARP has better continence rates up to 12 months compared with the conventional approach, but is associated with increased PSM at certain locations.

Robotic assisted kidney transplantation in grafts with multiple vessels: single center experience.

INTRODUCTION: The aim of this study was to assess the feasibility of robotic assisted kidney transplantation in graft with multiple vessels. MATERIALS AND METHODS: Eighteen patients underwent RAKT with grafts with multiple vessels (GMVs) from living donor performed by a single surgeon in single institution. The retrospective data obtained were compared to patients who underwent robotic assisted kidney transplant (RAKT) with single vessel and also open kidney transplant with GMVs. RESULTS: There were no significant differences in graft function outcome and perioperative parameters in all three groups. In comparison with OKT in GMVs we found that RAKT with GMVs had less pain score on post op 4th day. There was also a significant difference in mean analgesic requirement and incision length. CONCLUSION: With increasing experience, grafts with challenging vascular anatomy can be taken up for RAKT and GMVs should not be considered as a contraindication for RAKT.