Robot-assisted laparoscopic radical prostatectomy: Clinical experience of 200 cases

Purpose: We report the initial functional and surgical results of 200 robot-assisted laparoscopic radical prostatectornies performed at our hospital, and evaluate the efficacy and safety of this surgery. Materials and Methods: Between July 2005 and July 2007, 200 patients underwent robot-assisted laparoscopic radical prostatectomy (RLRP). All cases were performed using the four-arm da Vinci^TM robot system (Intuitive Surgical, Mountain View, USA). RLRP was performed by two surgeons. All operations were approached transperitoneally. We studied the perioperative parameters and early surgical outcome retrospectively. Results: The mean age at surgery was 64±8.2 years. The median preoperative prostate-specific antigen level was 8.24ng/ml (range, 1.37-726.60 ng/ml) and the mean preoperative Gleason score was 6.5 (range, 4-9). The median total operative time was 215 min (range, 140-418 min) and the median estimated blood loss was 300ml (range, 50-2,700ml). A positive surgical margin was found in 64 patients (32.0%). A normal diet was started 2.3 days after surgery and the median hospital stay was 5 days (range, 2-26 days). Among 71 patients with over 6 months follow-up, 69 patients (97.2%) were completely continent at 6 months after surgery and 29 patients (40.8%) were completely continent at catheter removal. In 58 patients who were younger than 65 years, potent preoperatively, and received a nerve sparing procedure, 31 patients (53.4%) were potent at 6 months after surgery. Conclusions: We were able to verify the feasibility and safety of RLRP in the management of prostate cancer. A longer follow-up of the data and larger prospective studies are necessary to confirm these results.