Results of robotic radical prostatectomy in the hands of surgeons without previous laparoscopic radical prostatectomy experience

摘要

We report our initial experience related with robot-assisted laparoscopic radical prostatectomy (RALRP) performed by a urologic surgeon without previous laparoscopic radical prostatectomy (LRP) experience. Materials and methods: The data of the first 70 patients who underwent RALRP between February 2009 and February 2010 are presented. Results: Mean console time was 214 ± 55.5 min with pelvic lymph node dissection (LND) in 14 patients. Mean intraoperative blood loss was 215 ± 227.3 cc. Fourteen patients had positive surgical margins: pT3 (n = 12) and pT2 (n = 2). Lodge drains and urethral catheters were removed at a mean of 2.9 ± 2.7 and 11.6 ± 5.9 days, respectively. Forty-three of 58 patients (82.9%) had urinary control at the 3-month follow-up. Regarding the patients with preoperative IIEF scores >= 19 (mean: 47.6 ± 17.0, n = 46), mean IIEF score was 45.3 ± 9.9 (n = 11) at the 9-month follow-up. Regarding patients with preoperative IIEF scores of 13-18 (mean: 16.3 ± 1.1, n = 6), mean IIEF score was 17.0 ± 3.5 (n = 3) at the 9-month follow-up. One patient who could not tolerate CO_2 insufflation was switched to open surgery due to deep acidosis development. Rectal injury occurred in 1 patient and was repaired robotically without postoperative problems. Conclusion: Previous LRP experience is not essential in order to perform RALRP, which can be learned and performed easily. Additionally, short-term surgical results and pathological outcomes of RALRP are excellent and satisfactory, respectively.