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Journal of the New Zealand Medical Association, 05-November-2010, Vol 123 No 1325

[full text] [PDF]

Robot-assisted laparoscopic prostatectomy: a 2010 update

James B Duthie, Joanna E Pickford, Peter J Gilling

Abstract

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.