title: Robot-assisted radical prostatectomy in obese patients.
abstract: OBJECTIVE
  Few centers perform extraperitoneal robot assisted radical prostatectomy. The average patient weight is increasing to the mildly obese. Little is known as to the difficulty-impact, obesity may have on robot-assisted extraperitoneal prostatectomy (RAP). We assess our own experience with obese patients undergoing RAP.
  
  
  METHODS
  Information on 375 consecutive patients undergoing robot-assisted extraperitoneal prostatectomy by a single surgeon was gathered. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m2. Patients with BMI >/= 30 were compared to those with BMI < 30. Specific comparators between the groups were: age, total operating time, estimated blood loss, total prostate specific antigen (PSA), specimen weight, pathological stage, grade and margin, complications, and functional outcomes.
  
  
  RESULTS
  Sixty-seven men were identified as obese. When comparing the two groups, no statistically significant difference (p > .05) was noted in operative time (229 versus 217 min), blood loss (205 versus 175 ml), PSA, clinical and pathologic stages, specimen weight, and complications. 15% of non-obese patients had a positive margin compared to 12% of obese patients (p > .05). The 6-month continence rate in patients with a BMI >/= 30 was 92% versus 97% in patients with a BMI < 30.
  
  
  CONCLUSIONS
  The extraperitoneal approach to performing a robot-assisted prostatectomy is not associated with increased morbidity in the obese patient. There were no statistically significant differences noted in oncological or functional outcomes between the two groups.
authors.affiliation: University of Rochester Medical Center, Department of Urology, Rochester, NY, USA.
authors.forename: Judd
authors.initials: J
authors.lastname: Boczko
authors.forename: Ralph
authors.initials: R
authors.lastname: Madeb
authors.forename: Dragan
authors.initials: D
authors.lastname: Golijanin
authors.forename: Erdal
authors.initials: E
authors.lastname: Erturk
authors.forename: Mary
authors.initials: M
authors.lastname: Mathe
authors.forename: Hitendra R H
authors.initials: HR
authors.lastname: Patel
authors.forename: Jean V
authors.initials: JV
authors.lastname: Joseph
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications; D012307:Risk Factors; D012371:Robotics