title: Does robot-assisted laparoscopic radical prostatectomy enable to obtain adequate oncological and functional outcomes during the learning curve? From the Korean experience.
abstract: To estimate the short-term results of robot-assisted laparoscopic radical prostatectomy (RALRP) during the learning curve, in terms of surgical, oncological and functional outcomes, we conducted a prospective survey on RALRP. From July 2007, a single surgeon performed 63 robotic prostatectomies using the same operative technique. Perioperative data, including pathological and early functional results of the patient, were collected prospectively and analyzed. Along with the accumulation of the cases, the total operative time, setup time, console time and blood loss were significantly decreased. No major complication was present in any patient. Transfusion was needed in six patients; all of them were within the initial 15 cases. The positive surgical margin rate was 9.8% (5/51) in pT2 disease. The most frequent location of positive margin in this stage was the lateral aspect (60%), but in pT3 disease multiple margins were the most frequent (41.7%). Overall, 53 (84.1%) patients had totally continent status and the median time to continence was 6.56 weeks. Among 17 patients who maintained preoperative sexual activity (Sexual Health Inventory for Men > or = 17), stage below pT2, followed up for > 6 months with minimally one side of neurovascular bundle preservation procedure, 12 (70.6%) were capable of intercourse postoperatively, and the mean time for sexual intercourse after operation was 5.7 months. In this series, robotic prostatectomy was a feasible and reproducible technique, with a short learning curve and low perioperative complication rate. Even during the initial phase of the learning curve, satisfactory results were obtained with regard to functional and oncological outcome.
authors.affiliation: Department of Urology, MIS & Robotic Urologic Surgery Center, Korea University School of Medicine, Seoul 136705, Korea.
authors.forename: Young Hwii
authors.initials: YH
authors.lastname: Ko
authors.forename: Jeong Hyeon
authors.initials: JH
authors.lastname: Ban
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Park
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.forename: Duck Ki
authors.initials: DK
authors.lastname: Yoon
authors.forename: Je Jong
authors.initials: JJ
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.forename: Vipul R
authors.initials: VR
authors.lastname: Patel
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000193:education* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D012725:Sexual Behavior; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence