Is robot assistance affecting operating room time compared with pure retroperitoneal laparoscopic radical prostatectomy?
OBJECTIVE
To compare operating room times between retroperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP) and pure retroperitoneal laparoscopic radical prostatectomy (LRP).


METHODS
From March 2007 to April 2008, 288 patients underwent an extraperitoneal LRP in our institution. Eighty-three LRPs were performed with robot assistance using the da Vinci Surgical System (RALRP) whereas 205 pure LRPs were performed. Operating room times were compared between the two groups.


RESULTS
Both groups were statistically equal concerning age (P = 0.95), body mass index (P = 0.52), prostate-specific antigen level (P = 0.40), prostate volume (P = 0.49), clinical stage (P = 0.11), and Gleason score on biopsy (P = 0.57). Total operating room time was not significantly different between the two groups (223.6 vs 215.7 minutes in LRP and RALRP groups, respectively; P = 0.23). Mean patient installation was longer in the RALRP group (33.2 vs 24.0 minutes, P < 0.01). Mean operative time was significantly shorter by about 20 minutes in the RALRP group (145.6 vs 164.7 minutes, P < 0.01). Mean estimated blood loss was significantly lower in the RALRP group (469 mL vs 889 mL in the LRP group, P < 0.01). No statistical differences were observed regarding hospital stay, bladder catheterization, and complication rate between the two groups.


CONCLUSIONS
Occupation times of the operating room are equivalent during pure retroperitoneal LRP and RALRP. For a trained team performing four procedures per week, the use of the robot for LRP with no lymph node dissection decreases actual operative time at the expense of an increase in installation time, compared with pure laparoscopy.
Ploussard
Guillaume
G
Department of Urology, CHU Henri Mondor, Créteil, France.
Xylinas
Evanguelos
E
Paul
Alexandre
A
Gillion
Norman
N
Salomon
Laurent
L
Allory
Yves
Y
Vordos
Dimitri
D
Hoznek
Andreas
A
Yiou
René
R
Abbou
Claude-Clément
CC
de la Taille
Alexandre
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D005791:Patient Care; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D012187:Retroperitoneal Space / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D013997:Time Factors