title: Intrapelvic fat makes robot-assisted radical prostatectomy difficult.
abstract: OBJECTIVE
  We investigated the relationship between a new index considering the estimated working space and difficulty of robot-assisted radical prostatectomy (RARP) using our database.
  
  
  METHODS
  Working height was calculated by the obstetric conjugate diameter minus the bladder and rectal wall thicknesses minus the thickness of postvesical fat minus the rectal fat thicknesses measured using preoperative magnetic resonance imaging (MRI). The proportion of working height was calculated by dividing the working height by the obstetric conjugate diameter.
  
  
  RESULTS
  A total of 112 RARP cases were enrolled. The mean obstetric conjugate was 105 mm and the mean proportion of working height was 72.5%. Multivariate linear regression analysis indicated that the proportion of working height was an independent predictive factor for both console time and estimated blood loss.
  
  
  CONCLUSIONS
  The difficulty of RARP can be predicted by measuring the fat thicknesses around the rectum and bladder by MRI before surgery.
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan yskadono@yahoo.co.jp.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kadono
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Makino
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ofude
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Izumi
authors.affiliation: Department of Radiology, Kanazawa University School of Medicine, Kanazawa, Japan.
authors.forename: Toshifimi
authors.initials: T
authors.lastname: Gabata
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
mesh_terms: D000273:Adipose Tissue; D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D012307:Risk Factors; D012371:Robotics; D025321:Surgery, Computer-Assisted
keywords: Radical prostatectomy; intrapelvic fat; robot-assisted prostatectomy