title: Robot-assisted radical prostatectomy in an initial Japanese series: the impact of prior abdominal surgery on surgical outcomes.
abstract: OBJECTIVE
  To evaluate the influence of prior abdominal surgery on surgical outcomes of robot-assisted radical prostatectomy in an early single center experience in Japan.
  
  
  METHODS
  We reviewed medical records of patients with localized prostate cancer who underwent robot-assisted radical prostatectomy from October 2010 to September 2013 at Tottori University Faculty of Medicine, Yonago, Tottori, Japan. Patients with prior abdominal surgery were compared with those with no prior surgery with respect to total operative time, port-insertion time, console time, positive surgical margin and perioperative complication rate. Furthermore, the number of patients requiring minimal adhesion lysis was compared between the two groups.
  
  
  RESULTS
  Of 150 patients who underwent robot-assisted radical prostatectomy, 94 (63%) had no prior abdominal surgery, whereas 56 patients (37%) did. The mean total operative time was 329 and 333 min (P = 0.340), mean port insertion time was 40 and 34.5 min (P = 0.003), mean console time was 255 and 238 min (P = 0.145), a positive surgical margin was observed in 17.9% and 17.0% patients (P = 0.896), and the incidence of perioperative complications was 25% and 23.4% (P = 0.825), respectively, in those with and without prior abdominal surgery. In the prior abdominal surgery group, 48 patients (80.4%) required adhesion lysis at the time of trocar placement or while operating the robotic console.
  
  
  CONCLUSIONS
  Robot-assisted radical prostatectomy appears to be a safe approach for patients with prior abdominal surgery without increasing total operative time, robotic console time, positive surgical margin or the incidence of perioperative complications.
authors.affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yumioka
authors.forename: Hideto
authors.initials: H
authors.lastname: Iwamoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Masago
authors.forename: Shuichi
authors.initials: S
authors.lastname: Morizane
authors.forename: Akihisa
authors.initials: A
authors.lastname: Yao
authors.forename: Masashi
authors.initials: M
authors.lastname: Honda
authors.forename: Kuniyasu
authors.initials: K
authors.lastname: Muraoka
authors.forename: Takehiro
authors.initials: T
authors.lastname: Sejima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takenaka
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000368:Aged; D006801:Humans; D007431:Intraoperative Complications; D007564:Japan; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013525:Surgical Instruments
keywords: lysis of adhesions; operation outcome; prior abdominal surgery; prostate cancer; robot-assisted radical prostatectomy