title: Switching from Endoscopic Extraperitoneal Radical Prostatectomy to Robot-Assisted Laparoscopic Prostatectomy: Comparing Outcomes and Complications.
abstract: OBJECTIVE
  Endoscopic extraperitoneal radical prostatectomy (EERPE) and robot-assisted laparoscopic prostatectomy (RALP) are minimally invasive surgical techniques to treat localized prostate cancer. We report the outcome and complications of these two techniques conducted by one individual surgeon.
  
  
  METHODS
  86 patients underwent EERPE between January 2008 and June 2011, and 100 patients underwent RALP between August 2011 and October 2012. All surgeries were performed by one single surgeon.
  
  
  RESULTS
  The patients of the EERPE and RALP groups had similar clinical characteristics in PSA, prostate volume and D'Amico classification, and were significantly different in their age and BMI as well as in the number of prior surgeries. RALP surgeries were significantly slower (183 vs. 157 min) but also involved lower blood loss (147 vs. 245 ml). Pathological stages and positive surgical margins were similar in both groups. Complications were assessed by the Clavien-Dindo classification. 6 patients in the EERPE group and 3 patients of the RALP group suffered major complications (IIIb-IV).
  
  
  CONCLUSIONS
  Altogether our results indicate that the learning curve for RALP was short after experience with EERPE. We hypothesize that this is more a result of the surgical experience of the surgeon with the EERPE than on the robotic technique.
authors.affiliation: Department of Urology, Klinikum Ingolstadt, Ingolstadt, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Wagenhoffer
authors.forename: Maren
authors.initials: M
authors.lastname: Gruner
authors.forename: Jan
authors.initials: J
authors.lastname: Schymik
authors.forename: Lydia
authors.initials: L
authors.lastname: Schachtner
authors.forename: Liviu
authors.initials: L
authors.lastname: Neagoe
authors.forename: Christine
authors.initials: C
authors.lastname: Berg
authors.forename: Andreas
authors.initials: A
authors.lastname: Schlichter
authors.forename: Andreas
authors.initials: A
authors.lastname: Manseck
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011183:Postoperative Complications; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology*