Robot-assisted laparoscopic radical prostatectomy – A report of our current robotic surgery –

This report is an examination of the results of the initial 200 cases that underwent robot assisted laparoscopic radical prostatectomy (RALP) at Kawasaki Medical School General Medical Center in Okayama, Japan. Two hundred patients that had RALP using the da Vinci Xi Surgical System from August 2016 to October 2019 were examined retrospectively. The median age was 70 years old, and the median PSA was 7.65 ng/ml. 35% of the cases had received a previous abdominal surgery. RALP was performed on all the patients. The median surgery time was 237.5 minutes, the median console time was 173 minutes and the median amount of bleeding was 150 ml. There were no intraoperative blood transfusions, complications or anastomotic failures. Histopathological examination found pT2 in 73.0% of cases and pT3 in 26.5% with positive surgical margins in 10.3% and 50.9% of cases, respectively. There were 17 postoperative cases confirmed to have an inguinal hernia and 3 cases with an incisional hernia. Also, one case had postoperative bleeding from the trocar insertion site, which required hemostasis and a blood transfusion. Urinary continence rates three months after surgery was 76.6% and was 95.3% after twelve months. RALP is a safe and minimally invasive method, but there are aspects that require improvement such as the pT3 positive surgical margin rate and postoperative continence.

Uehara S, et al