One-year Outcome Comparison of Laparoscopic, Robotic, and Robotic Intra-fascial Simple Prostatectomy for Benign Prostatic Hyperplasia

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laparoscopic-surgery-instrument-kit-70192-6823251The results of comparing preoperative, intraoperative, and postoperative variables at 1, 6, and 12 months after laparoscopic simple prostatectomy (LSP), robotic simple prostatectomy (RSP), and intra-fascial robotic simple prostatectomy (IF-RSP) were realesed on Journal of Endourology.

You can download this study at online.liebertpub.com

Abstract:

To compare preoperative, intraoperative, and postoperative variables at 1, 6, and 12 months after laparoscopic simple prostatectomy (LSP), robotic simple prostatectomy (RSP), and intra-fascial robotic simple prostatectomy (IF-RSP). Materials and Methods: From January 2003 to November 2014, 315 simple prostatectomies were performed using three techniques, LSP, RSP, and IF-RSP; of the patients who underwent these procedures, 236 met the inclusion criteria for this study. Results: No statistically significant difference (SSD) was found in preoperative or perioperative variables. Of the postoperative variables that were analyzed, a SSD (p>0.01) in prostate-specific antigen (PSA) levels was found, with levels of 0.07 ng/ml (±1.1 ng/ml) following IF-RSP, and the detection rate of prostate adenocarcinoma (PC; 26%) and high-grade intraepithelial neoplasia (HG-PIN; 12%) were higher for IF-RSP. We also found that lower International Prostate Symptom Scores (IPSS) were associated with LSP, at 4.8 (±3.2). Erectile function was reduced in IF-RSP patients in the first six months after surgery but was similar in all patient groups at 12 months after surgery; continence and other measured parameters were also similar at 12 months for all three techniques. Conclusion: The IF-RSP technique is safe and effective, with results at one-year follow-up for continence, IPSS, and SHIM scores similar to those for the LSP and RSP techniques. IF-RSP also offers the advantages that it does not require postoperative irrigation, has an increased ability to detect ADC and PIN-HG, Avoids the risk of future cancer and subsequent re-intervention for possible new prostate growth.