Presented by: RONALD CADILLO-CHAVEZ MD
University of Puerto Rico

Introduction

Robotic assisted simple prostatectomy (RASP) has been described as a good alternative in the management of large prostates. We described our experience with retzius-sparing robotic assisted simple prostatectomy

Materials

A retrospective reviewed of 82 patients who underwent RASP in our institution from August 2014 to October 2021. All procedures were performed by the single surgeon (RCC). We evaluate pre-operative and post-operative outcomes for a minimum follow up of year and half

Results

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Mean age was 66.8 years (Range from 52 to 83), body mass index (BMI) was 29.1 kg/m2 (Range from 23 to 42.7) and ASA Score was 2 (Range from 2 to 3). Mean prostate volume was 168.5gr (Range from 93 to 520 gr). Of 82 patients 10 (12.1%) had a previous endoscopic procedure.  

Mean operative time was 108 min (Range from 75 to 165), estimated blood loss was 150 ml (Range from 100 to 200) and length of stay was 1 day (Range from 1 to 2).  Foley catheter was removed after 5 days in all cases. Mean variation between pre and post operative hemoglobin was around 1.2 gr/dl. Bladder irrigation was not needed. The Da Vinci XI were used for the cases. Mean specimen size weight was 120.8 gr (72-.375). Pathology revealed benign prostatic hyperplasia: 79 (96.3 %), adenocarcinoma prostate 3 (3.7%)

There were no conversions to open surgery. There was no need for intra or post-operative blood transfusion. There were two post-operative complications (Clavien-Dindo  grade I).

There was a significant improvement in post-operative IPSS score, Qmax and PVR. All patient with durable and good urinary and functional outcomes.

Of 82 patients, 87.8% had at least a follow-up of ≥2 year and 12.2% had a minimum follow-up of 1.5 year.

Conclusion

RASP is a good option to manage large prostatic adenomas with good functional outcomes and low complications rate at medium follow up

Funding

None

Co-Authors

HECTOR LOPEZ-HUERTAS, MD
University of Puerto Rico