Posted 6/25/2009 9:21 PM (GMT 0)
Robotic radical prostatectomy: outcomes of 500 cases
Vipul R. Patel, Rahul Thaly and Ketul Shah
British Journal of Urology International v 99 I 5 pp1109-1112 (2007)
I find this a very interesting document because it reports on the first 500 robotic surgeries performed by a single surgeon at Ohio State University.. There were only two complications, both rectal injuries, and both occurring in the first 25 operations. They were detected and corrected lapriscopicaly during the operation.
Positive margins by number of operations performed
Overall -- 9.4% (by stage: T3b – 46%, T3a -- 23%, T2 – 2.5%)
first 100 -- 13%
second 100 -- 8%
third 100 -- 13%
fourth 100 -- 5%
last 100 -- 8%
This is not quite as straightforward as it may seem because, as their number of surgeries increased, they accepted more complex cases. Factors which added complexity were obesity, a history of TURP, and a prostate greater than 100g.
For the 173 patients who are more than one year after surgery 95% have a PSA <0.1
Some other information:
Complete continence (no pads)
At catheter removal – 27%
At 3 months – 89%
At 6 months – 95%
At 12 months – 97%
Greater experience resulted in faster return to continence
For the 200 patients who had adequate sexual function before surgery
and who had nerve sparing on one or both sides.
One year after surgery
78% capable of intercourse (includes those using oral medications)
7% capable of intercourse using injections
15% did not have erections capable of intercourse