Laparoscopic/ Robotic: Prostate

Moderated Poster Session

MP20-3 - Retzius-Sparing Robotic-Assisted Laparoscopic Radical Prostatectomy: A Safe Surgical Technique with Superior Continence Outcomes

Saturday, September 22
2:00 PM - 4:00 PM
Location: Room 242B

Introduction & Objective : To compare the peri-operative, oncologic, and functional outcomes of prostate cancer patients undergoing a Retzius-sparing robotic-assisted laparoscopic radical prostatectomy to those undergoing a conventional robotic-assisted laparoscopic radical prostatectomy.


Methods : This was a prospective, single-center, consecutive case series of 97 and 100 patients undergoing a Retzius-sparing and a conventional robotic-assisted laparoscopic radical prostatectomy, respectively, by a single surgeon between March 2015 and April 2017.


Results :

Baseline patient characteristics were similar between the two groups. The Retzius-sparing approach required significantly less console time (120.0 vs. 144.0 mins, p<0.001). There were no differences in intra- or post-operative complication rates and hospital length of stay was similar in the two groups. Incidence of positive surgical margins was non-significantly different between the two groups, with 17% and 13% of pT2 patients and 49% and 48% of pT3 patients in the Retzius-sparing and conventional groups, respectively. There were no differences in rates of biochemical failure at three and six months post-operatively. Patients in the Retzius-sparing group had significantly superior rates of achieving post-operative urinary continence (log-rank test: p<0.001), with 20% of patients continent within the first month, compared to 8% of patients in the conventional group. Mean number of pads per day needed at three, six, nine, and 12 months post-operatively was also significantly lower in the Retzius-sparing group.


Conclusions : Retzius-sparing robotic-assisted laparoscopic radical prostatectomy requires shorter console time, is oncologically safe, and leads to significantly superior continence outcomes compared to conventional robotic-assisted laparoscopic radical prostatectomy.

Rabii Madi

Professor of Urology
Medical College of Georgia at Augusta University Health

Rabii Madi, MD, MBA
Professor of Urology
Medical College of Georgia at Augusta University Health
DIRECTOR OF UROLOGIC ONCOLOGY AND ROBOTIC SURGERY

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    Rashid Sayyid

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      William Simpson

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        Caroline Lu

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          Martha Terris

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            Zachary Klaassen

            Augusta University

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