Purpose:We report our early experience of robotically assisted laparoscopic
radical prostatectomy.
Material and Methods: Five consecutive patients, with an average age of 58
years, PSA 12,1.6 positive biopsies, Gleason score 6, were operated in our
institution over a period of 1 week by the same surgeon. A robotically assi
sted laparoscopic nerve sparing radical prostatectomy was performed accordi
ng to the Montsouris technique with the Da Vinci robot (intuitive Inc., Mou
ntain View, Calif., USA).
Results. The mean installation time was 93 min (range 76-149). The mean ope
rating time (starting at the dissection of the seminal vesicles until the f
inal stitch of the anastomosis) was 222 min (range 150-381 min). The averag
e blood loss was 800 cm(3) (range 700-1,600 cm(3)). No postoperative compli
cations were seen. Bladder catheter time: 6.5 days, hospital stay 5.5 days,
urine leak 1/5, continence 4/5, positive margin 1/5.
Conclusion; After this short experience, we conclude that:The use of a tele
manipulation system accompanied by a three-dimensional view of the operati
ng field provides a real benefit for the surgeon, and the urethro-anastomos
is is easier to perform. The benefit for the patient is presently not very
clear in terms of operating time, postoperative course and functional resul
ts, our initial results show that the robotically assisted procedure is at
least as safe and effective as the conventional laparoscopic procedure. Cop
yright (C) 2001 S. Karger AG, Basel.