Robot-assisted radical prostatectomy in obese patients

Area of Science:

• Urology
• Robotic Surgery
• Oncology

Background:

• Increasing patient weight and mild obesity present potential challenges for robot-assisted extraperitoneal prostatectomy (RAP).
• Limited data exists on the impact of obesity on RAP outcomes.

Purpose of the Study:

• To evaluate the impact of obesity on outcomes in patients undergoing robot-assisted extraperitoneal prostatectomy (RAP).

Main Methods:

• A retrospective review of 375 consecutive RAP cases performed by a single surgeon.
• Patients were stratified by body mass index (BMI) >/= 30 kg/m2 (obese) versus < 30 kg/m2 (non-obese).
• Key outcomes compared included operative time, blood loss, oncological results (PSA, pathology, margins), complications, and functional outcomes (continence).

Main Results:

• Sixty-seven obese patients were identified and compared to non-obese patients.
• No statistically significant differences were observed in operative time, estimated blood loss, specimen weight, or complication rates.
• Oncological outcomes, including positive margin rates (12% obese vs. 15% non-obese), and 6-month continence rates (92% obese vs. 97% non-obese) showed no significant differences.

Conclusions:

• The extraperitoneal approach for robot-assisted radical prostatectomy is safe and effective in obese patients.
• Obesity is not associated with increased morbidity or compromised oncological and functional outcomes in RAP.