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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Retzius-Sparing Robot-Assisted Radical Prostatectomy

Published on: May 19, 2022

Robot-assisted simple prostatectomy (RASP): does it make sense?

Deliu V Matei1, Antonio Brescia, Federica Mazzoleni

  • 1Departments of Urology, IEO European Institute of Oncology, Saint Joseph Hospital, Milan, Italy. d.v.matei@gmail.com

BJU International
|May 22, 2012
PubMed
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Robot-assisted simple prostatectomy (RASP) is a feasible and reproducible therapy for high-volume prostate adenomas, offering improved outcomes compared to open or other minimally invasive methods. Surgeons need proficiency and training opportunities for successful RASP implementation.

Area of Science:

  • Urology
  • Surgical Technology

Background:

  • Open simple prostatectomy (OSP) is the standard for high-volume prostate adenomas, offering good results despite invasiveness.
  • Minimally invasive techniques have not replaced OSP.
  • Robot-assisted surgery offers optimal functional results and ease of performance for experienced surgeons.

Purpose of the Study:

  • To evaluate the outcome, feasibility, and reproducibility of robot-assisted simple prostatectomy (RASP) for high-volume symptomatic benign prostatic hyperplasia (HVS-BPH).

Main Methods:

  • 35 consecutive patients with HVS-BPH underwent RASP.
  • Mean prostate volume was 106.6 mL; 77.1% had adenoma volume >80 mL.
  • Preoperative mean International Prostate Symptom Score (IPSS) was 28.

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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Published on: May 19, 2022

Main Results:

  • Median operative time was 180 minutes; mean hospital stay was 3.17 days.
  • Mean postoperative peak urinary flow improved significantly (18.9 mL/s, P < 0.001) and mean IPSS decreased to 7 (P < 0.001).
  • RASP was found to be cheaper than OSP when considering hospitalization costs.

Conclusions:

  • RASP is a feasible and reproducible procedure with superior outcomes compared to open or other minimally invasive techniques for HVS-BPH.
  • A robot-assisted approach is recommended for high-volume prostate adenomas.
  • Surgeon proficiency and observational learning are crucial for successful RASP adoption.