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Updated: Jan 5, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Effects of Retzius sparing on robot-assisted laparoscopic prostatectomy: a systematic review with meta-analysis
Ting-En Tai1, Chien-Chih Wu1,2,3, Yi-No Kang4,5
1Department of Urology, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China.
Background:
To comprehensively evaluate the efficacy and safety of Retzius sparing (RS) for men undergoing robot-assisted laparoscopic prostatectomy (RARP).
Methods:
We searched four electronic databases and reference lists of relevant studies for eligible research published before March 11, 2019. After quality assessment, eligible studies were synthesized for relevant outcomes, including positive surgical margin (PSM), continence, incontinence, complication, console time, and hospital stay.
Results:
Two randomized clinical trials and four observational studies were included in this study. Quantitative syntheses revealed significantly higher PSM rates in RS-RARP compared with conventional RARP (c-RARP) (odds ratio [OR] 1.68, p = 0.02). Furthermore, we found significantly higher PSM rates at the anterior site in RS-RARP compared with c-RARP (OR 4.34, p = 0.03) and significantly lower incontinence rates in RS-RARP in the first month (OR 0.30, p < 0.001) and 12th month (OR 0.25, p < 0.001).
Conclusions:
Our syntheses revealed higher PSM rates in the RS-RARP group, especially in the anterior aspect. However, RS-RARP had superior functional outcome of urinary continence and lower console time than did c-RARP with equivalent complication rates. Thus, we suggest that operators pay more attention to making clear surgical margins if the lesion is in anterior prostate when performing RS-RARP.
Insights
Retzius sparing robot-assisted laparoscopic prostatectomy (RS-RARP) shows higher positive surgical margins but improved urinary continence and reduced console time compared to conventional RARP (c-RARP). Surgeons should focus on anterior margins during RS-RARP.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Robot-assisted laparoscopic prostatectomy (RARP) is a common treatment for prostate cancer.
- Retzius sparing (RS) is a technique used during RARP.
- Comprehensive evaluation of RS-RARP efficacy and safety is needed.
Purpose of the Study:
- To evaluate the efficacy and safety of Retzius sparing (RS) in robot-assisted laparoscopic prostatectomy (RARP).
- To compare outcomes of RS-RARP with conventional RARP (c-RARP).
Main Methods:
- Systematic search of four electronic databases and reference lists.
- Inclusion of randomized clinical trials and observational studies.
- Quantitative synthesis of outcomes including positive surgical margin (PSM), continence, complications, console time, and hospital stay.
Main Results:
- RS-RARP demonstrated significantly higher rates of positive surgical margins (PSM) compared to c-RARP (OR 1.68, p=0.02), particularly at the anterior site (OR 4.34, p=0.03).
- RS-RARP showed significantly lower incontinence rates at 1 month (OR 0.30, p<0.001) and 12 months (OR 0.25, p<0.001).
- RS-RARP had equivalent complication rates and lower console times compared to c-RARP.
Conclusions:
- RS-RARP is associated with increased PSM rates, especially anteriorly.
- RS-RARP offers superior urinary continence and reduced console time.
- Attention to surgical margins in the anterior prostate is crucial during RS-RARP procedures.
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