Related Experiment Video
Updated: Dec 20, 2025
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Techniques and Outcomes of Salvage Robot-Assisted Radical Prostatectomy (sRARP)
R De Groote1, A Nathan2, E De Bleser3
1Department of Urology, University College London Hospital. NHS Foundation Trust. London. UK; Department of Urology, Onze Lieve Vrouw Hospital Aalst, Aalst, Belgium.
Background:
Salvage Robot-Assisted Radical Prostatectomy (sRARP) has been described as feasible treatment for the management of localised prostate cancer (PCa) recurrence after primary treatment. However, no large reports have published cancer and quality outcomes.
Objective:
To report perioperative, functional and oncologic outcomes of sRARP in patients with localised PCa recurrence.
Design, Setting, And Participants:
We retrospectively evaluated 106 patients with local recurrence eligible for sRARP.
Surgical Procedure:
Surgery was performed using the DaVinci Si system similar to the standard approach but with adaptation to the primary treatment.
Measurements:
Peri-operative outcomes included 90-day complication rate. Functional outcomes included rates of incontinence and erectile dysfunction. Oncological outcomes included tumour staging, margin rate and recurrence.
Results And Limitations:
Primary treatment was High Intensity Focused Ultrasound (HIFU) in 59 (56%) patients, 27 (25%) radiotherapy, 10 (9%) seed brachytherapy, 8 (8%) solitary androgen deprivation therapy (ADT), one (1%) cryotherapy and one (1%) electroporation / Nanoknife. Median follow-up was 2.1 years. 90-day complication rate was 8%. At two years or more, 50% were fully continent and 33% were socially continent. Continence rates tended to be better after focal compared to whole-gland treatments. Erectile dysfunction was present in 95%. Positive surgical margin rate was 39%. Biochemical recurrence occurred in 13% and local or metastatic recurrence in 11%.
Conclusions:
sRARP is technically more challenging but is a feasible option in high-volume centres for treatment of recurrent PCa. Patients should be counselled that functional outcomes are inferior to primary RARP. Adjustment of surgical technique according to the primary treatment is key for good surgical outcomes.
Patient Summary:
We report our experience with sRARP for the management of localised PCa recurrence after primary treatment. This represents a feasible approach with acceptable peri-operative complications and cancer outcomes. Functional outcomes are inferior to RARP in the primary setting.
More Related Videos
12:45Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
12:34Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
Published on: January 3, 2020