Characteristic Findings in Aborted Robot-Assisted Radical Prostatectomies

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a common procedure for prostate cancer.
• Intraoperative abortion of RARP cases, though rare, can impact patient care and surgical planning.

Purpose of the Study:

• To determine the incidence and causes of aborted RARP procedures.
• To identify factors associated with aborted RARP cases.

Main Methods:

• Retrospective analysis of RARP cases performed by high-volume surgeons from January 2018 to June 2024.
• Comparison of clinical, radiologic, and pathologic characteristics between aborted and completed RARP cases.
• Analysis of imaging features in propensity-matched patients.

Main Results:

• The incidence of aborted RARP was 0.7% (26 out of 3316 cases).
• Leading causes included pelvic lipomatosis (35%), adhesions (27%), and cardiorespiratory events (12%).
• Higher body mass index (BMI) was significantly associated with aborted procedures (30.7 vs 27.8, p=0.015).

Conclusions:

• Aborted RARP is infrequent (<1%) among experienced surgeons.
• Pelvic lipomatosis and elevated BMI are significant risk factors for RARP abortion.
• Preoperative identification of pelvic lipomatosis and patient BMI can aid in counseling and decision-making.