Continence and potency outcomes after robotic radical prostatectomy in the hands of console surgeon with previous experience as a bedside assistant: first 50 cases

Önceden hasta başı asistans tecrübesi olan konsol cerrahının robotik radikal prostatektomi sonrası kontinans ve potens sonuçları: ilk 50 vaka

Abstract

OBJECTIVES: To present the robotic radical prostatectomy functional results of the console surgeon with previous experience as a bedside assistant. MATERIAL and METHODS: The medical records of the first 50 patients who underwent robotic radical prostatectomy between September 2016 – July 2018 were reviewed retrospectively. Continence was describedOBJECTIVES: To present the robotic radical prostatectomy functional results of the console surgeon with previous experience as a bedside assistant. MATERIAL and METHODS: The medical records of the first 50 patients who underwent robotic radical prostatectomy between September 2016 – July 2018 were reviewed retrospectively. Continence was described as no using pad or using safety pad. Mild incontinence was described as using 1 pad daily while using 2 and more pads described as severe incontinence. Patients with the International Index of Erectile Function (IIEF-5) score >21 were defined as potent, ≤21 were defined as impotent. RESULTS: Mean age was 64.06±6.15 and mean follow-up time was 14.9±6.9 months. Bilaterally, unilaterally and non nerve sparing surgery was performed in 37 (74%), 4 (8%) and 9 (18%) patients, respectively. Clavien grade 3 and higher complication was occurred in only 2 (4%) patients. Surgical margin involvement was detected in 11 (22%) patients and 5 (10%) patients developed biochemical recurrence. Forty (87%) patients were continent and 21 (45.7%) patients were potent at the 6th month postoperatively. CONCLUSION: Having experience as a bedside assistant before console surgery also minimizes complication rates in addition to the advantagesOBJECTIVES: To present the robotic radical prostatectomy functional results of the console surgeon with previous experience as a bedside assistant. MATERIAL and METHODS: The medical records of the first 50 patients who underwent robotic radical prostatectomy between September 2016 – July 2018 were reviewed retrospectively. Continence was described as no using pad or using safety pad. Mild incontinence was described as using 1 pad daily while using 2 and more pads described as severe incontinence. Patients with the International Index of Erectile Function (IIEF-5) score >21 were defined as potent, ≤21 were defined as impotent. RESULTS: Mean age was 64.06±6.15 and mean follow-up time was 14.9±6.9 months. Bilaterally, unilaterally and non nerve sparing surgery was performed in 37 (74%), 4 (8%) and 9 (18%) patients, respectively. Clavien grade 3 and higher complication was occurred in only 2 (4%) patients. Surgical margin involvement was detected in 11 (22%) patients and 5 (10%) patients developed biochemical recurrence. Forty (87%) patients were continent and 21 (45.7%) patients were potent at the 6th month postoperatively. CONCLUSION: Having experience as a bedside assistant before console surgery also minimizes complication rates in addition to the advantages of robotic surgery in functional outcomes. of robotic surgery in functional outcomes. as no using pad or using safety pad. Mild incontinence was described as using 1 pad daily while using 2 and more pads described as severe incontinence. Patients with the International Index of Erectile Function (IIEF-5) score >21 were defined as potent, ≤21 were defined as impotent. RESULTS: Mean age was 64.06±6.15 and mean follow-up time was 14.9±6.9 months. Bilaterally, unilaterally and non nerve sparing surgery was performed in 37 (74%), 4 (8%) and 9 (18%) patients, respectively. Clavien grade 3 and higher complication was occurred in only 2 (4%) patients. Surgical margin involvement was detected in 11 (22%) patients and 5 (10%) patients developed biochemical recurrence. Forty (87%) patients were continent and 21 (45.7%) patients were potent at the 6th month postoperatively. CONCLUSION: Having experience as a bedside assistant before console surgery also minimizes complication rates in addition to the advantages of robotic surgery in functional outcomes.

Özet

AMAÇ: Daha önceden hasta başı asistanı tecrübesi olan konsol cerrahının robotik radikal prostatektomi fonksiyonel sonuçlarını sunmak. GEREÇ ve YÖNTEM: Eylül 2016 – Temmuz 2018 yılları arasında prostat kanseri nedeniyle robotik radikal prostatektomi operasyonu uygulanan ilk 50 hastanın verileri retrospektif olarak değerlendirildi. Postoperatif kontrollerde hiç ped kullanmama yada güvenlik pedi kullanma kontinan, 1 ped kullanımı hafif derecede, 2 ped ve üzeri ise şiddetli derecede inkontinans olarak değerlendirildi. Uluslararası cinsel işlev formu (IIEF5) skoru >21 olan hastalar potent, ≤21 olanlar ise impotent olarak kabul edildi. BULGULAR: Ortalama hasta yaşı 64,06±6,15 ve ortalama takip süresi 14,9±6,9 aydı. Bilateral sinir koruyucu, tek taraflı sinir koruyucu ve sinir korumasız cerrahi sırasıyla 37 (%74), 4 (%8) ve 9 (%18) hastaya uygulandı. Sadece 2 (%4) hastada postoperatif Clavien grade 3 ve üzeri komplikasyon görüldü. Cerrahi sınır pozitifliği 11 (%22) hastada tespit edilirken, 5 (%10) hastada biyokimyasal nüks tespit edildi. Postoperatif 6. ayda 40 (%87) hasta kontinan iken, potent hasta sayısı ise 21 (%45,7) olarak bulundu. SONUÇ: Konsol cerrahisi öncesi hasta başı asistans tecrübesine sahip olmak robotik cerrahinin fonksiyonel sonuçlardaki avantajlarına ek olarak komplikasyon oranlarını da minimalize etmektedir.