Robot-Assisted Prostatectomy

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 258 Experts worldwide ranked by ideXlab platform

Vipul R. Patel - One of the best experts on this subject based on the ideXlab platform.

  • Nerve‐sparing in salvage robot‐assisted Prostatectomy: surgical technique, oncological and functional outcomes at a single high‐volume institution
    BJU international, 2018
    Co-Authors: Xavier Bonet, Gabriel Ogaya-pinies, Tracey L. Woodlief, Eduardo Hernandez-cardona, Hariharan Palayapalayam Ganapathi, Travis Rogers, Rafael F. Coelho, Bernardo Rocco, Francesc Vigués, Vipul R. Patel
    Abstract:

    Objective To show the feasibility, oncological and functional outcomes of neurovascular bundle (NVB) preservation during salvage Robot-Assisted radical Prostatectomy (RARP). Patients and methods In the present institutional review board-approved retrospective analysis, between January 2008 and March 2016, 80 patients underwent salvage RARP, performed by a single surgeon (V.P), because of local recurrence after primary treatment. These patients were categorized into two groups depending on the degree of nerve-sparing (NS) performed: a good-NS group (≥50% of NVB preservation) and a poor-NS group ( 50% of the time, while full continence after salvage RARPwas defined as 0 pads used. The Kaplan-Meier method was used for survival and predictive estimations, and regression models were used to identify the predictors of potency, continence and biochemical failure (BCF). Results The potency rate at 12 months was higher in the good-NS group (25.6% vs 4.3%; P = 0.036) regardless of previous SHIM score, and good NS tended to be predictive of potency after salvage RARP (P = 0.065). The full continence rate at 12 months and BCF rate were similar in the two groups, and non-radiation primary treatment was the only predictor of continence at 12 months after salvage RARP (P = 0.033). Conclusions Our data support the feasibility and safety of NVB preservation for salvage RARP conducted in select patients in a high-volume institution and the subsequent better recovery of adequate erections for intercourse.

  • The effects of steep trendelenburg positioning on intraocular pressure during robotic radical Prostatectomy.
    Anesthesia & Analgesia, 2009
    Co-Authors: Hamdy Awad, Scott Santilli, Andrew G. Roth, Soledad Fernandez, Steven Roth, Vipul R. Patel
    Abstract:

    BACKGROUND:Intraocular pressure (IOP) increases in steep Trendelenburg positioning, but the magnitude of the increase has not been quantified. In addition, the factors contributing to this increase have not been studied in Robot-Assisted Prostatectomy cases. In this study, we sought to quantify the

Stephen E. Pautler - One of the best experts on this subject based on the ideXlab platform.

Mani Menon - One of the best experts on this subject based on the ideXlab platform.

  • Ureteral injuries sustained during Robot-Assisted radical Prostatectomy
    Journal of endourology, 2013
    Co-Authors: Jay K. Jhaveri, Mani Menon, Frank J. Penna, Mireya Diaz-insua, Wooju Jeong, James O. Peabody
    Abstract:

    Abstract Background and Purpose: During the last decade, the annual volume of Robot-Assisted prostatectomies performed in the United States has risen steadily. Refinements in surgical technique, understanding of anatomy, and experience have led to more complex patients being offered surgery for management of organ-confined prostate cancer. Complication rates of Robot-Assisted Prostatectomy have been reported in several articles; however, a paucity of data exists when evaluating ureteral injuries sustained during Robot-Assisted Prostatectomy. No standardized universal criteria for reporting and grading of complications exists; therefore, the Martin-Donat criteria with Clavien-Dindo classification system were used to evaluate ureteral injuries in our series. Patients and Methods: From January 2001 to June 2013, 6442 consecutive patients were treated with Robot-Assisted Prostatectomy at the same institution by one of five surgeons. All complications were documented through a prospectively maintained prostate...

  • Intraoperative finding of gross lymph node metastasis during Robot-Assisted Prostatectomy
    Journal of Robotic Surgery, 2012
    Co-Authors: Wooju Jeong, Mani Menon, James O. Peabody, Shyam Sukumar, Firas Petros, Craig G. Rogers
    Abstract:

    Discovery of macroscopically positive lymph nodes (LN) during radical Prostatectomy for clinically localized prostate cancer (PCa) is a rare event. We describe our experience of intraoperative finding of grossly positive LN during radical Prostatectomy and evaluate outcomes and predictors. A total of 4,480 patients underwent Robot-Assisted radical Prostatectomy (RARP) for clinically localized PCa from 2001 to 2010, and pelvic LN dissection was performed in 4,090 of these patients (91.3%). Patients with macroscopically positive LN discovered and confirmed intraoperatively were assessed, as was surgical decision (abort versus continue RARP). Patients with macroscopic LN-positive disease were also evaluated and oncologic outcomes were compared with patients with microscopic LN-positive disease on final pathology. LN-positive disease was found at final pathology in 87 patients (2.1%), of whom 13 (14.9%) had grossly abnormal LN confirmed intraoperatively by frozen section. RARP was aborted in nine cases and completed in four patients. All patients received adjuvant therapy with hormonal deprivation and/or radiation. Two patients in the aborted RARP subset died of PCa. All patients who underwent completion RARP are still alive at a mean follow-up of 57.2 months with one patient still alive at 95 months. Patients with macroscopically positive LN had a higher median preoperative prostate serum antigen (PSA) (17.2 vs. 6.7 μg/L, P  = 0.002) and were more likely have biopsy perineural invasion (77.8 vs. 32.4%, P  = 0.012). Intraoperative findings of macroscopically positive LN during RARP is a rare event that may occur in high-risk patients, particularly in those with a high PSA and biopsy perineural invasion. Long-term survival is possible after completion RARP.

  • Radical Prostatectomy: Should the retropubic approach remain the standard of care?
    Contemporary urology, 2004
    Co-Authors: Mani Menon, Ashutosh Tewari, J. Brantley Thrasher, William J. Catalona, Robert B. Nadler, Misop Han
    Abstract:

    While retropubic Prostatectomy has been the unchallenged standard of care for the treatment of localized prostate cancer for more than a decade, the perineal approach is undergoing a resurgence in popularity and supporters of Robot-Assisted Prostatectomy are growing. The authors debate the advantages and disadvantages of these 3 approaches.

  • a prospective comparison of radical retropubic and robot assisted Prostatectomy experience in one institution
    BJUI, 2003
    Co-Authors: Ashutosh Tewari, A. Srivasatava, Mani Menon
    Abstract:

    The authors from the Vattikuti Institute in the USA report a prospective comparison of radical Prostatectomy and Robot-Assisted Prostatectomy. They found that the Robot-Assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into Robot-Assisted radical cystoProstatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion. There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case-control study of men aged <70 years, ejaculatory frequency was negatively associated with the risk of prostate cancer. Technology has made many contributions to the management of urological patients. The classic example is that of urinary stone management. Authors from the USA evaluated cyroablation of renal carcinoma in patients with solitary kidneys. They are encouraged by their results and suggest that there is merit in this treatment, but indicate the need for a longer follow-up. OBJECTIVE To prospectively compare standard radical retropubic Prostatectomy (RRP) and the robotically assisted Vattikuti Institute Prostatectomy (VIP) in the management of localized prostate cancer. PATIENTS AND METHODS The study was a single-institution, prospective, unrandomized comparison of histopathological, and functional outcomes, at baseline and during and after surgery, in 100 patients undergoing RRP and 200 undergoing VIP. RESULTS While the variables before surgery, the operative duration (163 vs 160 min) and pathological stages were comparable, there were significant differences in the measured outcomes. The blood loss was 910 and 150 mL for RRP and VIP, respectively, and transfusion was greater after RRP (67% vs none; both P < 0.001). There were four times as many complications after RRP (20% vs 5%, P < 0.05), the haemoglobin level at discharge was lower (100 vs 130 g/L, P < 0.005) and the hospital stay longer (3.5 vs 1.2 days; P < 0.05). Most (93%) of VIP and none of the RRP patients were discharged within 24 h (P < 0.001); the duration of catheterization was twice as long after RRP (15.8 vs 7 days; P < 0.05). Positive margin was more frequent after RRP (23% vs 9%, P < 0.05). After VIP, patients achieved continence and return of erections more quickly than after RRP (160 vs 44, and 180 vs 440 days, both P < 0.5). The median return to intercourse was 340 days after VIP but after RRP half the patients have as yet not resumed intercourse at 700 days (P < 0.05). CONCLUSIONS The VIP procedure appears to be safer, less bloody and requires shorter hospitalization and catheterization. The oncological and functional results were favourable in patients undergoing VIP.

  • A prospective comparison of radical retropubic and Robot-Assisted Prostatectomy: experience in one institution.
    BJU international, 2003
    Co-Authors: Ashutosh Tewari, A. Srivasatava, Mani Menon
    Abstract:

    The authors from the Vattikuti Institute in the USA report a prospective comparison of radical Prostatectomy and Robot-Assisted Prostatectomy. They found that the Robot-Assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into Robot-Assisted radical cystoProstatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion. There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case-control study of men aged

Joseph L. Chin - One of the best experts on this subject based on the ideXlab platform.

Ashutosh Tewari - One of the best experts on this subject based on the ideXlab platform.

  • use of a novel absorbable barbed plastic surgical suture enables a self cinching technique of vesicourethral anastomosis during robot assisted Prostatectomy and improves anastomotic times
    Journal of Endourology, 2010
    Co-Authors: Ashutosh Tewari, Abhishek Srivastava, Prasanna Sooriakumaran, Adam Slevin, Sonal Grover, Olivia Waldman, Sivaram Rajan, Michael Herman, Roy Berryhill, Robert Leung
    Abstract:

    Abstract Purpose: To demonstrate a novel technique of self-cinching anastomosis using a barbed and looped suture during Robot-Assisted radical Prostatectomy (RARP). Patients and Methods: This is a feasibility study of 50 consecutive patients who underwent this novel self-cinching anastomotic technique using a V-Loc™ 180 absorbable barbed suture after RARP for clinically localized prostate cancer. The results were then compared with 50 consecutive patients who underwent RARP by the same surgeon before this new technique. We examined whether this novel technique had any effects on posterior reconstruction time, vesicourethral anastomosis time, and thus total reconstruction and operative time by inference. Results: The V-Loc 180 group had significantly shorter posterior reconstruction (40 seconds vs 60 seconds; P = < 0.001) and vesicourethral anastomotic times (7 min vs 12 min; P = < 0.001). By inference, this meant that total reconstruction and operative times were also significantly less (8 minutes vs 13.5...

  • Radical Prostatectomy: Should the retropubic approach remain the standard of care?
    Contemporary urology, 2004
    Co-Authors: Mani Menon, Ashutosh Tewari, J. Brantley Thrasher, William J. Catalona, Robert B. Nadler, Misop Han
    Abstract:

    While retropubic Prostatectomy has been the unchallenged standard of care for the treatment of localized prostate cancer for more than a decade, the perineal approach is undergoing a resurgence in popularity and supporters of Robot-Assisted Prostatectomy are growing. The authors debate the advantages and disadvantages of these 3 approaches.

  • a prospective comparison of radical retropubic and robot assisted Prostatectomy experience in one institution
    BJUI, 2003
    Co-Authors: Ashutosh Tewari, A. Srivasatava, Mani Menon
    Abstract:

    The authors from the Vattikuti Institute in the USA report a prospective comparison of radical Prostatectomy and Robot-Assisted Prostatectomy. They found that the Robot-Assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into Robot-Assisted radical cystoProstatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion. There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case-control study of men aged <70 years, ejaculatory frequency was negatively associated with the risk of prostate cancer. Technology has made many contributions to the management of urological patients. The classic example is that of urinary stone management. Authors from the USA evaluated cyroablation of renal carcinoma in patients with solitary kidneys. They are encouraged by their results and suggest that there is merit in this treatment, but indicate the need for a longer follow-up. OBJECTIVE To prospectively compare standard radical retropubic Prostatectomy (RRP) and the robotically assisted Vattikuti Institute Prostatectomy (VIP) in the management of localized prostate cancer. PATIENTS AND METHODS The study was a single-institution, prospective, unrandomized comparison of histopathological, and functional outcomes, at baseline and during and after surgery, in 100 patients undergoing RRP and 200 undergoing VIP. RESULTS While the variables before surgery, the operative duration (163 vs 160 min) and pathological stages were comparable, there were significant differences in the measured outcomes. The blood loss was 910 and 150 mL for RRP and VIP, respectively, and transfusion was greater after RRP (67% vs none; both P < 0.001). There were four times as many complications after RRP (20% vs 5%, P < 0.05), the haemoglobin level at discharge was lower (100 vs 130 g/L, P < 0.005) and the hospital stay longer (3.5 vs 1.2 days; P < 0.05). Most (93%) of VIP and none of the RRP patients were discharged within 24 h (P < 0.001); the duration of catheterization was twice as long after RRP (15.8 vs 7 days; P < 0.05). Positive margin was more frequent after RRP (23% vs 9%, P < 0.05). After VIP, patients achieved continence and return of erections more quickly than after RRP (160 vs 44, and 180 vs 440 days, both P < 0.5). The median return to intercourse was 340 days after VIP but after RRP half the patients have as yet not resumed intercourse at 700 days (P < 0.05). CONCLUSIONS The VIP procedure appears to be safer, less bloody and requires shorter hospitalization and catheterization. The oncological and functional results were favourable in patients undergoing VIP.

  • A prospective comparison of radical retropubic and Robot-Assisted Prostatectomy: experience in one institution.
    BJU international, 2003
    Co-Authors: Ashutosh Tewari, A. Srivasatava, Mani Menon
    Abstract:

    The authors from the Vattikuti Institute in the USA report a prospective comparison of radical Prostatectomy and Robot-Assisted Prostatectomy. They found that the Robot-Assisted procedure was safer, and yielded favourable oncological and functional results. They also present work in association with the Department of Urology in Mansoura into Robot-Assisted radical cystoProstatectomy and urinary diversion, and point out the advantages and disadvantages associated with performing the most complex types of urinary diversion. There is also an interesting paper relating to the association between sexual factors and prostate cancer, from authors in institutions in Australia, New Zealand and Italy. They found that in a case-control study of men aged

Related terms

Robot-Assisted Prostatectomy - 15 days free trial to Access Experts & Abstracts