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A role for laparoscopy in the age of robotics: a retrospective cohort study of perioperative outcomes between 2D laparoscopic radical prostatectomy vs 3DHD laparoscopic radical prostatectomy

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Abstract

Purpose

Our study compares perioperative outcomes between two-dimensional (2D) laparoscopic radical prostatectomy (LRP) and the 4th generation three-dimensional/high definition (3DHD) LRP.

Methods

Retrospectively acquired data from patients that underwent 2D LRP (n = 75) and 3DHD LRP (n = 75) from March 2013 to October 2015 were evaluated. Procedures were performed by a single surgeon. The extra-peritoneal approach with 5 trocars was utilized. Perioperative outcomes, potency, and continence were compared between groups.

Results

Patient characteristics were similar between the two groups in terms of age (p = 0.44), prostate-specific antigen (PSA) levels (p = 0.34), and Gleason scores (p = 0.14). Body mass index (BMI) was significantly higher in the 3DHD group (p = 0.0036). Postoperatively, no significant differences were observed in Hgb loss (p = 0.50), positive surgical margins (p = 1.00), and post-op Gleason scores (p = 0.30). Significant differences were observed for length of hospital stay (p < 0.001) and Jackson-Pratt (JP) drainage (p < 0.001). Regarding potency, 73.7% and 51.6% of the patients in the 3DHD and 2D groups regained potency at 6 months, respectively (p = 0.0025). Almost 43% of the patients in the 3DHD group regained continence at 1 month while for the 2D groups it was only 17.3% (p = 0.0008).

Conclusion

3DHD and 2D LRP have resulted in good outcomes in the perioperative periods. Our results show decreased JP drainage, shorter length of hospital stay, earlier return of urinary control, and earlier return of sexual function in the 3DHD LRP group. In lower volume centers where robotics equipment is not feasible due to economic barriers 3DHD can be safely performed as a minimally invasive alternative.

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Data availability

The data that support the findings of this study are available from the corresponding author, Gilberto Ruiz-Deya upon reasonable request.

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Authors and Affiliations

  1. St. Luke’s Episcopal Hospital, Ponce, PR, 00733, USA

    Andrew Engel-Rodriguez, Isabel Ruiz-Irizarry, Natalie Engel-Rodriguez & Gilberto Ruiz-Deya

  2. VA Caribbean Healthcare Systems, San Juan, 00921, USA

    Andrew Engel-Rodriguez

  3. Nova Southeastern University-Puerto Rico Regional Campus, San Juan, PR, 00926, USA

    Isabel Ruiz-Irizarry

  4. San Juan Bautista School of Medicine, Caguas, PR, 00727, USA

    Natalie Engel-Rodriguez

  5. Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA

    Carmen Ortiz-Sánchez & Jarline Encarnación-Medina

  6. Department of Surgery, Ponce Health Sciences University, Ponce, PR, 00716-2347, USA

    Gilberto Ruiz-Deya

Authors
  1. Andrew Engel-Rodriguez
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  2. Isabel Ruiz-Irizarry
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  3. Natalie Engel-Rodriguez
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  4. Carmen Ortiz-Sánchez
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  5. Jarline Encarnación-Medina
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  6. Gilberto Ruiz-Deya
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Contributions

AER: Protocol/project development, Data collection or management, Manuscript writing/editing. IRI: Data collection or management, Manuscript writing/editing. NER: Data collection or management, Manuscript writing/editing. COS: Data analysis, Manuscript writing/editing. JEM: Data analysis, Manuscript writing/editing. GRD: Protocol/project development, Manuscript writing/editing.

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Correspondence to Gilberto Ruiz-Deya.

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Engel-Rodriguez, A., Ruiz-Irizarry, I., Engel-Rodriguez, N. et al. A role for laparoscopy in the age of robotics: a retrospective cohort study of perioperative outcomes between 2D laparoscopic radical prostatectomy vs 3DHD laparoscopic radical prostatectomy. World J Urol 41, 443–448 (2023). https://doi.org/10.1007/s00345-022-04276-w

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  • DOI: https://doi.org/10.1007/s00345-022-04276-w

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