Initial consecutive 125 cases of robotic assisted laparoscopic radical prostatectomy performed in Ireland’s first robotic radical prostatectomy centre

Abstract

Background

We examined the patient characteristics, operative proceedings and the outcomes of the initial series of 125 cases of robot-assisted laparoscopic radical prostatectomy (RALRP) in an independent hospital in Ireland, performed by two surgeons using the da Vinci^® surgical system.

Materials and methods

The series data were gathered prospectively in a consecutive series. Focus was given to the outcome trifecta of oncological control, urinary continence and erectile function. We also report on complications reported using the Clavien–Dindo classification.

Results

Mean patient age was 58.86 years, with a range between 47 and 71 years. Positive surgical margin rates were 11.3% overall (n = 14); 7.8% (n = 8) in the pT2 group (n = 101) and 30% (n = 6) in the pT3/pT4 (n = 20) group. 93% (n = 125) of patients are continent at 6 months. Biochemical recurrence-free survival was 92.4%. 72% (n = 43) of patients under the age of 65 with normal preoperative erectile function are potent at 1 year post-operatively. No patient in this series required a blood transfusion. Some form of relatively minor complication occurred in 12.8% (n = 16) of cases; there was no mortality rate, and no complication was life-threatening or resulted in single-organ or multiple-organ failure.

Conclusions

With a combination of high-level fellowship training of surgeons, a co-operative and combined approach to cases between surgeons, institutional support, and enthusiasm, encouragement and dedication from ancillary staff and colleagues, we have shown that a programme can be established with excellent levels of safety and efficacy.