Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases

OBJECTIVE: To evaluate the initial functional and oncologic results of 184 robot-assisted radical prostatectomies performed at our hospital. METHODS: A retrospective study was made of the first 184 consecutive robot-assisted radical prostatectomies performed at our hospital between February 2003 and December 2005. The procedures were performed by two surgeons who used the da Vinci robot with three robot arms. A transperitoneal approach was used in all patients. All patients had clinically organ-confined prostate cancer (< or =cT2c). The median follow-up was 6 mo. RESULTS: A positive surgical margin was found in 29 of the 184 patients (mean: 15.7%). The percentage positive surgical margins for the organ-confined (pT2) and non-organ-confined prostate cancers (pT3) were 2.5% and 38%, respectively. Ninety-five percent of patients were completely continent or wore one safety liner. Forty-three percent of the continent patients achieved complete continence within 28 d. Eighty-one percent of the patients who were younger than 60 yr and received a nerve-sparing procedure were potent and able to perform sexual intercourse. This percentage dropped to 51% in patients older than 60 yr. No major complications were encountered. CONCLUSIONS: The functional and oncologic results of this minimally invasive procedure seem very promising. Longer follow-up of the data and larger prospective studies are necessary to confirm these promising results.