Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy: Initial Experience in Ramathibodi Hospital

Abstract

Background: Robotics assisted laparoscopic prostatectomy (RALRP) has been shown to improve functional outcomes when compared to open or laparoscopic prostatectomy with similar oncologic results. It has become a famous procedure for treating patients with localized prostate cancer. The program of RALRP has just been started at Ramathibodi Hospital for about a year. The feasibility of this procedure in our institution has to be established. Objective: To evaluate the feasibility of the RALRP that was performed early at Ramathibodi Hospital. Methods: Medical records of 30 patients with clinically localized prostate cancer who underwent RALRP by two laparoscopic-experienced urologists in Ramathibodi Hospital from May 2013 to January 2014 were retrospectively reviewed including outcomes, complications, and cost per admission for RALRP. Results: Mean operative time was 4.2 hours (range 2.0 – 7.3) and mean estimated blood loss was 527 mL (range 100 – 2200) without blood transfusion requirement in 80% of all patients. There were no intraoperative complications and no conversions to open surgery. Twenty-four patients (80%) had pT2 disease and 6 patients had pT3 disease. Positive surgical margin rate was 53%. There were 20% minor post-operative complications, and no major post-operative complications and mortalities. Mean length of hospital stay was 8 days (range 5 - 19) and mean duration of urethral catheter indwelling was 11 days (range 5 – 22). Mean post-operative serum PSA level was 0.08 ng/mL (range 0.00 - 1.12) with mean follow-up duration of 86 days. Total cost per admission for RALRP was 126,875 baht (range 50.968 - 343,027) Conclusions: RALRP for prostate cancer in Ramathibodi Hospital is safe but additional studies are needed to indicate the feasibility of this procedure.