Robot-Assisted Prostate Surgery Is Safe

Robot-assisted radical prostatectomy (RARP) to remove cancerous prostate glands is safe over the long term, with a major complication rate of less than 1%, according to a new study.

Researchers at Henry Ford Hospital (Detroit, MI, USA) analyzed the surgical outcomes of 3,317 consecutive RARP patients between January 2005 and December 2009. Complications were captured by exhaustive review of multiple datasets, including a prospective prostate cancer database, claims data, and electronic medical and institutional morbidity and mortality records. Complications were stratified by type (medical/surgical), Clavien classification, and timing of onset, and underwent subsequent multivariable analysis of factors predictive of complications.

The results demonstrated a median hospitalization time of only one day for all patients. There were 368 complications in 326 of the patients (9.8%) of the total, most of which were minor and occurred within 30 days of the surgery. The researchers found that the patient's prostate-specific antigen (PSA) scores before surgery, as well as cardiac disease, were found to predict medical complications after RARP; age, gastroesophageal reflux disease (GERD), and biopsy score predicted possible surgical complications. The researchers concluded that RARP is a safe operation. The study was published in the May 2011 issue of European Urology.

"We have always felt that robotic surgery for prostate cancer was safe, but there have been no studies that have looked at long-term safety," said Mani Menon, MD, director of Henry Ford's Vattikuti Urology Institute. "While these results provide strong endorsement for robotic surgery, we want to emphasize that the results are dependent more on the surgical team that controls the da Vinci robot, rather than just the robot."

RARP uses a surgeon-controlled robot, the da Vinci minimally invasive surgery system. The potential benefits for the patient include shorter recovery times, less trauma, and reduced hospitalization costs. It is also the basis of a "nerve-sparing" procedure called the Veil of Aphrodite, developed to minimize the erectile dysfunction common in men after undergoing traditional radical prostatectomy.

Related Links:
Henry Ford Hospital