robotic simple prostatectomy: initial single-center experience in taiwan

Objective: For patients with symptomatic large volume benign prostate hyperplasia, open simple prostatectomy has traditionally been the treatment of choice but laparoscopic simple prostatectomy (LSP) has become an effective surgical option. Since the first case of LSP was described in 2002, surgeons have continued to expand the use of minimally invasive surgery. In 2008, the first case of robotic simple prostatectomy (RSP) was reported. We herein report our initial experience with robotic simple prostatectomy. Materials and methods: We performed retropubic robotic simple prostatectomy using a transperitoneal approach in 10 patients. All of them had significant symptomatic prostate enlargement confirmed by abdominal or transrectal ultrasound (mean 138.2 mL). Demographic data, perioperative outcomes, and functional outcomes were recorded. Results: The median age of patients was 68 years (range 60–76 years). The median International Prostate Symptom Score at baseline was 24 (range 18–34). The median operation time was 150 minutes (range 130–180 minutes). The median estimated blood loss was 100 mL (range 50–850 mL). Intraoperative blood transfusion was required in one patient (10%). The median resected prostate weight was 77.5 g (range 60–120 g). The median hospital stay was 5 days (range 3–5 days). The median urethral catheterization was 12 days (range 9–14 days). All of these patients gained significant improvement in maximum urine flow rate (preoperative vs. postoperative 9.8 mL/min vs. 21.5 mL/min, p = 0.001) and postvoid residual urine (preoperative vs. postoperative 125 mL vs. 10 mL, p = 0.001). Conclusion: Robotic simple prostatectomy is a feasible alternative for a greatly enlarged prostate gland with acceptable complications.