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2008 Annual Meeting Abstracts
Robot Assisted Laparoscopic Prostatectomy: A Single Institutions Learning Curve
Jamison S Jaffe, Sean A Castellucci, Xavier Cathelineau, François Rozet, Justin D. Harmon, Eric Barret, Guy Vallancien
Institut Montsouris, Paris, France
Introduction: To evaluate the results of robot assisted laparoscopic prostatectomy (RALP) at a high volume conventional laparoscopic radical prostatectomy (LRP) center to determine if a learning curve still exists.
Methods: A total of 293 consecutive men underwent RALP between May of 2000 and November of 2006. Patient data was prospectively collected and reviewed including the preoperative PSA and Gleason score, operative duration, blood loss, duration of hospitalization, pathologic Gleason score and margin status.
Results: Mean operative duration for the entire group was 158±50min, blood loss was 533±416ml, hospital duration was 5 days and age was 61 years. Operative time showed a statistically significant decline at two different break points; after the first 12 cases, and after 189 cases dividing the patients into three groups. Operative times were 242±64 min, 165±43 min, and 134±45 min for each group respectively. The positive margin rate in each group was 7/12(58%), 41/180(23%), and 10/89(9%) which was statistically significant. Foley catheter duration was also statistically significant between the three groups. Age, preoperative Gleason and PSA were statistically significant between the second and third groups only. There was no statistical significance demonstrated in blood loss, post operative Gleason score, and length of hospital stay.
Conclusions: As experience with the RALP technique increases, there continues to be a significant decrease in operative time, positive margin rate, and duration of foley catheterization. Therefore, even at a high volume LRP center a learning curve exists when performing RALP.
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