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67th Annual Meeting Abstracts
Anterior versus Posterior Approach to Seminal Vesicle Dissection During Robotic Assisted Laparoscopic Prostatectomy
*Eric E Coronato1, *Jaspreet Singh1, *Phillip C Ginsberg1, *Jamison S. Jaffe2, *Justin D. Harmon2
1Philadelphia College of Osteopathic Medicine, Philadelphia, PA;2Hahnemann University Hospital, Philadelphia, PA
Introduction: We compare our experience with both anterior and posterior approaches to RALP, and evaluate both perioperative and postoperative factors for each technique.
Materials & Methods: A retrospective analysis was obtained on a consecutive series of 105 patients undergoing RALP, performed by 2 surgeons (JJ and JH), at a single institution. Patients were divided into 2 groups: anterior approach (AA) and posterior approach (PA). Patient demographics, operative parameters, pathological characteristics and complications were compared between groups.
Results: Preoperative factors among the AA and AP groups were similar with mean age of 60 years [range 40-74], mean PSA of 6.3ng/mL [range 0.5-22.3], and similar clinical stage. The pathologic staging, Gleason scores, and margin status were not significantly different (p>0.05) in both groups. The factors that proved to be of statistical significance included a lower console time for PA of 162.1 minutes versus 193.8 minutes in AA group (p=0.01) and a lower transfusion rate (p < 0.0001) in the PA group. There was one rectal injury in both groups repaired robotically. In addition, all patients in the PA group were able to undergo a pure RALP without conversion to LRP. Hospital stay and length of foley catheter duration were similar in both groups, a reflection of the surgeons’ practice.
Conclusions: With preoperative factors being similar, the posterior approach to a RALP is associated with lower console time and a lower transfusion rate. Perhaps this approach may facilitate in shortening the learning curve for RALP.
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