Abstract

MORENO SIERRA, Jesús et al. Da Vinci^® robot assisted radical prostatectomy: one year experience at the Hospital Clínico San Carlos. Arch. Esp. Urol. [online]. 2008, vol.61, n.3, pp.385-396. ISSN 0004-0614.

Objectives: Hospital Clínico San Carlos in Madrid is the first Spanish public centre using the latest surgical technology: the Da Vinci^® robot. First operation was carried out in our department in October 9th 2006. Since then, numerous changes have happened which enabled us to overcome difficulties, to complete the learning curve. Methods: Between October 9th 2006 and November 30th 2007 we performed 30 radical prostatectomies with the Da Vinci^® robot. Mean patient age was 63 years (47-70 years) with an ASA (American society of anesthesia) risk below III in all cases, a Gleason score between 2 and 8 and a PSA ≤ 15 (3.5-15). Mean prostatic volume measured by transrectal ultrasound was 36 cc (16-90 cc). Results/Conclusions: Six trocars and a 15 mm Hg pneumoperitoneum were employed. Mean operative room occupation time was 5.9 hours (4-14 hours). Two cases were converted to open surgery and one to laparoscopy. No major intraoperative complications have happened. In the immediate post-operative period, 2 patients presented plexopathy and arthralgia, 1 infection at the site of one trocar, and 2 haematomas at the site of trocar insertion. Sixteen patients required transfusion (mean 1 red blood cells unit (0-4)). Bladder catheter was retrieved between 5th and 21st post-operative days (mean 11 days). Regarding continence: 10 patients were completely continent or present mild incontinence (0-1 pad) and 5 had moderate incontinence (2-5 pads). Three patients preserve sexual potency, the rest show different grades of dysfunction.

Keywords : Prostate cancer; Radical prostatectomy; Da Vinci robot^®.

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