Advantages and disadvantages of main surgical approaches for robot-assisted radical prostatectomy

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patient’s age, anatomical features of the prostate gland, the state of the patient’s erectile function, and the history of operations on the abdominal cavity and pelvic organs.

Full Text

Restricted Access

About the authors

Dmitriy M. Il’in

City Mariinsky Hospital

Author for correspondence.
Email: melker@mail.ru

Urologist of the Urological Division, Deputy Head of the Center for Robotic Surgery

Russian Federation, 191104, Saint Petersburg, Litejnyj Prospekt, 56

Vladimir A. Makeev

Academician I.P. Pavlov First Saint Petersburg State Medical University

Email: dr.makeev2016@mail.ru

Student

Russian Federation, 196022, Saint Petersburg, Lva Tolstogo street, 6-8

References

  1. Menon M, Dalela D, Jamil M, et al. Functional recovery, oncologic outcomes and postoperative complications after robot-assisted radical prostatectomy: An evidence-based analysis comparing the retzius sparing and standard approaches. J Urol. 2018;199(5):1210-1217. https://doi.org/10.1016/j.juro. 2017.11.115
  2. Мосоян М.С., Аль-Шукри С.Х., Ильин Д.М. Пятилетний опыт лечения рака предстательной железы на роботе «Da Vinci» // Нефрология. – 2016. – Т. 20. – № 4. – С. 103–106. [Mosoyan MS, Al-Shukri SKh, Ilin DM. Five year experience in prostate cancer surgery on “Da Vinci” robot. Nephrology. 2016; 20(4): 103-106. (In Russ.)]
  3. Мосоян М.С., Ильин Д.М. Раннее восстановление функции удержания мочи после робот-ассистированной радикальной простатэктомии // Трансляционная медицина. – 2017. – Т. 4. – № 6. – С. 53–61. [Mosoyan MS, Ilin DM. Early continence recovery after robot-assisted radical prostatectomy. Translational Medicine. 2017;4(6):53-61. (In Russ.)]. https://doi.org/10.18705/2311-4495-2017-4-6-53-61.
  4. Прилепская Е.А., Мальцев Е.Г., Колонтарев К.Б. и др. Сравнительный анализ функциональных и онкологических результатов радикальной простатэктомии — позадилонной, лапароскопической и робот-ассистированной // Онкоурология. – 2015. – Т. 11. – № 4. – С. 54–58. [Prilepskaya EA, Maltsev EG, Kolontarev KB, et al. Comparison of oncological results and functional outcomes of radical prostatectomy techniques – retropubic, laparoscopic and robot-assisted. Cancer Urology. 2015;11(4):54-58. (In Russ.)]. https://doi.org/10.17650/1726-9776-2015-11-4-54-58.
  5. Пушкарь Д.Ю., Дьяков В.В., Васильев А.О., Котенко Д.В. Сравнение функциональных результатов после радикальной позадилонной и робот-ассистированной простатэктомий, выполненных по нервосберегающей методике хирургами с опытом более 1000 операций // Урология. – 2017. – № 1. – С. 50–53. [Pushkar DYu, Dyakov VV, Vasilyev AO, Kotenko DV. Comparison of functional outcomes after retropubic and robot-assisted radical nerve-sparing prostatectomy conducted by surgeons with total caseloads of over 1000 prostatectomies. Urologiia. 2017;(1): 50-53. (In Russ.)]. https://dx.doi.org/10.18565/urol.2017.1. 50-53
  6. Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):418-430. https://doi.org/10.1016/j.eururo.2012.05.046
  7. Бормотин А.В., Рева И.А., Дьяков В.В. и др. Качество жизни пациентов старше 70 лет, перенесших радикальное оперативное лечение по поводу рака предстательной железы // Онкоурология. – 2014. – Т. 10. – № 1. – С. 58–63. [Bormotin AV, Reva IA, Dyakov VV, et al. Quality of life in patients over 70 years old after radical surgery for prostate cancer. Cancer Urology. 2014; 10(1):58-63. (In Russ.)].
  8. Зингеренко М.Б., Мирзоев К.М. Робот-ассистированная радикальная простатэктомия у больных с раком простаты пожилого возраста: наш опыт // Клиническая геронтология. – 2017. – Т. 9–10. – С. 26–28. [Zingerenko MB, Mirzoev KM. Robot-assisted radical prostatectomy in elderly age patients with prostate cancer: our experience. Clinical gerontology. 2017: (9-10);26-28. (In Russ.)].
  9. Мосоян М.С. Робот-ассистированные операции в урологии. Опыт и перспективы // Дайджест урологии. – 2019. – № 3. – С. 60–64. [Mosoyan MS. Robot-assistirovannye operacii v urologii. Opyt i perspektivy. Dajdzhest urologii. 2019;(3):60–64. (In Russ.)]. Режим доступа: https://urodigest.ru/sites/default/files/issue/03-2019.pdf. Дата обращения: 14.12.2020.
  10. Раснер П.И., Пушкарь Д.Ю., Колонтарев К.Б., Котенко Д.В. Индивидуальная кривая обучения технике выполнения радикальной робот-ассистированной простатэктомии на примере трех специалистов, работающих в одной клинике // Урология. – 2014. – № 6. – С. 61–68. [Rasner PI, Pushkar DYu, Kolontarev KB, Kotenko DV. Individual learning curve for radical robot-assisted prostatectomy based on the example of three professionals working in one clinic. Urologiia. 2014;(6):61-68. (In Russ.)]
  11. Eden CG. Retzius-sparing robotic radical prostatectomy. Asian J Androl. 2020;22(2):149-151. https://doi.org/10.4103/aja.aja_82_19.
  12. Maurice MJ, Kaouk JH. Single-Port Robot-Assisted Perineal Prostatectomy and Pelvic Lymphadenectomy: Step-by-Step Technique in a Cadaveric Model. J Endourol. 2018;32(S1):93-96. https://doi.org/10.1089/end.2017.0707.
  13. Kaouk J, Bertolo R, Eltemamy M, Garisto J. Single-Port Robot-Assisted Radical Prostatectomy: First Clinical Experience Using the SP Surgical System. Urology. 2019;124:309. https://doi.org/10.1016/j.urology.2018.10.025.
  14. Ramirez D, Maurice MJ, Kaouk JH. Robotic perineal radical prostatectomy and pelvic lymph node dissection using a purpose-built single-port robotic platform. BJU Int. 2016;118(5):829-833. https://doi.org/10.1111/bju.13581.
  15. Taşçi AI, Şimşek A, Şam E, et al. Gasless robotic perineal radical prostatectomy: An initial experience. Turk J Urol. 2019;45(Supp.1):117-120. https://doi.org/10.5152/tud.2018. 48085.
  16. Tuğcu V, Akça O, Şimşek A, et al. Robot-assisted radical perineal prostatectomy: first experience of 15 cases. Turk J Urol. 2017;43(4):476-483. https://doi.org/10.5152/tud.2017. 35488.
  17. Tuğcu V, Akça O, Şimşek A, et al. Robotic perineal radical prostatectomy and robotic pelvic lymph node dissection via a perineal approach: The Tugcu Bakirkoy Technique. Turk J Urol. 2018;44(2):114-118. https://doi.org/10.5152/tud.2018. 24603.
  18. Tuğcu V, Akça O, Şimşek A, et al. Robotic-assisted perineal versus transperitoneal radical prostatectomy: A matched-pair analysis. Turk J Urol. 2019;45(4):265-272. https://doi.org/10.5152/tud.2019.98254.
  19. Garisto J, Bertolo R, Wilson CA, Kaouk J. The evolution and resurgence of perineal prostatectomy in the robotic surgical era. World J Urol. 2020;38(4):821-828. https://doi.org/10.1007/s00345-019-03004-1.
  20. Gillitzer R, Thomas C, Wiesner C, et al. Single center comparison of anastomotic strictures after radical perineal and radical retropubic prostatectomy. Urology. 2010;76(2):417-422. https://doi.org/10.1016/j.urology.2009.10.009.
  21. Tugcu V, Simsek A, Yigitbasi I, et al. Robotic perineal radical prostatectomy with high prostate volume. Arch Ital Urol Androl. 2018;90(1):65-67. https://doi.org/10.4081/aiua.2018. 1.65.
  22. Tugcu V, Simsek A, Yigitbasi I, et al. Robot-assisted perineal radical prostatectomy in a post-kidney transplant recipient. J Endourol Case Rep. 2018;4(1):21-24. https://doi.org/10.1089/cren.2017.0119.
  23. Yenice MG, Yigitbasi I, Sam E, et al. Robotic perineal radical prostatectomy in a patient with a pre-existing three piece inflatable penile prosthesis. Aktuelle Urol. 2020. https://doi.org/10.1055/a-0945-2489.
  24. Asimakopoulos AD, Corona Montes VE, Gaston R. Robot-assisted laparoscopic radical prostatectomy with intrafascial dissection of the neurovascular bundles and preservation of the pubovesical complex: a step-by-step description of the technique. J Endourol. 2012;26(12):1578-1585. https://doi.org/10.1089/end.2012. 0405.
  25. Asimakopoulos AD, Mugnier C, Hoepffner JL, et al. Bladder neck preservation during minimally invasive radical prostatectomy: a standardised technique using a lateral approach. BJU Int. 2012;110(10):1566-1571. https://doi.org/10.1111/j.1464-410X.2012.11604.х.
  26. Galfano A, Di Trapani D, Sozzi F, et al. Beyond the learning curve of the Retzius-sparing approach for robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of the first 200 patients with ≥1 year of follow-up. Eur Urol. 2013;64(6):974-980. https://doi.org/10.1016/j.eururo.2013. 06.046.
  27. Asimakopoulos AD, Miano R, Galfano A, et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: Critical appraisal of the anatomic landmarks for a complete intrafascial approach. Clin Anat. 2015;28(7):896-902. https://doi.org/10.1002/ca.22576.
  28. Ильин Д.М., Гулиев Б.Г. Ретциус-сберегающая робот-ассистированная радикальная простатэктомия: первый опыт и техника выполнения // Урологические ведомости. – 2019. – Т. 9. – № 4. – C. 19–24. [Ilin DM, Guliev BG. Retzius-sparing robot-assisted radical prostatectomy: initial experience and surgical technique. Urologicheskie vedomosti. 2019;9(4):19-24. (In Russ.)]. https://doi.org/10.17816/uroved9419-24.
  29. Stonier T, Simson N, Davis J, Challacombe B. Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) vs standard RARP: it’s time for critical appraisal. BJU Int. 2019;123(1):5-7. https://doi.org/10.1111/bju.14468.
  30. Rashid K, Rabii M. The untold advantages of Retzius-sparing Robotic Radical Prostatectomy. J Endourol. 2018;32(7):671-672. https://doi.org/10.1089/end.2018.0274
  31. Lee J, Kim HY, Goh HJ, et al. Retzius sparing robot-assisted radical prostatectomy conveys early regain of continence over conventional robot-assisted radical prostatectomy: A propensity score matched analysis of 1,863 patients. J Urol. 2020; 203(1):137-144. https://doi.org/10.1097/JU.00000000000 00461.
  32. Phukan C, Mclean A, Nambiar A, et al. Retzius sparing robotic assisted radical prostatectomy vs. conventional robotic assisted radical prostatectomy: a systematic review and meta-analysis. World J Urol. 2020;38(5):1123-1134. https://doi.org/10.1007/s00345-019-02798-4.
  33. Dirie NI, Pokhrel G, Guan W, et al. Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis. Asian J Urol. 2019;6(2):174-182. https://doi.org/10.1016/j.ajur.2018.02.001.
  34. Asimakopoulos AD, Topazio L, De Angelis M, et al. Retzius-sparing versus standard robot-assisted radical prostatectomy: a prospective randomized comparison on immediate continence rates. Surg Endosc. 2019;33(7):2187-2196. https://doi.org/10.1007/s00464-018-6499-z.
  35. Galfano A, Panarello D, Secco S, et al. Does prostate volume have an impact on the functional and oncological results of Retzius-sparing robot-assisted radical prostatectomy? Minerva Urol Nefrol. 2018;70(4):408-413. https://doi.org/10.23736/S0393-2249.18.03069-2.
  36. Abdel Raheem A, Rha KH. Reply: Retzius-sparing robot-assisted radical prostatectomy (RARP) vs standard RARP. BJU Int. 2019;123(1):8-10. https://doi.org/10.1111/bju.14545.
  37. Kim LHC, Santok GD, Raheem AA, et al. Retzius-sparing robot-assisted radical prostatectomy is safe for patients with prior transurethral prostate surgery. Int Braz J Urol. 2018;44(4):842-843. https://doi.org/10.1590/S1677-5538.IBJU.2017.0316.
  38. Невирович Е.С., Борискин А.Г. Радикальная простатэктомия с сохранением ретциевого пространства. Опыт применения и результаты // Экспериментальная и клиническая урология. – 2018. – № 4. – С. 36–39. [Nevirovich ES, Boriskin AG, Radical prostatectomy with preservation of Retzius’ space. Application experience and its results. Experimental and Clinical Urology. 2018;(4):36-39. (In Russ.)]
  39. Sayyid RK, Simpson WG, Lu C, et al. Retzius-Sparing Robotic-Assisted Laparoscopic Radical Prostatectomy: A Safe Surgical Technique with Superior Continence Outcomes. J Endourol. 2017;31(12):1244-1250. https://doi.org/10.1089/end.2017. 0490.
  40. Lim SK, Kim KH, Shin TY, et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches. BJU Int. 2014;114(2):236-244. https://doi.org/10.1111/bju.12705.
  41. Abdel Raheem A, Chand KD, Alenzi MJ, et al. Predictors of biochemical recurrence after Retzius-sparing robot-assisted radical prostatectomy: Analysis of 359 cases with a median follow-up period of 26 months. Int J Urol. 2018;25(12):1006-1014. https://doi.org/10.1111/iju.13808.
  42. Dalela D, Jeong W, Prasad MA, et al. A Pragmatic Randomized Controlled Trial Examining the Impact of the Retzius-sparing Approach on Early Urinary Continence Recovery After Robot-assisted Radical Prostatectomy. Eur Urol. 2017;72(5):677-685. https://doi.org/10.1016/j.eururo.2017.04.029.
  43. Chang LW, Hung SC, Hu JC, Chiu KY. Retzius-sparing Robotic-assisted Radical Prostatectomy Associated with Less Bladder Neck Descent and Better Early Continence Outcome. Anticancer Res. 2018;38(1):345-351. https://doi.org/10.21873/anticanres. 12228.
  44. Chang KD, Abdel Raheem A, Santok GDR, et al. Anatomical Retzius-space preservation is associated with lower incidence of postoperative inguinal hernia development after robot-assisted radical prostatectomy. Hernia. 2017;21(4):555-561. https://doi.org/10.1007/s10029-017-1588-9.
  45. Shimbo M, Endo F, Matsushita K, et al. Incidence, Risk Factors and a Novel Prevention Technique for Inguinal Hernia after Robot-Assisted Radical Prostatectomy. Urol Int. 2017;98(1):54-60. https://doi.org/10.1159/000448339.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Il’in D.M., Makeev V.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ №ФС77-65570 от 04 мая 2016 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies