Posterior Reconstruction Before Anastomosis Improves the Anastomosis Time During Robot-Assisted Radical Prostatectomy

Aaron M. Bernie, Arthur A. Caire, Sarah P. Conley, Mathew Oommen, Ugur Boylu, Raju Thomas, Benjamin R. Lee

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background and Objectives: Our goal was to evaluate posterior reconstruction of the rhabdosphincter during robot-assisted radical prostatectomy and determine whether this technique decreased anastomotic time of a surgeon in training to perform vesicourethral reconstruction. Methods: We reviewed the first 25 robot-assisted prostatectomies performed by 2 urology surgeons in training (surgeon 1 and surgeon 2). The patient populations were matched for age, Gleason score, clinical stage, and PSA. Whereas surgeon 1 performed the vesicourethral anastomosis without posterior reconstruction, surgeon 2 reapproximated Denonvilliers' fascia of the posterior bladder to the rhabdosphincter. Time for each surgeon to complete the anastomosis and clinical factors was compared. Results: Surgeon 1 had a median anastomosis time of 25 minutes (range, 17 to 48), whereas surgeon 2 had a median anastomosis time of 15 minutes (range, 10 to 30) (P<0.001). Biopsy Gleason score, pathological tumor stage, perineural invasion, median age at the time of surgery, PSA, prostate weight, and estimated blood loss were not significantly different between surgeons (P>0.05). Pathological Gleason score (P=0.045) and total console time (surgeon 1=216 minutes, surgeon 2=176 minutes; P=0.002) were significantly different between surgeons. Conclusion: Posterior reconstruction prior to anastomosis decreases anastomosis time for robotic surgeons in training.

Original languageEnglish (US)
Pages (from-to)520-524
Number of pages5
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume14
Issue number4
DOIs
StatePublished - Oct 2011

Keywords

  • Anastomosis
  • Prostatectomy
  • Prostatic neoplasms
  • Robotics
  • Surgical

ASJC Scopus subject areas

  • Surgery

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