[Vattikuti institute prostatectomy (VIP) and current results].
نویسندگان
چکیده
OBJECTIVES To describe a technique of Robot Assisted Radical Prostatectomy (RAP) for localized carcinoma of the prostate, the Vattikuti Institute Prostatectomy (VIP) and an innovative incremental nerve preservation technique, the Veil of Aphrodite. We also report complications, oncological and functional outcomes in a cohort of the patient operated during 2001-2006. METHODS 2,652 patients with localiced carcinoma of prostate underwent VIP at our centre between 2001-2006. Our current technique involves: early division of the bladder neck, preservation of the lateral pelvic fascia and control of the dorsal vein complex after apical dissection of the prostate. Oncological, functional and follow-up information was obtained through "ROBOSURG" data base, which is managed by an independent group not involved in the patient care. VIP, as it has evolved in our hands over a period of 5 years, has given excellent outcomes in terms of cancer control, continence and erectile function. Our modifications of the surgical technique had a singular focus on consistent improvement of the so called "Trifecta", taking radical retropubic prostatectomy (RRP) published data as a reference standard. We present our current technique of VIP with preservation of the lateral prostatic fascia ("Veil of Aphrodite"). RESULTS In this report we include 2077 patients with follow-up ranging from 4 weeks to 260 weeks (median 68 weeks). We have a low incidence (1.5%) of perioperative complications. 97.6% of our patients had a hospital stay of less than 48 hours. There were 5.8% unscheduled postoperative visits. With the PSA cut-off limit of 0.4 ng/ml, the overall biochemical recurrence rate was 3.9%. Median duration of incontinence was 4 weeks; 0.8% patients had total incontinence at 12 months. The intercourse rate was 93% in men with no pre-operative erectile dysfunction undergoing veil nerve-sparing surgery, although only 51% returned to baseline function. CONCLUSION Vattikuti Institute Prostatectomy offers excellent patient recovery with significant reduction in first 30 days morbidity and provides excellent oncological and functional outcomes. The preservation of the "Veil of Aphrodite" helps in postoperative return of erectile function in patients with normal preoperative erectile function.
منابع مشابه
Robotic radical prostatectomy and the Vattikuti Urology Institute technique: an interim analysis of results and technical points.
We have performed >350 robotic radical prostatectomies in the last 2 years. A single surgeon (MM) performed 250 of these procedures using a technique developed at our institution, the Vattikuti Urology Institute. This article summarizes the technical highlights and interim results of the Vattikuti Institute Prostatectomy (VIP) technique. We prospectively collected baseline demographic data, suc...
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130. 9. Guillonneau B, Vallencien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 2000; 163: 1643–9. 10. Abbou CC, Salomon L, Hoznek A, Antiphon P, Cicco A, Saint F, Alame W, Bellot J, Chopin D. Laparoscopic radical prostatectomy: preliminary results. Urology 2000; 55: 630–4. 11. Abbou CC, Hoznek A, Salomon I, Olsson L, Lobontiu A, Saint F, Cicco A, Antiphon P, Chopin D....
متن کاملUrology Robotic Surgery
RESULTS: Factors affecting erectile function include age, preoperative SHIM scores, co-morbidities and nerve sparing techniques. Large robotic-assisted laparoscopic radical prostatectomy (RALP) series like the Vattikuti Institute’s and Ohio State University’s demonstrate early potency outcomes: 70% and 80% of patients, respectively, who underwent bilateral nerve sparing and had a pre-operative ...
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ورودعنوان ژورنال:
- Archivos espanoles de urologia
دوره 60 4 شماره
صفحات -
تاریخ انتشار 2007