Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes.

The purpose of this narrative review is to describe the different nerve-sparing techniques applied during radical prostatectomy and document their functional impact on postoperative outcomes. We performed a PubMed search of the literature using the keywords "nerve-sparing", "techniques", "prostatectomy" and "outcomes". Other potentially eligible studies were retrieved using the reference list of the included studies.

Extraperitoneal vs. transperitoneal robot-assisted laparoscopic radical prostatectomy-analysis of perioperative outcomes, a single surgeon's experience.

Robot-assisted laparoscopic radical prostatectomy (RRP) has traditionally been done using transperitoneal (TP) approach. This requires patients to be in the steep Trendelenburg position with antecedent risks of high intraoperative ventilatory pressure, post-operative confusion status, corneal and cerebral edema, deep vein thrombosis (DVT), predisposes risk of intestinal injury and slight delay in bowel recovery. Extraperitoneal (EP-RRP) approach circumvents the above given issues.

National trends and differences in morbidity among surgical approaches for radical prostatectomy in Germany.

Objective: In this study, we document trends in radical prostatectomy (RP) employment in Germany during the period 2005-2012 and compare the morbidity of open (ORP), laparoscopic and robotic-assisted RP based on nationwide administrative data of Allgemeine Ortskrankenkassen (AOK) German local healthcare funds.

Materials And Methods: Administrative claims data of all AOK patients subjected to RP during 2005-2012 (57,156 cases) were used to evaluate the employment of minimally invasive RP (MIRP) procedures, pelvic lymph node dissection (PLND) and nerve-sparing approaches during this period. In addition, data from the most recent three-year period of our dataset (2010-2012) were used to compare the morbidity among the different surgical approaches.

Robot-assisted laparoscopic total extraperitoneal hernia repair during prostatectomy: technique and initial experience.

Introduction: To describe the technique of total extraperitoneal inguinal hernia repair performed during Robot-assisted Endoscopic Extraperitoneal Radical Prostatectomy (R-EERPE) and to present the initial outcomes.

Material And Methods: 12 patients underwent inguinal hernia repair during 120 R-EERPEs performed between July 2011 and March 2012. All patients had a clinically palpable inguinal hernia preoperatively.

Acceptance, Prevalence and Indications for Robot-Assisted Laparoscopy - Results of a Survey Among Urologists in Germany, Austria and Switzerland.

Background: Robotic-assisted laparoscopy (RAL) is being widely accepted in the field of urology as a replacement for conventional laparoscopy (CL). Nevertheless, the process of its integration in clinical routines has been rather spontaneous.

Objective: To determine the prevalence of robotic systems (RS) in urological clinics in Germany, Austria and Switzerland, the acceptance of RAL among urologists as a replacement for CL and its current use for 25 different urological indications.

Development of urologic laparoscopy in Germany, Austria, and Switzerland: a survey among urologists.

Purpose: Laparoscopy introduction has dramatically changed urology. Novel techniques, such as laparoendoscopic single-site surgery (LESS) and natural orifice translumenal endoscopic surgery (NOTES), might also have substantial influence. This 2012 survey evaluated present laparoscopy use, its appraisal among urologic surgeons, laparoscopy training, and use of new techniques.

Unfavorable outcomes of laparoscopic pyeloplasty using barbed sutures: a multi-center experience.

Purpose: Barbed self-retaining sutures (SRS) have been introduced as an advance in suture technology, facilitating reconstructive laparoscopic surgery. We present the experience of three centers performing laparoscopic pyeloplasty with the use of SRS.

Methods: Preoperative, intraoperative and follow-up data were collected for 6 patients undergoing pyeloplasty using the Quill SRS (Angiotech, Vancouver, CAN) in three centers.

Evolution of care pathway for laparoscopic radical prostatectomy.

Purpose: We report results of the introduction of a laparoscopic radical prostatectomy (LRP) care pathway. This included the introduction of a transversus abdominis plane (TAP) local anesthetic block and other measures to reduce the impact of factors known to delay postoperative recovery. Outcomes including pain, analgesic requirements, complications, and length of stay are reported.

Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology: a critical analysis of the literature.

Context: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery.

Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology.

Evidence Acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology.

Laparoscopic partial nephrectomy.

At the moment, OPN is considered to be the gold standard in nephron sparing surgery. LPN has become a reliable option for many patients with renal tumors up to 7 cm in many centres. Oncological data are promising and the requirements of warm ischemia time, closure of the pelvicaliceal system and hemostasis can be solved without increased risk for the patients involved.

Laparoscopy in German urology: changing acceptance among urologists.

Background: Laparoscopic techniques have dramatically influenced urologic surgery in the past 2 decades.

Objectives: A questionnaire was distributed in 2006 to analyse laparoscopic practice patterns in Germany. The results were compared with a survey performed in 2002.

Reconsidering the use of the International Index of Erectile Function questionnaire in evaluating the preoperative erectile function status of patients undergoing radical prostatectomy.

Objective: To assess the use of the International Index of Erectile Function (IIEF), routinely used in patients being treated for localized prostate cancer, including potency-preserving, nerve-sparing radical prostatectomy (RP), as many patients complain that the results of the IIEF over 4 weeks before RP are not representative.

Patients And Methods: The study included 123 consecutive patients (mean age 64.6 years, range 52-78) who had endoscopic-extraperitoneal RP and who completed the IIEF.

Laparoscopic radical prostatectomy--the experience of the German Laparoscopic Working Group.

Purpose: To present the current status of laparoscopic radical prostatectomy (LRP) in Germany, Austria and Switzerland with respect to transferability, learning curve, and outcome.

Material And Methods: The data of 5824 patients who underwent LRP in 18 centers by 50 urologists from March 1999 to August 2004 were analyzed retrospectively. Three centers performed more than 500, and six more than 250 cases.