Management of patients who opt for radical prostatectomy during the coronavirus disease 2019 (COVID-19) pandemic: an international accelerated consensus statement.

Objective: Coronavirus disease-19 (COVID-19) pandemic caused delays in definitive treatment of patients with prostate cancer. Beyond the immediate delay a backlog for future patients is expected. The objective of this work is to develop guidance on criteria for prioritisation of surgery and reconfiguring management pathways for patients with non-metastatic prostate cancer who opt for surgical treatment.

Robotic paediatric urology.

Unlabelled: What's known on the subject? and What does the study add? Robot assisted laparoscopic surgery (RALS) is slowly gaining acceptance in the field of paediatric urology. Accumulating data on safety and efficacy when performing paediatric robotic urologic procedures has led paediatric urologists to gradually embrace increasingly more complex reconstructive surgeries. Indeed, the unique and delicate movements generated by the robotic system make this technology ideal for children who often require reconstructive procedures.

Does the presence of median lobe affect outcomes of robot-assisted laparoscopic radical prostatectomy?

Purpose: To determine whether the presence of median lobe (ML) affects perioperative outcomes, positive surgical margin (PSM) rates, and recovery of urinary continence after robot-assisted radical prostatectomy (RARP).

Patients And Methods: We analyzed 1693 consecutive patients undergoing RARP performed by a single surgeon. Patients were analyzed in two groups based on the presence or not of a ML identified during RARP.

Oncological and functional outcomes after robot-assisted radical cystectomy: critical review of current status.

Although open radical cystectomy (ORC) remains the gold-standard management of muscle-invasive bladder cancer, the number of centers performing robotic-assisted radical cystectomy (RARC) has recently increased, prompting greater oncological outcome concerns. Although limited in patient number and follow-up, short-term RARC data from centers of excellence appear to show the approach to be safe and effective, with improved perioperative and functional outcomes, while maintaining comparable oncologic efficiency. Nevertheless, despite the surge of centers adopting RARC, the long-term effectiveness of minimally-invasive techniques has yet to be proven.

Modified technique of robotic-assisted simple prostatectomy: advantages of a vesico-urethral anastomosis.

Objectives: To describe a technical modification during robotic-assisted simple prostatectomy (RASP) aiming to decrease perioperative blood loss, shorten the length of hospital stay and eliminate the need of postoperative continuous bladder irrigation. To describe perioperative outcomes, pathological findings and functional outcomes of our single-surgeon series using this technique.

Methods: We analysed six consecutive patients who underwent RASP using our technical modification between February and September 2010.

Complex robotic reconstructive surgical procedures in children with urologic abnormalities.

Purpose Of Review: Robot-assisted laparoscopic surgery (RALS) is evolving rapidly in the pediatric surgical field. The unique attributes of the robotic interface makes this technology ideal for children with congenital anomalies who often require reconstructive procedures. Furthermore, the system can generate extremely delicate movements in a confined working space such as the one generally found in the pediatric population.

Incidence of lymphoceles after robot-assisted pelvic lymph node dissection.

Objective: • To determine the incidence and predictive factors of lymphocele formation in patients undergoing pelvic lymph node dissection (PLND) during robot-assisted radical prostatectomy (RARP).

Patients And Methods: • Between April and December 2008, 76 patients underwent PLND during RARP for ≥cT2c, prostate-specific antigen level ≥10, Gleason score ≥7 prostate cancer. • All patients were prospectively followed up with pelvic computed tomography 6-12 weeks after the procedure.

Robotic technologies in surgical oncology training and practice.

The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor.

Pentafecta: a new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy.

Background: Widespread use of prostate-specific antigen screening has resulted in younger and healthier men being diagnosed with prostate cancer. Their demands and expectations of surgical intervention are much higher and cannot be adequately addressed with the classic trifecta outcome measures.

Objective: A new and more comprehensive method for reporting outcomes after radical prostatectomy, the pentafecta, is proposed.

Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers.

Purpose: To critically review perioperative outcomes, positive surgical margin (PSM) rates, and functional outcomes of several large series of retropubic radical prostatectomy (RRP), laparoscopic RP (LRP), and robot-assisted radical prostatectomy (RARP) currently available in the literature.

Methods: A Medline database search was performed from November 1994 to May 2009, using medical subject heading search terms "prostatectomy" and "Outcome Assessment (Health Care)" and text words "retropubic," "robotic," and "laparoscopic." Only studies with a sample size of 250 or more patients were considered.

History of robotic surgery.

Robotic surgery is one of the most advanced forms of Minimally Invasive Surgery. Although the application of robotic technology to surgical robotics started some 20 years ago, the earliest work in robotics and automation can be traced back to 400 BC. Some of the early pioneers include Archytas of Arentum, Leonardo da Vinci, Gianello Toriano, and Pierre Jaquet-Droz, and we owe to these philosophers and scientists the fact that we can offer the benefit of minimal invasion in surgery.

Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy.

Background: Posterior reconstruction (PR) of the rhabdosphincter has been previously described during retropubic radical prostatectomy, and shorter times to return of urinary continence were reported using this technical modification. This technique has also been applied during robot-assisted radical prostatectomy (RARP); however, contradictory results have been reported.

Objective: We describe here a modified technique for PR of the rhabdosphincter during RARP and report its impact on early recovery of urinary continence and on cystographic leakage rates.

Continence, potency and oncological outcomes after robotic-assisted radical prostatectomy: early trifecta results of a high-volume surgeon.

Objective: • To evaluate early trifecta outcomes after robotic-assisted radical prostatectomy (RARP) performed by a high-volume surgeon.

Patients And Methods: • We evaluated prospectively 1100 consecutive patients who underwent RARP performed by one surgeon. In all, 541 men were considered potent before RARP; of these 404 underwent bilateral full nerve sparing and were included in this analysis.

Techniques of nerve-sparing and potency outcomes following robot-assisted laparoscopic prostatectomy.

Purpose: Nerve sparing radical prostatectomy is the gold standard for the treatment of prostate cancer. Over the past decade, more and more surgeons and patients are opting for a robot-assisted procedure. The purpose of this paper is to briefly review different techniques and outcomes of nerve sparing robot assisted laparoscopic prostatectomy (RALP).

Erectile dysfunction after robot-assisted radical prostatectomy.

With younger and healthier men being diagnosed and treated for localized prostate cancer, postradical prostatectomy erectile dysfunction has become an ever more important matter of debate. However, the lack of a standardized definition for potency and no consensus regarding the optimal instrument for assessing recovery of erectile function after prostatectomy makes comparison among different series extremely difficult. The potential morbidity associated with the open surgical approach has resulted in the search for less invasive surgical options.

Early complication rates in a single-surgeon series of 2500 robotic-assisted radical prostatectomies: report applying a standardized grading system.

Background: Perioperative complications following robotic-assisted radical prostatectomy (RARP) have been previously reported in recent series. Few studies, however, have used standardized systems to classify surgical complications, and that inconsistency has hampered accurate comparisons between different series or surgical approaches.

Objective: To assess trends in the incidence and to classify perioperative surgical complications following RARP in 2500 consecutive patients.

Predictive factors for positive surgical margins and their locations after robot-assisted laparoscopic radical prostatectomy.

Background: Positive surgical margin (PSM) after radical prostatectomy (RP) has been shown to be an independent predictive factor for cancer recurrence. Several investigations have correlated clinical and histopathologic findings with surgical margin status after open RP. However, few studies have addressed the predictive factors for PSM after robot-assisted laparoscopic RP (RARP).

Serum creatinine can be used as a surrogate for glomerular filtration rate in single renal unit models.

Background And Purpose: Single renal unit models are invaluable for studies in renal physiology, transplantation and response to ischemic injury. Glomerular filtration rate (GFR) is commonly used for evaluation of renal function. Measuring the GFR involves relatively complicated and expensive systems.

High intensity focused ultrasound renal tissue ablation: a laparoscopic porcine model.

Purpose: High intensity focused ultrasound for renal lesions is still experimental. In a porcine model we evaluated the safety and efficacy of a newly designed laparoscopic high intensity focused ultrasound probe and software that allows real-time ultrasound guidance during renal tissue ablation.

Materials And Methods: A Sonatherm 600 high intensity focused ultrasound system with a newly designed laparoscopic high intensity focused ultrasound probe was used through a standard Endopath 18 mm port.

Artery-only occlusion may provide superior renal preservation during laparoscopic partial nephrectomy.

Objectives: Artery-only occlusion (AO) has been used during nephron-sparing surgery to reduce ischemic damage. However, this has not been demonstrated in laparoscopic partial nephrectomy (LPN). We compared our experience with AO and both artery and vein occlusion (AV) in LPN to optimize the method of ischemia.

Efficacy of the argon beam coagulator alone in obtaining hemostasis after laparoscopic porcine heminephrectomy: a pilot study.

Introduction: The argon beam coagulator (ABC) is used in combination with other hemostatic agents and suture renorrhaphy to obtain hemostasis after laparoscopic partial nephrectomy. We performed a pilot study evaluating the efficacy of the ABC-alone in obtaining hemostasis during laparoscopic heminephrectomy (LHN) in a porcine model.

Methods: Eight pigs (4 small (30 kg-40 kg) and 4 large (70 kg-80 kg)), underwent bilateral LHN.

Internet survey of management trends of urethral strictures.

Objectives: The management of urethral stricture is often complex and the decision to proceed to urethroplasty may be difficult. A variety of factors are used by urologists to help guide this decision. We sought to conduct a survey to define current management trends and referral patterns in the treatment of urethral stricture disease.

Comparison of laparoscopic and open partial nephrectomy in clinical T1a renal tumors.

Purpose: Partial nephrectomy has been established as a standard of care for T(1a) renal tumors. Laparoscopic partial nephrectomy (LPN) has been described as more difficult to perform than open partial nephrectomy (OPN). We compare our series of LPN and OPN.