Robotic radical prostatectomy and the vattikuti urology institute technique: an interim analysis of results and technical points

Abstract 

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, such as age, race, body mass index (BMI), serum prostate-specific antigen values, prostate volume, Gleason score, percentage cancer, TNM clinical staging, and comorbidities. Urinary symptoms were measured with the International Prostate Symptom Score, and sexual health with the Sexual Health Inventory of Males. In addition, patients received the Expanded Prostate Inventory Composite at baseline and at 1, 3, 6, 12 and 18 months after the procedure via mail. Data collection is complete on 200 of the first 250 patient cases. Gleason score ≥7 was noted in 40% of patients. The average BMI was high (28), and 86% patients were classified as pathologic stage pT2a to pT2b. The mean operative time was 160 minutes and the mean blood loss was 153 mL. No patient required blood transfusion. At 6 months, 82% of the men who were <60 years of age and 75% of those >60 years of age had return of sexual function, and 64% and 38%, respectively, had sexual intercourse. At 6 months, 96% patients were continent.