J. Jhaveri

Robotic prostatectomy: a review of outcomes compared with laparoscopic and open approaches.

Prostate cancer affects the lives of millions of Americans each year. Since the advent of prostate-specific antigen testing, many cancers are found in initial stages and have the potential for curative resection; however, choosing which type of surgery to undergo can be a difficult task. This article reviews the outcomes of robotic prostatectomy in comparison with laparoscopic or open procedures. A PubMed search was performed to identify specific articles describing intraoperative details, surgical complications, cancer control, and continence and potency outcomes. Articles that revealed pertinent data were included in this study comparing robotic with laparoscopic or open prostatectomies.

Anatomic Restoration Technique: A Biomechanics-based Approach for Early Continence Recovery After Minimally Invasive Radical Prostatectomy

Despite refinements in surgical technique over the past decade, urinary incontinence following radical prostatectomy remains a frustrating and costly side effect that significantly impairs patients’ quality of life. With the increasing popularity of radical prostatectomy as a firstline treatment for early prostate cancer, and with more patients being diagnosed and treated at a younger age, post prostatectomy incontinence remains a significant issue. Reported risk factors include increasing patient age, bladder dysfunction before surgery, previous transurethral resection of the prostate for obstructive symptoms, anastomotic stricture, surgical technique, and surgeon experience. 1,2 Beginning in 2006, our group has made stepwise progress in overcoming this problem through technical innovations borne from study of real-time intraoperative video and cadaveric anatomy, histopathologic analysis of final prostatectomy specimens, and data analysis of functional outcomes. 3-7 We have developed a paradigm of 7 key principles based on possible biomechanical forces acting on the urethral rhabdosphincter and newly fashioned anastomosis that we believe will hasten early con