Feasibility of robot-assisted prostatectomy performed at ultra-low pneumoperitoneum pressure of 6 mmHg and comparison of clinical outcomes vs standard pressure of 15 mmHg.

Document Type

Article

Publication Title

BJU international

Abstract

OBJECTIVES: To evaluate the feasibility of performing robot-assisted laparoscopic prostatectomy (RALP) at an ultra-low pressure of 6 mmHg and to assess the potential impact on its clinical outcomes, as compared to those of a historical cohort of patients in which RALP was performed at a pressure of 15 mmHg.

PATIENTS AND METHODS: We evaluated 600 consecutive RALP procedures, performed by a single surgeon, including 300 procedures performed at 6 mmHg and the previous 300 performed at 15 mmHg. We compared preoperative patient characteristics and outcomes including pain scores, morphine equivalents, length of stay (LOS) and complications. After implementing the adjustment to 6 mmHg, we began allowing same-day discharge in patients meeting established criteria.

RESULTS: All 300 consecutive RALP procedures were completed at 6 mmHg with no pressure adjustments for the entirety of the case. There were no significant differences in patient or pathological features between groups. Body mass index was 19.5-44.3 kg/m

CONCLUSION: Robot-assisted laparoscopic prostatectomy at a pneumoperitoneum pressure of 6 mmHg was uniformly feasible without increasing complications. Ultra-low pneumoperitoneum may confer a pain benefit, which may contribute to safe same-day discharge.

First Page

308

Last Page

313

DOI

10.1111/bju.14682

Publication Date

8-1-2019

Link to Full Text

Share

COinS