Long-term patient outcomes from the first year of a robotic surgery program using multi-surgeon implementation

  • Joshua Montroy The Ottawa Hospital Research Institute, Otawa, Ontario
  • Ehab Elzayat Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Chris Morash Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Brian Blew Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Luke T. Lavallée Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Ilias Cagiannos Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • James Watterson Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Jeffrey S. Oake Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario
  • Michael FungKeeFung Department of Gynecology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario
  • Calvin Thompson Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Ontario
  • Robert Weber Department of Nursing, The Ottawa Hospital, Ottawa, Ontario
  • Rodney H. Breau Department of Surgery, Division of Urology, The Ottawa Hospital, Ottawa, Ontario

Abstract

Introduction: There is concern that surgical quality initially declines during the learning phase of robotic surgery. At our institution, we used a multi-surgeon programmatic approach to the introduction of robotic surgery. The purpose of this study was to evaluate outcomes of patients treated during the first year of our program.

Methods: This is a historical cohort of all radical prostatectomy patients during a one-year period. Baseline, perioperative, and long-term followup data were prospectively and retrospectively collected. Treatment failure was a composite of any postoperative radiation, androgen-deprivation, or prostate-specific antigen (PSA)≥0.2.

Results: During the study period, 225 radical prostatectomy procedures were performed (104 robotic and 121 open). Baseline characteristics were similar between groups (p>0.05). All patients were continent and 74% were potent prior to surgery. Mean estimated blood loss (280 cc vs. 760 cc; p<0.001) and blood transfusion (0% vs. 8.3%; p=0.002) was lower in the robotic cohort. Non-transfusion complications were similar between groups (13% vs. 12%; p=0.7). Mean hospital stay was shorter in the robotic cohort (1.4 vs. 2.5 days). There was no difference in overall positive margin rate (38% vs. 43%; p=0.4) or treatment failure at a median followup of 3.5 years (p=0.4). Robotically treated patients were more often continent (89% vs. 77%; p=0.02) and potent (48% vs. 32%; p=0.02).

Conclusions: Using an inclusive multi-surgeon approach, robotic prostatectomy was introduced safely at a Canadian academic institution.

Published
2017-12-01
How to Cite
Montroy, J., Elzayat, E., Morash, C., Blew, B., Lavallée, L., Cagiannos, I., Watterson, J., Oake, J., FungKeeFung, M., Thompson, C., Weber, R., & Breau, R. (2017). Long-term patient outcomes from the first year of a robotic surgery program using multi-surgeon implementation. Canadian Urological Association Journal, 12(2), 38-43. https://doi.org/10.5489/cuaj.4528
Section
Original Research