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

Authors

  • 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

DOI:

https://doi.org/10.5489/cuaj.4528

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.

Downloads

Download data is not yet available.

Downloads

Published

2017-12-01

How to Cite

Montroy, J., Elzayat, E., Morash, C., Blew, B., Lavallée, L. T., Cagiannos, I., Watterson, J., Oake, J. S., FungKeeFung, M., Thompson, C., Weber, R., & Breau, R. H. (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

Issue

Vol. 12 No. 2 (2018): CUAJ February

Section

Original Research

License

You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:

  • Post the Article on any Web site
  • Translate or authorize a translation of the Article
  • Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
  • Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.

The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.

You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.

The CUA also requires you to warrant the following:

  • That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
  • That all individuals who have made a substantive contribution to the article are acknowledged;
  • That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
  • That the Article does not libel or violate the privacy rights of any third party.