Laparoscopic radical prostatectomy in a community hospital without robotic assistance.

OBJECTIVES

To develop a laparoscopic radical prostatectomy program in a community-based hospital without robotic assistance.

METHODS

A total of 60 consecutive patients underwent laparoscopic radical prostatectomy by a single urologist in a community-based hospital without the use of the da Vinci robotic system. A general surgeon with advanced laparoscopic experience was initially used as the proctor. The data of all patients were kept on a database and included the preoperative and intraoperative data and postoperative results.

RESULTS

The median operative time was 259 minutes, and the last 10 cases had a median operative time of 192 minutes. The median blood loss was 168 mL. The postoperative median hospital stay was 2.3 days, the median morphine use was 4.2 mg, and the median catheter dwell time was 5.5 days. At 6 months postoperatively, 90% of patients were continent, using 0 to 1 pad per day. No major complications occurred. One case was converted to open radical prostatectomy.

CONCLUSIONS

Laparoscopic radical prostatectomy can be performed in a community-based hospital without robotic assistance. The use of a laparoscopically trained general surgeon and time spent in a dry laboratory are essential to the success of this program.