Is Robot Assistance Affecting Operating Room Time Compared with Pure Retroperitoneal Laparoscopic Radical Prostatectomy?

Purpose: To compare operating room times between retroperitoneal robot-assisted laparoscopic radical prostatectomy (RALRP) and pure retroperitoneal laparoscopic radical prostatectomy (LRP). Patients and Methods: From March 2007 to April 2008, 288 patients underwent an extraperitoneal LRP in our institution. Eighty-three LRPs were performed with robot assistance using the da Vinci (R) Surgical System (RALRP) whereas 205 pure LRPs were performed. Operating room times were compared between the two groups. Results: Both groups were statistically equal concerning age (P - 0.95), body mass index (P - 0.52), prostate-specific antigen level (P - 0.40), prostate volume (P - 0.49), clinical stage (P - 0.11), and Gleason score on biopsy (P - 0.57). Total operating room time was not significantly different between the two groups (223.6 vs 215.7 minutes in LRP and RALRP groups, respectively; P - 0.23). Mean patient installation was longer in the RALRP group (33.2 vs 24.0 minutes, P < 0.01). Mean operative time was significantly shorter by about 20 minutes in the RALRP group (145.6 vs 164.7 minutes, P < 0.01). Mean estimated blood loss was significantly lower in the RALRP group (469mL vs 889mL in the LRP group, P < 0.01). No statistical differences were observed regarding hospital stay, bladder catheterization, and complication rate between the two groups. Conclusion: Occupation times of the operating room are equivalent during pure retroperitoneal LRP and RALRP. For a trained team performing four procedures per week, the use of the robot for LRP with no lymph node dissection decreases actual operative time at the expense of an increase in installation time, compared with pure laparoscopy.