Transition from standard robotic prostatectomy to Retzius-sparing prostatectomy: feasibility and early outcomes

Background and ObjectiveRetzius-sparing robotic-assisted radical prostatectomy (rsRARP) has gained popularity due to superior early continence outcomes compared to standard robotic prostatectomy (sRARP). We evaluate the results of a single surgeon who transitioned from sRARP to rsRARP and compare oncologic and functional outcomes.MethodsWe retrospectively reviewed all prostatectomies performed by a single surgeon between June 2018 and October 2020. Perioperative, oncologic, and functional data were collected and analyzed. Patients who underwent sRARP were compared with those who underwent rsRARP. ResultsBoth groups contained 37 consecutive patients each. Preoperative patient characteristics and biopsy results were similar between the two groups. Perioperative outcomes were significant for longer operative room time and higher proportion of T3 tumors in the rsRARP group. Thirty-day complication and readmission rates were similar between groups. There was no difference in early oncologic outcomes, including positive surgical margin rate, biochemical recurrence, and need for adjuvant or salvage treatments. The time to urinary continence and immediate continence rate was superior in the rsRARP group.ConclusionsThe Retzius-sparing approach can be safely adopted by surgeons experienced in sRARP without compromising early oncologic outcomes and with the benefit of improved early continence recovery.

Automated summary

This study compared the outcomes of a single surgeon who transitioned from standard robotic-assisted radical prostatectomy (sRARP) to Retzius-sparing robotic-assisted radical prostatectomy (rsRARP). The rsRARP group had longer operative room time and a higher proportion of T3 tumors, but similar oncologic and functional outcomes compared to the sRARP group. The rsRARP group showed superior early continence recovery.