Robot-assisted radical prostatectomy is a safe procedure

INTRODUCTION: We present our departmental experience with robot-assisted radical prostatectomy and describe complications and early results for the first 239 consecutive patients. MATERIAL AND METHODS: A total of 239 patients were planned to undergo robot-assisted radical prostatectomy performed with a DaVinci robot. Final histopathology and pre- and perioperative parameters were registered. Furthermore, early and late complications were recorded according to the Clavien-Dindo classification. RESULTS: Robot-assisted radical prostatectomy was completed in 232 patients (97.1%). The median duration of surgery decreased significantly from initially 4.6 h in the first quartile to 3.1 h in the last quartile (p < 0.001). Overall, the median perioperative blood loss was 300 ml (range: 25-1,000 ml). The median admission time was one day (range: 1-5 days), and the median duration of bladder catheterization was eight days (range: 6-149 days). In total, 88 post-operative complications were observed in 73 patients (31.5%). A total of 70 complications appeared within 30 days of surgery, whereas 18 occurred later. Among the early complications, the majority (57.1%) were minor (Clavien-Dindo grade <= II); however, overall 2.6% suffered an early grade >= IIIb complication. Overall, the margin-positive rate was 29.3% decreasing from 43.1% in the first quartile to 24.7% in the last three quartiles (p = 0.008). CONCLUSION: Robot-assisted laparoscopic radical prostatectomy is a safe procedure with minimal blood loss, short hospitalization and short time catheter time post-operatively.