Robotic Radical Prostatectomy at the Egyptian National Cancer Institute: Overcoming the Challenges in the Initial Case Series

Ashraf Zaghloul; Ahmed Abdelbary; Amr Fergany; Hatem Aboulkassem; Waleed Mohamed Fadlalla

doi:10.3889/oamjms.2021.6107

Authors

Ashraf Zaghloul Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Ahmed Abdelbary Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt https://orcid.org/0000-0001-5240-8532
Amr Fergany Consulting Urologist, Sebastian River Medical Center, Florida, USA
Hatem Aboulkassem Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Waleed Mohamed Fadlalla Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.6107

Keywords:

Robotic surgical procedures, Learning curve, Technical difficulties, Re-docking, Robotic to open conversion, Operative time

Abstract

BACKGROUND: Robotic prostatectomy is showing progressive worldwide spread owing to potential clinical benefits, but at a higher cost.

AIM: This article describes the challenges and clinical outcomes of the first group of patients undergoing robotic prostatectomy in Egypt.

DESIGN, SETTING, PARTICIPANTS: From 2017 to 2019, the data of all (55) patients undergoing robotic radical prostatectomy at the National Cancer Institute of Egypt were retrospectively analyzed.

OUTCOME EVALUATION: Short-term operative outcomes, complications, technical difficulties, pathologic data, and biochemical recurrence were reported.

RESULTS: Average blood loss was 296 ml; one patient required blood transfusion. One case required open conversion, another required re-docking of the robot. Setup time was significantly improved from an average of 27.7 min in the first 27 cases to an average of 17.3 min in the final 28 cases (p < 0.0001). Complications developed in 27% of our patients. Continence recovery at catheter removal, 1st, 3rd, 6th, and 12th months were 32.7%, 50.9%, 65.5%, 74.5%, and 96%, respectively.

CONCLUSIONS: Results from the first series of robotic radical prostatectomy were encouraging. Technical challenges can be overcome in a short period using a dedicated team supplemented by institutional support. Acceptable complication rate and satisfactory outcomes regarding continence and blood loss were observed.

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