Menon M, Tewari A. Robotic Radical Prostatectomy and the Vattikuti Urology Institute Technique: An Interim Analysis of Results and Technical Points. Urology 2003;61:15-20.
In their 2003 paper entitled "Vattikuti Institute Prostatectomy: Surgical Technique and Current Results," authors Ashutosh Tewari, MD and Mani Menon, MD give an overview of their noteworthy clinical results with radical prostatectomy using the da Vinci® Surgical System:
"The Vattikuti Urology Institute has been developing a robotic prostatectomy system for the management of prostate cancer. This technique is based on the scientific foundations of Walsh's anatomic prostatectomy. Two hundred fifty patients with clinically localized prostate cancer have undergone this technique. Preoperative, operative, and postoperative parameters were collected, and functional outcomes using previously validated quality-of-life instruments were evaluated. The mean operating time for these patients was 2.5 hours (165 and 135 minutes with and without lymphadenectomy, respectively), and the average blood loss was 150 mL. The median specimen Gleason score was 7, and the mean tumor volume was 7 mL. Four patients had a positive surgical margin (three unifocal, one multifocal). Ninety-five percent of the patients were discharged within 23 hours, and the mean catheterization time was 4.2 days. The complication rate was 4%. Approximately 78% of the patients had intact erectile response and 96% achieved continence by the sixth month after surgery."
"The robotic prostatectomy system is a safe and effective operation for the management of prostate cancer."
We have performed >350 robotic radical prostatectomies in the last 2 years. A single surgeon (MM) performed 250 of these procedures using a technique developed at our institution, the Vattikuti Urology Institute. This article summarizes the technical highlights and interim results of the Vattikuti Institute Prostatectomy (VIP) technique. We prospectively collected baseline demographic data, such as age, race, body mass index (BMI), serum prostate-specific antigen values, prostate volume, Gleason score, percentage cancer, TNM clinical staging, and comorbidities. Urinary symptoms were measured with the International Prostate Symptom Score, and sexual health with the Sexual Health Inventory of Males. In addition, patients received the Expanded Prostate Inventory Composite at baseline and at 1, 3, 6, 12 and 18 months after the procedure via mail. Data collection is complete on 200 of the first 250 patient cases. Gleason score >or=7 was noted in 40% of patients. The average BMI was high (28), and 86% patients were classified as pathologic stage pT2a to pT2b. The mean operative time was 160 minutes and the mean blood loss was 153 mL. No patient required blood transfusion. At 6 months, 82% of the men who were <60 years of age and 75% of those >60 years of age had return of sexual function, and 64% and 38%, respectively, had sexual intercourse. At 6 months, 96% patients were continent.
Link to PubMed.
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