Open Access

ARTICLE

Robot-assisted radical prostatectomy in obese patients

Judd Boczko¹, Ralph Madeb¹, Dragan Golijanin¹, Erdal Erturk¹, Mary Mathe¹, Hitendra R. H. Patel², Jean V. Joseph¹

1 University of Rochester Medical Center, Department of Urology, Rochester, NY, USA
2 University College, London, England
Address correspondence to Dr. Jean V. Joseph, Head-Section of Laparoscopic and Robotic Surgery,Department of Urology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 656, Rochester, NY 14642 USA

Canadian Journal of Urology 2006, 13(4), 3169-3173.

Abstract

Objectives: Few centers perform extraperitoneal robot assisted radical prostatectomy. The average patient weight is increasing to the mildly obese. Little is known as to the difficulty-impact obesity may have on robot-assisted extraperitoneal prostatectomy (RAP). We assess our own experience with obese patients undergoing RAP.
Materials and methods: Information on 375 consecutive patients undergoing robot-assisted extraperitoneal prostatectomy by a single surgeon was gathered. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m². Patients with BMI ≥30 were compared to those with BMI <30. Specific comparators between the groups were: age, total operating time, estimated blood loss, total prostate specific antigen (PSA), specimen weight, pathological stage, grade and margin, complications, and functional outcomes.
Results: Sixty-seven men were identified as obese. When comparing the two groups, no statistically significant difference (p>0.05) was noted in operative time (229 versus 217 min), blood loss (205 versus 175 ml), PSA, clinical and pathologic stages, specimen weight, and complications. 15% of non-obese patients had a positive margin compared to 12% of obese patients (p>0.05). The 6-month continence rate in patients with a BMI ≥30 was 92% versus 97% in patients with a BMI <30.
Conclusions: The extraperitoneal approach to performing a robot-assisted prostatectomy is not associated with increased morbidity in the obese patient. There were no statistically significant differences noted in oncological or functional outcomes between the two groups.

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