Retzius-Sparing Robot-Assisted Robotic Prostatectomy : Past, Present, and Future - 18/11/20

Doi : 10.1016/j.ucl.2020.09.012

Meghan Davis, MD, MPH ^a , Jillian Egan, MD ^a , Shawn Marhamati, MD ^b, Antonio Galfano, MD ^c, Keith J. Kowalczyk, MD ^a,^⁎
^a Department of Urology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USA
^b Austin Hospital, Department of Urology, 145 Studley Rd, Heidelberg VIC 3084, Australia
^c Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milano 20162, Italy

^∗Corresponding author. Department of Urology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USA.Department of UrologyMedStar Georgetown University Hospital3800 Reservoir Road NorthwestWashingtonDC20007USA

Résumé

Radical prostatectomy has undergone many adaptations since its inception, including the Retzius-sparing robotic-assisted radical prostatectomy approach. In this article, we review the origins of radical prostatectomy, the theoretic basis for Retzius-sparing robotic-assisted radical prostatectomy, and outline the key steps of the procedure. To date, there have been 9 studies comparing the outcomes of Retzius-sparing robotic-assisted radical prostatectomy with standard robotic-assisted radical prostatectomy, which have demonstrated improved continence outcomes for Retzius sparing robotic assisted radical prostatectomy within the first year and equivalent oncologic efficacy out to 18 months. Further research is needed to evaluate sexual function outcomes as well as long-term oncologic outcomes.

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Keywords : Robotic-assisted surgery, Retzius sparing prostatectomy, Urinary function, Incontinence, Outcomes, Prostate cancer