What factors affect the operative time of robot-assisted laparoscopic radical prostatectomy?
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and Other Interventional Techniques
What factors affect the operative time of robot‑assisted laparoscopic radical prostatectomy? Takato Uchida1 · Taro Higure1 · Masayoshi Kawakami1 · Mayura Nakano1 · Nobuyuki Nakajima1 · Hakushi Kim1 · Masahiro Nitta1 · Masanori Hasegawa1 · Yoshiaki Kawamura1 · Sunao Shoji1 · Akira Miyajima1 Received: 21 May 2020 / Accepted: 25 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Robot-assisted radical prostatectomy (RARP) has gained prominence since the da Vinci surgical system was introduced in 2000. RARP has now become a standard procedure for treating cases with localized prostate cancer. However, no study has examined its surgical time by accurately measuring the pelvic visceral fat (PVF) volume. This study aimed to investigate the factors associated with prolonged console time and surgical difficulty by RARP surgeons. Methods This study included 405 patients who underwent RARP between 2014 and 2019 at our institution. Given that the anatomical characteristics were considered to affect RARP, PVF and working space (WS) were estimated preoperatively by computed tomography using a 3D image analysis system. Univariate and multivariate logistic regression analyses were performed to identify the factors prolonging console time, such as body mass index (BMI), prostate volume, previous abdominal surgery, nerve-sparing procedure, PVF, and WS. We also investigated whether post-operative complications were associated with any of these factors. Results Larger PVF (p = 0.028, odds ratio (OR) 1.43), smaller WS (p
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