The Evolution of Retzius-Sparing Robot-Assisted Laparoscopic Prostatectomy: An Idea, Development, Evolution, Assessment, and Long-Term Study Perspective

Rachael Gotlieb, Sean McSweeney, Caitlin Bakker, Joel Rosenberg, Philipp Dahm

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: The Retzius-sparing (RS) approach represents an important surgical innovation in how robotic-assisted laparoscopic prostatectomy (RALP) is performed.The aim of this study was to examine to what extent its development has followed the Idea, Development, Evolution, Assessment and Long-term study (IDEAL) recommendations.

MATERIAL AND METHODS: We conducted a comprehensive literature search for studies up to the 18th of March 2021. Abstracted data-points included authorship, year of publication, study design, reported endpoints, and length-of follow-up. We mapped each study to the five IDEAL stages of surgical innovation using published criteria.

RESULTS: Of 415 references, 118 were included in our analysis. Five academic centers authored over 50% of all study reports, with the groups from Seoul (24; 20.3%), Milan (15; 12.7%) and Ninjang (10; 8.5%) being the main contributors. Approximately 40% of studies (50/118) were reported as full-text publications. Most of the reports mapped to retrospective studies (97/118; 82.2%) with approximately one-third (31/97; 32.0%) reporting the use of prospectively collected data. Cumulatively, 17,974 RS-RALP were reported on. Of those, 13,929 were unique cases. Approximately 23% of cases were reported in multiple publications (4,045/17,974). We mapped two, 12, and three studies to the Idea, Assessment and Long-term study stages, respectively, and zero to the Development and Evaluation stages.

CONCLUSIONS: Few reported studies followed the IDEAL stages for surgical innovation; none addressed the stages of Development and Evaluation. Future systematic, prospectively planned assessments would be helpful to refine the approach and address issues related to the surgical learning curve.

Original languageEnglish (US)
Pages (from-to)1077-1082
Number of pages6
JournalJournal of endourology
Volume36
Issue number8
Early online dateApr 18 2022
DOIs
StatePublished - Aug 1 2022

Bibliographical note

Publisher Copyright:
© 2022, Mary Ann Liebert, Inc., publishers 2022.

Keywords

  • IDEAL
  • Retzius-sparing
  • robot-assisted laparoscopic prostatectomy
  • surgical innovation
  • urinary continence
  • Robotic Surgical Procedures
  • Humans
  • Male
  • Treatment Outcome
  • Laparoscopy
  • Robotics
  • Prostatectomy
  • Retrospective Studies

PubMed: MeSH publication types

  • Journal Article

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