Robotic Radical Prostatectomy at the Egyptian National Cancer Institute: Overcoming the Challenges in the Initial Case Series

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Abstract Background Robotic prostatectomy is showing progressive worldwide spread owing to potential clinical benefits, but at a higher cost. Objective This article describes the challenges and clinical outcome of the first group of patients undergoing robotic prostatectomy in Egypt. Design, setting, participants From 2017 to 2019, the data of all (55) patients undergoing robotic radical prostatectomy at the National Cancer Institute of Egypt was analyzed. Outcome evaluation Short term operative outcomes, complications, technical difficulties, pathologic data and biochemical recurrence were reported. Results Average blood loss was 296 ml; one patient required blood transfusion. One case required open conversion, another required re-docking of the robot. Setup time was significantly improved from an average of 27.7 minutes in the first 27 cases to an average of 17.3 minutes in the final 28 cases (p < 0.0001). Complications developed in 27% of our patients. Continence recovery at catheter removal, first, third, sixth and twelfth months were 32.7%, 50.9%, 65.5%, 74.5%, and 96%, respectively. Conclusions Results from the first series of robotic radical prostatectomy were encouraging. Technical challenges can be overcome in a short period. Acceptable complication rate and satisfactory outcomes regarding continence and blood loss were observed.

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