Robotics in Urology Lund, Sweden

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Robotics in Urology Lund, Sweden

• Magnus Annerstedt MD
• Dept. of Urology
• Lund University Hospital
• Sweden

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Preparations

• ERUS 2005
• Team training at Karolinska Univ. Hospital
• Surgeons, nurses, anesthesiology staff
• Visit at OSU, Columbus, USA. Dr Patel
• Console surgeon, 1 week
• System training (porcine) Aarhus, Denmark
• Surgeons and nurses
• DryLab
• Anastomotic model

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Console Surgeon 1

• Experience of open- and lap. radical
  prostatectomy
• First 50 cases as single surgeon
• Assistants with limited experience of the
  procedure
• First 2 cases mentored by Prof. Wiklund
• 2 cases per day after the first 20

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Results
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Demographic data

• No.pts 50
• Age 62.5 (45-74)
• Mean serum PSA (range) (ng/ml) 6.9 (2.4-30)
• Mean Gleason score 6.1 (4-7)
• No. clinical stage ()
• T1c 33 (66)
• T2 17 (34)

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Operative data

• Operative time skin to skin (mins) 188
• Estimated blood loss (cc) 297
• No. intraop complications 0
• Blood transfusion 1
• - coagulation disorder
• - perop blood loss 1000 cc
• No. conversions to open procedure 1

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Postoperative data

• Hospital stay lt 24h postop 88
• Mean days Foley catheterization (range) 8.8
  (7-21)
• Functional data is not yet mature enough to
  evaluate

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Pathology

• Pathological stage
• pT2 38
• pT3a 10
• pT3b 2
• No. Pos margins by stage ()
• pT2 3/38 (7.9)
• pT3a 5/10 (50)
• pT3b 1/2 (50)
• All stages 9/50 (18)

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Comments

• Learning curve is about 20-25 cases
• A dedicated team is the key to success
• Ideal with one assistant
• Pick a mentor
• Go visit top centers
• Study Dvds

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Operating with the daVinci system is like a
combination of diving and playing golf You dive
into the console and strive for perfection
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Thank You!