Abstract: PD41-11
Sources of Funding: None

Introduction

Live surgery events (LSE), have become one of the most attended activities at surgical meetings, providing a unique opportunity for surgeons to observe in real time, the decision-making process by skilled and experienced surgeons. However, there is an ongoing discussion on whether patients who are treated during LSE are at a higher risk for complications._x000D_ The purpose of this study is to examine the safety of live robotic-assisted radical prostatectomy (RARP) cohort, performed in our institution by a single surgeon and to provide evidence on this practice._x000D_

Methods

From January 2008 through April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live transmission via video link from our institution to an external cogress of RARP. A propensity-matched analysis was conducted, in a 1:3 proportion, comparing outcomes of live transmission cases to those operated under regular circumstances. Postoperative outcomes were analyzed between the live surgery (LS) group (n=36) and the propensity-matched group (control group; n=108).

Results

There were no significant demographic differences between the two groups regarding the comorbidities, clinical tumor stage, pre-operative PSA, biopsy Gleason score, body mass index (BMI), pre-operative SHIM score and AUA symptoms score and D&[prime]Amico class. The only significant difference in the demographic was the age: 55.42 ± 7.33 y.o for the LS group vs. 58.76 ± 6.24 y.o for the control group (p= 0.016). The operative time was longer in the LS group when compared to the control: 136.14 min ± 24.29 vs. 122.43 min ± 23.72, respectively (p= 0.0036), however, the console time was shorter for the LS group 72.6 min ± 10.41 compared to the 76.48 min ± 9.42, of the control group (p= 0.0402). No major complications were reported in any of the groups, and only 4 minor complications were observed in the control group (p= 0.2415). After a median follow-up of 31.17 ±[ge] 19.17 months, only one patient (2.77%) in the live surgery group presented biochemical recurrence vs. four (3.71%) in the control group (p= 0.7927). No differences were seen in the continence rate, 97.22% for both groups, and no differences were observed in the potency rate for either group: 69.44% for the LS group vs. 67.59% in the control group (p=0.4034).

Conclusions

In this series of live transmission of RARP, the perioperative results (oncological/ functional outcomes and complications) were similar to those found in daily practice. These findings suggest that LS of this procedure in selected patients and selected centers is safe.

Funding

None