Introduction:

1. No. 084 Outcomes of 400 consecutive Robotic Assisted Radical Prostatectomies with 1 to 6 years of follow up. L HAREWOOD Epworth Health Care Group and the Department of Urology, Royal Melbourne Hospital, Department of Surgery, University of Melbourne. Pathological Outcomes: Median weight prostate; 46 gm. (22 – 240 gm) Pathology Gleason score:Gl 6 = 56 (14.0%), Gl 7 = 320 (80.0%) Gl 8 = 11 (2.75%), Gl 9 = 13 (3.25 %) Pathology Stage: pT2 = 287 (71.75%), pT3 total = 113 (28.25 %) with pT3a = 90 (22.5%) and pT3b = 23 (5.75%). Margin status:Overall positive margin rate; 29/400 (7.25%) pT2 = 5/287 (1.74%), pT3 = 24/113 (21.24%) Functional and Oncological Outcomes: Follow Up: Minimum FU of 1 year = 380/400. Minimum FU of 2 years = 288/400. Median 2 years. Mean 30.4 mo. Maximum FU 6 years. PSA recurrence: PSA ≥ 0.1ng/ml = 51/400 (12.8%) Had treatment at < 0.1 = 4/400 (1.0%) Nadir PSA of > 0.01 = 30/400 (7.5%) Had treatment for PSA recurrence = 37/400 (9.3%) EBRT =16, EBRT and LHRH = 11 LHRH alone = 10. Continence outcomes assessed at 1 year FU: Total available 380 Pad free or security pad only 340/380 (89.5%), 1 pad 24/380 (6.3%), 2 pads or more; 16/380 (4.2%). Total social continence (1 pad or less) = 364/380 (95.8%). Had treatment of incontinence: 8/380 (2.1%). Sling in 4 and AUS in 4. Last patient requiring treatment was number 219 operated Feb 2009. Potency outcomes assessed at 2 years of FU: Total available = 288 Totalnumber of patients having erections post operatively satisfactory for intercourse with or without a pde5 drug: 148/288 (51.4%) If good erections prior to surgery, and a bilateral nerve spare including at least one side with a retrograde intra-fascial nerve spare: Total with erections satisfactory for intercourse: 86/113 (76.1%) If a pre-op SHIM score of > 21 and a bilateral nerve spare: Total with erections ok for sex: 92/130 (70.8%) Return to baseline SHIM or within 2-3 points: 52/130 (40.0%) If a pre-op SHIM of 25, age 60 or younger and bilateral nerve spare: Total with erections satisfactory for intercourse: 27/30 (90.0%), Return to baseline SHIM: 16/30 (53.3%). Long term complications: Bladder neck stenosis: 3/400 (0.8%) Urethral stricture: 13/400 (3.3%) Introduction: Significant debate surrounds the value of Robotic Assisted Radical Prostatectomy (RARP). This paper documents the outcomes of the first 400 procedures by a single surgeon in the Australian setting. Method: From August 2005 until October 2010, 400 consecutive RARP were carried out by a single surgeon. All data was collected prospectively in an electronic database called HanDbase. Five patients were excluded by personal choice or because of abdominal scarring, the last being in 2007. One patient was converted from Robotic surgery because of intra-abdominal adhesions from prior surgery. Clinical Variables: Median age: 61 years. (range 46 - 78) Median PSA: 5.75 ng/ml (0.7 – 65) Clinical stage: cT1 = 219 (54.75%) cT2 = 75 (43.75%) cT3 = 6 (1.5%) Biopsy Gleason (Gl) score: Gl 5-6 = 181 (45.25%), Gl 7 = 200 (50%), Gl 8 = 12 (3.0%), Gl 9 = 7 (1.75%). D’Amico risk: Low; 161 (40.25%) Intermediate; 190 (47.5%) High; 49 (12.25%) Prior surgery: TURP 13, Laser prostatic 2, HIFU 1, Significant abdominal surgery 77, Lap Mesh Hernia 10. Operative details: Median operative time 205 min (135 – 380); console time 165 min (100 – 335); Blood loss 300 ml. (50 – 3200); Blood transfusion 9 patients (2.25%). Bilateral nerve spare 372 (93%), unilateral nerve spare 17 (4.6%), no nerve spare 11 (2.4%). Rocco suture used in all of the last 311 patients Median post operative stay: 3 days (1 – 13), Median catheter duration: 9 days (6 – 35). Clavien (Cl) complication: 53/400 (13.25%), Cl 1 = 31/400 (7.75%), Cl 2 = 16 (4.0%), Cl IIIB = 6 (1.5%) References Cathcart P, Murphy DG, Moon D, Costello AJ, Frydenberg M.Perioperative, functional and oncological outcomes after open and minimally invasive prostate cancer surgery: experience from Australasia. BJU International April 2011, 107 supplement 3, 11-19. Coelho RF, Chauhan S, Palmer KJ, Rocco B, Patel MB, Patel VR. Robotic-assisted radical prostatectomy: a review of current outcomes. BJU International. 2009 104: 1428-1435 Conclusions The clinical, oncological and functional outcomes of patients in this series compare favourably with the outcomes of other series of Open, Laparoscopic and Robotic assisted surgery in all parameters reported. Acknowledgements: The pathological assessments were made by TissuPath, Melbourne, Australia, with thanks to Associate Professor John Pedersen. Poster presentation sponsor