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    Robot assisted partial nephrectomy: Single center our experiences
    (2019) Karabulut, Ibrahim; Yilmaz, Ali Haydar; Yilmazel, Fatih Kursat; Ceylan, Onur
    Aim: In this study, we aimed to present the functional and oncologic results of robotic assisted partial nephrectomy (RAPN) in clinical stage T1 tumors.Material and Methods: Fifteen patients who had undergone RAPN for T1a-b kidney tumor between July 2017 and January 2019 were included in the study. The demographic data, mean operation time, estimated blood loss, duration of warm ischemia, length of hospital stay and oncologic results were evaluated retrospectively.Results: Ten male and five female patients with a mean age of 55.4±7.6 (48-71) years were included in the study. A 4-port trans peritoneal approach was applied to all the patients. Nine right and six left renal masses with a mean tm diameter of 2.8±0.4 (2.4-3.6) cm were operated. The mean operation time was 217 (185-250) minutes, the mean blood loss was 225.6 (180-265) cc. Bleeding requiring transfusion was seen in one patient and a spontaneously resolved ileus was seen in another patient. Urethral stents were placed into two patients because the collector system was opened. 8 (53%) of renal masses were reported as renal cell carcinoma. Surgical margin positivity was identified in 2 (13%) of the patients. No local recurrence or distant metastasis was observed in any of the patients. None of the patients experienced incisional hernia and late complications. Conclusion: Robot-assisted partial nephrectomy is presently the gold standard treatment for patients with clinical stage T1 renal tumor. RAPN is an effective, safe and minimally invasive treatment modality in patients eligible for partial nephrectomy.
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    Robot-assisted laparoscopic radical prostatectomy: A single center initial experience
    (2019) Karabulut, Ibrahim; Yilmaz, Ali Haydar; Yilmazel, Fatih Kursat; Keskin, Ercument
    Aim: The aim of this study is to present the surgical, oncologic and functional results of the first 34 robotic radical prostatectomy (RARP) procedures performed in our clinic.Material and Methods: Data of 34 patients who underwent RARP between July 2017 and October 2019 were evaluated.Results: The mean patient age was 58.73±4.94 years, and the mean preoperative serum prostate-specific antigen level was 8.9±2.07 ng/mL. Bilateral neurovascular bundle (NVB) sparing, unilateral NVB-sparing, and non-NVB-sparing surgery were performed in 7.5, and 22 cases, respectively. The mean prostate weight was 58.73±26.03g. Anterior reconstruction suture was performed in 22 (64.7%) cases. Mean console time, intraoperative blood loss, duration of hospital stay, and urethral catheter removal time were 195.2±14.03min, 120.3±21.2cc, 7.34±1.62 days, and 7.26±1.26 days, respectively. Biochemi¬cal recurrence was observed in two patients, one of whom received maximal androgen blockage (MAB), and the other one received pelvic radiotherapy+MAB. All the patients with at least one-year follow-up were fully continent (0 pads/day). Of the 16 (47%) patients with no preoperative erectile dysfunction (ED) and with at least three-month follow-up, 9 (62.5%) had no ED, with or without any additional medica¬tion including phosphodiesterase-5 (PDE5) inhibitors. Conclusion: RARP is a safe minimally invasive procedure with acceptable morbidity, excellent operative, pathological and oncological outcomes, and satisfactory functional results.