Moderate Intra-Abdominal Pressure Levels in Robot-Assisted Radical Prostatectomy Seem to Have No Negative Impact on Clinical Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Curation
2.3. Statistics
3. Results
3.1. Characteristics of the Study Population
3.2. Characteristics of the RALRP Procedures Performed
- Number of trocars: 4;
- Trocar sizes: four 8 mm trocars (three trocars for the robotic arms and one for the camera/extraction), one 5 mm trocar (for assistant or suction), and one 12 mm trocar (for assistant or insufflation);
- Insufflation: high-flow, low-pressure pneumoperitoneum; standard IAP 10 mmHg, temporary increase to 15 mmHg during the manipulation of the prostatic plexus for 1–3 min, reduction to 5 mmHg during the lymphadenectomy in the final 20 min of the surgery.
3.3. Postoperative Clinical Outcomes
3.4. Effects of Capnoperitoneum on the Clinical Outcome
3.5. Effects of Visceral Fat on the Inflammatory Response
3.6. Effects of Dexamethasone on the Clinical Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | |
---|---|
Age in years, median | 67 (IQR 10; range 39–79) |
Weight in kg, median | 85 (IQR 18; range 61–125) |
Height in m, mean ± SD | 1.78 ± 0.06 m (range 1.60–1.96) |
BMI in g/m2, median | 26.87 (IQR 5.31; range 19.88–40.96) |
Waist circumference in cm, median | 97 (IQR 17.3; range 78–131) |
Waist–hip ratio | 0.55 (IQR 0.09; range 0.44–0.78) |
Property of PP | Median |
---|---|
Duration | 143 min (IQR 46; range 94–265) |
Insufflation pressure at start | 10 mmHg (IQR 1; range 7–17) |
Insufflation volume at start | 4.35 L (IQR 2.3, range 1.5–50.6) |
Average IAP | 10 mmHg (IQR 2; range 8–16) |
Maximum IAP | 15 mmHg (IQR 1; range 10–22) |
Duration × average IAP | 1529 mmHg min (IQR 570; range 972–3180) |
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Ippolito, A.; Mulier, J.; Hahn, M.; Wenzel, M.; Mandel, P.; Flinspach, A.N.; Wenger, K.J. Moderate Intra-Abdominal Pressure Levels in Robot-Assisted Radical Prostatectomy Seem to Have No Negative Impact on Clinical Outcomes. J. Clin. Med. 2024, 13, 1202. https://doi.org/10.3390/jcm13051202
Ippolito A, Mulier J, Hahn M, Wenzel M, Mandel P, Flinspach AN, Wenger KJ. Moderate Intra-Abdominal Pressure Levels in Robot-Assisted Radical Prostatectomy Seem to Have No Negative Impact on Clinical Outcomes. Journal of Clinical Medicine. 2024; 13(5):1202. https://doi.org/10.3390/jcm13051202
Chicago/Turabian StyleIppolito, Angelo, Jan Mulier, Marta Hahn, Mike Wenzel, Philipp Mandel, Armin N. Flinspach, and Katharina J. Wenger. 2024. "Moderate Intra-Abdominal Pressure Levels in Robot-Assisted Radical Prostatectomy Seem to Have No Negative Impact on Clinical Outcomes" Journal of Clinical Medicine 13, no. 5: 1202. https://doi.org/10.3390/jcm13051202
APA StyleIppolito, A., Mulier, J., Hahn, M., Wenzel, M., Mandel, P., Flinspach, A. N., & Wenger, K. J. (2024). Moderate Intra-Abdominal Pressure Levels in Robot-Assisted Radical Prostatectomy Seem to Have No Negative Impact on Clinical Outcomes. Journal of Clinical Medicine, 13(5), 1202. https://doi.org/10.3390/jcm13051202