MP50-09 THE EFFECT OF VIRTUAL 3D MODELS ON TRIFECTA OUTCOMES AFTER ROBOTIC PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III (MP50)1 Sep 2021MP50-09 THE EFFECT OF VIRTUAL 3D MODELS ON TRIFECTA OUTCOMES AFTER ROBOTIC PROSTATECTOMY Joseph Shirk, Eric Wallen, Ray Pak, Thomas Ahlering, Robert Reiter, and James Porter Joseph ShirkJoseph Shirk More articles by this author , Eric WallenEric Wallen More articles by this author , Ray PakRay Pak More articles by this author , Thomas AhleringThomas Ahlering More articles by this author , Robert ReiterRobert Reiter More articles by this author , and James PorterJames Porter More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002076.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Planning complex operations such as robotic-assisted laparoscopic radical prostatectomy (RALP) requires surgeons to review two-dimensional Magnetic Resonance Imaging (MRI) images to understand three-dimensional (3D) anatomy. We examined the use of virtual 3D models for planning RALP to determine the effect on the trifecta of cancer control, continence, and erectile function. METHODS: Patients undergoing RALP performed by fifteen surgeons at six hospitals were enrolled in a randomized, single-blind clinical trial. Patients were assigned either to a control group undergoing preoperative planning with MRI, or to an intervention group where MRI was supplemented with a 3D model. The model was viewed on the surgeon’s mobile phone, in virtual reality using a headset, or on the surgical console using Tile Pro. Postoperative trifecta outcomes were 6-month continence, erectile function, and PSA. RESULTS: Ninety-two patients were analyzed with no significant difference in preoperative characteristics except race (Table 1). After controlling for significant covariates, using a multivariable linear model, there were trends towards lower positive margin rates (25% vs 33%), better sexual function (43% vs 36% erectile fullness), and better urinary continence (0.9 vs 1.4 pads/day) in the intervention group compared to the control group, and no significant difference in nerve sparing and bladder neck sparing (Table 2). Detectable PSA was significantly lower in the intervention group (31% vs 9%, p=0.35) (Table 2). Comparing cases in the intervention group in which the surgeon changed operative plan based on the model (32%) to the control group, there was a strong trend towards increased bilateral nerve sparing (78% vs 92%), and a significant difference in postoperative detectable PSA (31% vs 0%, p=0.038) (data not shown). CONCLUSIONS: Use of a virtual 3D model when performing RALP improves oncologic outcomes while maintaining functional outcomes. Source of Funding: Urology Care Foundation Research Scholar Award (Shirk) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e889-e889 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joseph Shirk More articles by this author Eric Wallen More articles by this author Ray Pak More articles by this author Thomas Ahlering More articles by this author Robert Reiter More articles by this author James Porter More articles by this author Expand All Advertisement Loading ...