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Year : 2012  |  Volume : 28  |  Issue : 2  |  Page : 231-232
 

Robotic-assisted simple prostatectomy with complete urethrovesical reconstruction


1 Department of Urology, Manipal Hospital, Airport Road, Bangalore, India
2 Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

Date of Web Publication13-Jul-2012

Correspondence Address:
Deepak Dubey
Department of Urology, Manipal Hospital, Airport Road, Bangalore - 560 037
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.98479

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How to cite this article:
Dubey D, Hemal A K. Robotic-assisted simple prostatectomy with complete urethrovesical reconstruction. Indian J Urol 2012;28:231-2

How to cite this URL:
Dubey D, Hemal A K. Robotic-assisted simple prostatectomy with complete urethrovesical reconstruction. Indian J Urol [serial online] 2012 [cited 2019 Nov 14];28:231-2. Available from: http://www.indianjurol.com/text.asp?2012/28/2/231/98479



   Surgical Technique Top


Minimally invasive treatment options for large prostatic adenomas include Holmium laser prostatectomy and laparoscopic simple prostatectomy. We describe a technique of robotic simple prostatectomy with complete urethrovesical reconstruction.

A five-port technique is used. After docking the da Vinci robot the retropubic space is entered and the fat over the prostato-vesical junction is cleaned to identify the bladder neck. An incision is made over the prostatic capsule at the level of the bladder neck. A plane is created between the prostate capsule and adenoma. Under direct vision, the entire prostatic adenoma is shelled from the prostatic fossa. The hand-stimulated endo-wrist movements of the robotic arms in the capsular plane allow for haemostatic and meticulous dissection and prevent avulsion of the prostatic capsule. The three-dimensional vision coupled with magnification allows for a precise apical dissection, thereby avoiding injury to the external sphincter. A complete urethrovesical anastomosis is performed using a 3-0 barbed vicryl suture. A catheter is left postoperatively for three days and removed following an MCU . Complete urethrovesical reconstruction is possible with excellent vision and assisted suturing using the da Vinci robot. This maneuver completely obliterates the prostatic cavity and has the potential for better haemostasis and early catheter removal.




Three patients with large prostatic adenomas have undergone robotic simple prostatectomy with complete urethrovescial reconstruction. The mean operative time was 220 min with a mean blood loss of 160 ml. None of the patients required bladder irrigation postoperatively. A micturating cysto-urethrogram was performed on postoperative Day 3 which demonstrated excellent healing. The mean hospital stay was 3.5 days.

Robotic simple prostatectomy with complete urethrovescial reconstruction is a minimally invasive technique for large prostatic adenomas which provides excellent outcomes.



This article has been cited by
1 Extraperitoneal Approach for Robotic-assisted Simple Prostatectomy
Jens-Uwe Stolzenburg,Panagiotis Kallidonis,Hasan Qazi,Phuc Ho Thi,Anja Dietel,Evangelos N. Liatsikos,Minh Do
Urology. 2014; 84(5): 1099
[Pubmed] | [DOI]
2 Robot-Assisted Laparoscopic Simple Anatomic Prostatectomy
Manish N. Patel,Ashok K. Hemal
Urologic Clinics of North America. 2014;
[Pubmed] | [DOI]



 

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