Surgical Hints for Robot-Assisted Transvesical Simple Prostatectomy

Urology
Jaya Sai ChavaliJihad H Kaouk

Abstract

To report a step-by-step technique for robot-assisted transvesical simple prostatectomy (RASP) focusing on surgical hints to facilitate the procedure. From January 2014 to April 2018 the institutional database was queried for consecutive patients undergoing RASP performed by a single-surgeon. Procedures were performed according to standardized steps as reported in the accompanying video. Ports were placed in a 'W' configuration. Surgery started with the bladder detachment, then the endopelvic fascia was exposed. The bladder neck was incised in a longitudinal fashion. Exposure of the adenoma was aided by using Keith needles. The bladder mucosa was incised and the dissection of the adenoma was performed till complete adenomectomy. Hemostasis of the enucleation bed was performed with electrocauterization. A 2-0 Polysorb suture was used for accomplishing the trigonization. Bladder closure was performed in double layer. A Foley catheter was inserted, then a water-tightness test was performed. Specimen was retrieved via the incision for the optical port. Twenty-eight patients were performed, according to the described technique. Median prostate volume was 180 cm3. Median blood losses were 200 mL. No intraoperative complications were ...Continue Reading

Citations

Jun 13, 2020·Journal of Clinical Medicine·Yakup KordanJean de la Rosette

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