Preperitoneal Robotic Prostate Adenomectomy

John, Hubert; Bucher, Christine R.; Engel, Nadja; Fischer, Boris; Fehr, Jean-Luc

doi:10.1016/j.urology.2008.09.028

Cited by 73 publications

(36 citation statements)

References 21 publications

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“…Since 2008, six series of RASP have been published ( Table 5 ) [ 9, 34 -38 ] comprising 59 patients, excluding three fi nger-assisted procedures [ 35 ] . We analysed the data, including the update ( + 20 patients) of the present series (overall 79 patients).…”

Section: © 2 0 1 2 T H E a U T H O R S B J U I N T E R N A T I O N A mentioning

confidence: 99%

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Robot‐assisted simple prostatectomy (RASP): does it make sense?

Matei¹,

Brescia²,

Mazzoleni

et al. 2012

BJU International

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What ' s known on the subject? and What does the study add?The open simple prostatectomy (OSP) is the ' gold standard ' for high-volume prostate adenomas. It shows very good functional results despite its invasiveness. Minimally invasive approaches, e.g. laparoscopy or holmium laser enucleation of the prostate, have been ' tested ' but none have proved a substitute for the OSP.The robot-assisted approach provides optimal functional results and is easy to perform for experienced robotic surgeons. Extending the indication of robotics to low-incidence pathologies can take advantage of the opportunity to ' see the procedure ' using available information technology, e.g. Youtube TM that presents as an unexpectedly useful tool. OBJECTIVE• To evaluate the outcome, feasibility and reproducibility of a robot-assisted (RA) approach for simple prostatectomy (SP) in cases of high-volume symptomatic benign prostatic hyperplasia (HVS-BPH). PATIENTS AND METHODS• In all, 35 consecutive patients underwent RASP for HVS-BPH using a previously described technique.• The mean prostate volume on preoperative transrectal ultrasonography was 106.6 mL.• All but two patients (with bladder calculi) had an adenoma volume of > 65 mL and 27 (77.1%) > 80 mL. Nine patients (25.7%) had an indwelling catheter.• The mean International Prostate Symptom Score (IPSS) was 28. RESULTS• The median operative duration was 180 min and the mean hospital stay was 3.17 days.• The mean catheter duration was 7.4 days and discontinuous or continuous catheter irrigation was required in two and seven patients, respectively (25.1%).• In all, 10 patients (28.6%) had practically no blood loss. No patients had a transfusion.• The mean postoperative peak urinary fl ow was 18.9 mL/s ( P < 0.001), while the mean IPSS was 7 ( P < 0.001).• For costs, while superfi cially RASP appeared more expensive than open SP (OSP), when considering the higher costs of hospitalisation for OSP, RASP was cheaper. Also, bipolar-TURP costs in patients with large-volume prostates had rather similar costs to RASP. CONCLUSIONS• RASP is a feasible and reproducible procedure with outcome advantages when compared with the open or with other minimally invasive techniques (laser or laparoscopy). As a result, a RA approach is worth considering in cases of high-volume prostate adenomas.• Extending the indication of the RA approach, to the SP, requires fi rstly that the surgeon be profi cient in RA surgery and secondly that as the incidence rate of HVS-BPH is low, the surgeon has had the opportunity to ' see the procedure ' . calculi, diverticula, etc.) were present. In fact, for these patients, OSP seems to be more effective and safer than TURP [ 7 ] .Nevertheless, looking at historical and more recent series [ 1 -7 ] one notices that, while

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Section: © 2 0 1 2 T H E a U T H O R S B J U I N T E R N A T I O N A mentioning

confidence: 99%

“…On the other hand, by sharply shortening the convalescence and the back-to-work time [ 35 ] , the social impact (i.e. saving) of RA surgery might be more relevant, even if more diffi cult to quantify.…”

Section: © 2 0 1 2 T H E a U T H O R S B J U I N T E R N A T I O N A mentioning

confidence: 99%

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Matei¹,

Brescia²,

Mazzoleni

et al. 2012

BJU International

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“…The operative times, the hospitalization, the low dose of analgesics required and the minimal blood loss calculated, were similar to those seen in laparoscopic series. [7,15,[17][18][19] Matei et al [20] have recently reported the series of 35 patients underwent RASP. Although Matei and colleagues presented the largest series of RASP, we reported our series of 18 patients treated with RASP and early vascular control: the temporarily bilateral internal iliac arteries clamping.…”

Section: Discussionmentioning

confidence: 99%

“…Open surgeries such as Trans-Vesical or Retropubic Adenomectomies are indicated in case of large adenoma and/or complex BPH but these techniques often show massive intraoperative blood loss and have the risk of blunt dissection particularly in the area around the apex and the urinary sphincter. [2][3][4][5] For this reason, new techniques have been developed to combine the benefits of open simple prostatectomy with potential advantages of minimally invasive technique such as laparoscopic and robotic approaches. Robotassisted laparoscopic simple prostatectomy (RASP) represents a new treatment alternative, in expert hands, for these complex cases.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted simple prostatectomy with temporary internal iliac arteries clamping: our preliminary results

Falavolti¹,

Petitti²,

Buscarini³

2017

MIS

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Aim: This study proposed the robot-assisted laparoscopic simple prostatectomy (RASP) as safe and reliable surgical option for the treatment of men with prostate size > 80 mL. It was aimed to evaluate preoperative and postoperative results in RASP using a surgical variation to the standard technique: the temporary bilateral internal iliac arteries clamping. Methods: This study analyzed 18 patients underwent RASP with temporary clamping of bilateral internal iliac arteries. Procedures were performed by two surgeons in two different hospitals using the same surgical technique. Preoperative and postoperative data were collected and statistically analyzed. Results: The temporary clamping duration was less than 12 min during each adenoma's enucleation. Despite the vascular control, the median operating time was similar to RASP performed without iliac clamping. The results showed minimal blood loss, a median catheter duration of 5 days, a median duration of postoperative continuous catheter irrigation of 41 h, and short hospitalization (3.2 days). A significant corellation was observed between the estimated blood loss and the duration of irrigation. Conclusion: RASP performed with bilateral vascular control, combined with the known benefits of minimally invasive surgery resulted in bleeding reduction. The minimal blood loss further reduces catheter duration, decreases continuous catheter irrigation and patient's hospitalization duration. Key words:Benign prostatic hyperplasia, clamping, prostatectomy, robotic ABSTRACTArticle history:

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“…John et al [9] Die Holmiumlaserenukleation konnte sich in den vergangenen Jahren immer weiter durchsetzen und wurde in Publikationen bereits im Jahr 2008 von unterschiedlichen Autoren als neuer Goldstandard bezeichnet. In jüngster Zeit wird alternativ der Thuliumlaser zur Laserenukleation eingesetzt.…”

Section: Operative Therapieunclassified

Benigne Prostatahyperplasie und Urolithiasis

Krombach

Michel

2010

Urologe

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Benign prostatic hyperplasia and urolithiasis are widespread diseases and are two of the most important elements of the urological therapeutic spectrum. This article gives an overview of the most interesting publications on the subject from the past few years. Particularly the link with cardiovascular risk factors like obesity and diabetes appears to be stronger than supposed. The diagnostic and therapeutic tools of the future will be developed with respect to this.

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Preperitoneal Robotic Prostate Adenomectomy

Cited by 73 publications

References 21 publications

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Robot-assisted simple prostatectomy with temporary internal iliac arteries clamping: our preliminary results

Benigne Prostatahyperplasie und Urolithiasis

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