Robotic approach to vesicourethral anastomotic stenosis and resection of remaining prostate after radical prostatectomy

Capibaribe, Diego Moreira; Avilez, Natália Dalsenter; Sacomani, Carlos Alberto Ricetto; Lucena, Alexandre Sá Pinto da Nóbrega; Reis, Leonardo Oliveira

doi:10.1590/s1677-5538.ibju.2022.0249

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…When dividing the posterior apex, it is critical to place the Maryland forceps underneath this layer to prevent rectal injury, particularly in the salvage setting where the posterior urethra may be fibrous and adherent to the rectum. A similar technique has been described to repair stenosis of failed vesicourethral anastomosis in primary open prostatectomy ( 71 ). If Denonvillier’s fascia is robust, we use a 3-0 V-lock, barbed suture to perform a Rocco stitch.…”

Section: Surgical Description Tips and Tricksmentioning

confidence: 99%

A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Thakker,

Sandberg,

Hemal

et al. 2024

Int. braz j urol.

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Section: Surgical Description Tips and Tricksmentioning

confidence: 99%

A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Thakker,

Sandberg,

Hemal

et al. 2024

Int. braz j urol.

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“…However, it is advised to reserve this for short strictures (<0.5cm) only. 17,23,[61][62][63]70,[88][89][90][91][92][93] The majority of robotic reports are transperitoneal, but Lavolle et al 94 and Diamant et al 64 also trialed extraperitoneal access with end-to-end anastomosis. However, outcomes were worse when compared to the transperitoneal approach and first-time treatment success was only 50% and continence rates ranged from 37.5% to 50%.…”

Section: Access To Defectmentioning

confidence: 99%

Refractory Bladder Neck Contracture (BNC) After Radical Prostatectomy: Prevalence, Impact and Management Challenges

Uguzova,

Beisland,

Honoré

et al. 2023

RRU

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Bladder neck contracture is a recognised complication associated with radical prostatectomy. The management can be challenging, especially when refractory to initial intervention strategies. For the patient, the burden of disease is high and continence status cannot be overlooked. This review serves to provide an overview of the management of this recognised clinical pathology. Consideration needs to be given to minimally invasive approaches such as endoscopic incision, injectables, implantable devices as well as major reconstructive surgery where the condition persists. For the latter, this can involve open and robotic surgery as well as use of grafts and artificial sphincter surgery. These elements underline the need for a tailored and a patient centred approach.

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_______________________________________________________________________________________Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1,2], and it may affect surgical margins rate and functional outcomes [3,4]. Given the relationship between outcomes and surgical experience [5][6][7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention.

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confidence: 99%

Different approaches for bladder neck dissection during robot-assisted radical prostatectomy: the Aalst technique

et al. 2023

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Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [ 1 , 2 ], and it may affect surgical margins rate and functional outcomes [ 3 , 4 ]. Given the relationship between outcomes and surgical experience [ 5 – 7 ], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium). Surgical Technique: We illustrated five different techniques for bladder neck dissection during RARP. The anterior technique tackles the bladder neck from above until the urethral catheter is visualized, and then the dissection is completed posteriorly. The lateral and postero-lateral approaches involve the identification of a weakness point at the prostate-vesical junction and aim to develop the posterior plane – virtually until the seminal vesicles – prior to the opening of the urethra anteriorly. Finally, we described our techniques for bladder neck dissection in more challenging cases such as in patients with bulky middle lobes and prior surgery for benign prostatic hyperplasia. All approaches follow anatomic landmarks to minimize positive surgical margins and aim to preserve the bladder neck in order to promote optimal functional recovery. All procedures were performed with DaVinci robotic platforms using a 3-instruments configuration (scissors, fenestrated bipolar, and needle driver). As standard protocol at our Institution, urinary catheter was removed on postoperative day two [ 8 ]. Conclusions: Five different approaches for bladder neck dissection during RARP were described in this video compilation. We believe that the technical details provided here might be of help for clinicians who are starting their practice with this surgical intervention.

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Robotic approach to vesicourethral anastomotic stenosis and resection of remaining prostate after radical prostatectomy

Cited by 6 publications

References 12 publications

A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

A Comprehensive Review of the Current State of Robot-assisted Laparoscopic Salvage Prostatectomy

Refractory Bladder Neck Contracture (BNC) After Radical Prostatectomy: Prevalence, Impact and Management Challenges

Different approaches for bladder neck dissection during robot-assisted radical prostatectomy: the Aalst technique

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