Robotic Assisted Laparoscopic Prostatectomy Performed after Previous Suprapubic Prostatectomy

Tsui, Johnson F.; Feuerstein, Michael; Jazayeri, Seyed Behzad; Samadi, David B.

doi:10.1155/2016/4573819

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Tsui et al reported their case in 2016 with favorable results. 4 At 9 weeks postoperative follow-up, their patient was continent and with a PSA <0.01 ng/mL; it was too soon to assess erectile function. Tsui et al's approach to the RALP was different than our approach in that they relied on ureteral stent placement after bladder neck incision to mark the positions of the ureteral orifices because of altered anatomy.…”

Section: Discussionmentioning

confidence: 95%

Challenging Case: Robot-Assisted Laparoscopic Prostatectomy After Prior Suprapubic Open Prostatectomy

Razdan

Razdan²

2018

Journal of Endourology Case Reports

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Introduction: Given the ubiquity of robot-assisted laparoscopic prostatectomy (RALP) for treatment of localized prostate cancer, more surgeons are encountering challenging cases, either secondary to difficult anatomy, prior abdominal surgery, or prior radiation therapy. Our case is of RALP in a patient after prior suprapubic prostatectomy.Case Presentation: A 61-year-old otherwise healthy Hispanic gentleman presented for consultation after being found to have Gleason 4 + 4 = 8 prostate cancer on transrectal ultrasound-guided biopsy by an outside provider in July 2017. He had previously undergone suprapubic simple prostatectomy for benign prostatic hyperplasia (BPH) in Nicaragua more than a decade prior. The patient underwent RALP with bilateral nerve sparing in September 2017. The surgery was challenging in that extensive lysis of adhesions had to be performed and typical dissecting planes at the bladder neck and apex were distorted, insofar as meticulous care was taken to judiciously use thermal energy and rely on blunt dissection at these critical junctures. That being said, there were no operative or postoperative complications, the patient was discharged on postoperative day 1, and at 3-month follow-up, the patient was fully continent, maintained erections adequate for sexual intercourse, and had a prostate specific antigen <0.1. Pathology report returned Gleason 3 + 3 = 6 disease with negative surgical margins.Discussion: There is only one other example in the literature of RALP being performed after prior suprapubic prostatectomy. Our large RALP case volume (>5000 patients for a single surgeon and counting) provided us with the necessary experience required for encountering atypical anatomy, and thereby contributed to our patient's effective surgical outcome, both oncologic and functional.Conclusion: RALP for treatment of prostate cancer is a safe and appropriate option in men who have previously undergone suprapubic open prostatectomy for BPH, especially in the hands of an experienced surgeon.

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Section: Discussionmentioning

confidence: 95%

Challenging Case: Robot-Assisted Laparoscopic Prostatectomy After Prior Suprapubic Open Prostatectomy

Razdan

Razdan²

2018

Journal of Endourology Case Reports

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“… 4 – 7 The evidence on the feasibility and safety of RALRP following previous open trans-vesical adenomectomy is scanty. 6 , 8 – 10 The available evidence to date is limited to three case reports and a small series of five patients. The reason for the scanty available evidence may be the fact that open trans-vesical adenomectomy has these days been largely replaced by laparoscopic/robotic and endoscopic enucleation techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Movement of the catheter balloon can also help at this step. Tsui et al 10 recommend preoperative cystoscopic assessment of the bladder neck anatomy and the proximity of the ureteric orifice to the bladder neck. They go on to recommend intraoperative ureteric stenting to avoid ureteric orifice injury.…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted laparoscopic radical prostatectomy following open trans-vesical adenomectomy: A single centre experience and review of the literature

2020

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Introduction: Robotic assisted laparoscopic radical prostatectomy (RALRP) following endoscopic resection of the prostate is known to be feasible with good outcomes. However, the literature evidence is limited on the feasibility and outcomes of RALRP following open prostatic surgery. In this study, our aim was to report our experience with RALRP in patients who had undergone trans-vesical adenomectomy of the prostate in the past. Patients and methods: We reviewed our prospectively maintained database of men treated with RALRP at our institution to identify patients with previous history of open suprapubic trans-vesical adenomectomy, between 2016 and 2020. Data were collected on demographic information, interventions, oncological outcomes and follow-up. Results: Out of 362 patients, four individuals were identified that had previous open suprapubic trans-vesical adenomectomy. The mean age was 71 years with a mean pre-operative prostate specific antigen (PSA) of 11.35 ng/ml, and an average of 10 years after their trans-vesical adenomectomy. The mean console time was 119 min with an average estimated blood loss of 137.5 ml and 75% underwent lymphadenectomy. Post-operatively, all patients were discharged after 1 day with their urinary catheters removed at 7 days post-op. For one of the patients, a urine leak was identified, and his pelvic drain was removed at 5 days instead of 1 day as for the other three patients. No other complications were noted within 30 days. The average prostate weight was 54.7 g with all specimens being T3a R0. At 6 weeks follow-up, PSA was undetectable, three patients reported full continence and 1 was using two pads/day. Conclusion: RALRP following previous open trans-vesical prostatectomy is feasible and safe with excellent oncological outcomes. They are, however, more challenging and cumbersome with increased console time.

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Challenging Scenarios in Radical Prostatectomy: How to Ensure Similar Functional Outcomes

Razdan,

Parekh,

Razdan

2024

Urinary Continence and Sexual Function After Robotic Prostatectomy, Radiation, and Novel Therapies

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Robotic Assisted Laparoscopic Prostatectomy Performed after Previous Suprapubic Prostatectomy

Cited by 4 publications

References 13 publications

Challenging Case: Robot-Assisted Laparoscopic Prostatectomy After Prior Suprapubic Open Prostatectomy

Challenging Case: Robot-Assisted Laparoscopic Prostatectomy After Prior Suprapubic Open Prostatectomy

Robotic assisted laparoscopic radical prostatectomy following open trans-vesical adenomectomy: A single centre experience and review of the literature

Challenging Scenarios in Radical Prostatectomy: How to Ensure Similar Functional Outcomes

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