A Novel Technique for Robotic Simple Prostatectomy: An Evolution of Retzius-sparing Technique

Concilio, Bernardino De; Silvestri, Tommaso; Justich, Matteo; Vedovo, Francesca; Zeccolini, Guglielmo; Celia, Antonio

doi:10.1016/j.urology.2018.01.025

Cited by 8 publications

(3 citation statements)

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“…The reason for the longer catheterization time is the bladder incision which is given a couple of days to heal before catheter removal. As a technical modification, vesico-urethral anastomosis has been shown to have the potential to decrease the risk of bleeding and reduce catheterization time in RASP [20,21]; only small case series have been published, however. Looking at complications, no difference was observed in either CDC or CCI.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Outcome of Thulium Laser Enucleation of the Prostate versus Robot-Assisted Simple Prostatectomy: A Propensity Score-Matched Analysis

et al. 2023

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Introduction: The aim of this study was to investigate and compare clinical safety and efficiency of Thulium laser enucleation of the prostate (ThuLEP) and robot-assisted simple prostatectomy (RASP) for the treatment of large gland benign prostatic hyperplasia in a tertiary care center. Methods: Perioperative data of 39 patients who underwent RASP in our institution from 2015 to 2021 was collected. Propensity score matching using prostate volume, patient age, and body mass index (BMI) was performed from a database of 1,100 Patients treated by ThuLEP from 2009 to 2021. A total of 76 patients were matched. Preoperative parameters such as BMI, age, and prostate volume, as well as intra- and postoperative parameters such as operation time, resection weight, transfusion rate, postoperative catheterization time, length of hospital stay (LoS), hemoglobin drop, postoperative urinary retention (PUR), Clavien-Dindo Classification (CDC), and the Combined Complication Index (CCI), were evaluated. Results: There was no difference in mean hemoglobin drop (2.2 vs. 1.9 g/dL, p = 0.34), yet endoscopic surgery showed superiority in mean operation time (109 vs. 154 min, p < 0.001), mean postoperative catheterization time (3.3 vs. 7.2 days, p < 0.001), and mean LOS (5.4 vs. 8.4 days, p < 0.001). Complication rates evaluated by CDC (p = 0.11) and CCI (p = 0.89) were similar in both groups. Within the documented complications, transfusion rate (0 vs. 3, p = 0.08) and the occurrence of PUR (1 vs. 2, p = 0.5) showed no significant difference. Conclusion: ThuLEP and RASP show similar perioperative efficacy and a low rate of complications. ThuLEP had shorter operation times, shorter catheterization time, and a shorter LoS.

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Section: Discussionmentioning

confidence: 99%

Perioperative Outcome of Thulium Laser Enucleation of the Prostate versus Robot-Assisted Simple Prostatectomy: A Propensity Score-Matched Analysis

et al. 2023

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“…Leslie et al [6] reported a posterior transvesical approach involving transversal incision of the bladder dome without dropping it. By contrast, De Concilio et al [7] reported a single case of Retzius-sparing (RS) RASP in which the prostatic capsule was incised through the pouch of Douglas. Following our transition to an RS approach for robot-assisted radical prostatectomy, we elected to adopt a similar RS approach for RASP.…”

Section: Introductionmentioning

confidence: 98%

Retzius-sparing Robot-assisted Simple Prostatectomy: Perioperative and Short-term Functional Outcomes Assessed via Validated Questionnaires

Novara,

Zattoni,

Parisotto

et al. 2024

European Urology Open Science

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confidence: 99%

Robot-assisted simple prostatectomy: the evolution of a surgical technique

et al. 2021

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_______________________________________________________________________________________Purpose: Enucleation of a large prostate is the best surgical choice for patients refractory to clinical treatment (1, 2). Since the first robot-assisted simple prostatectomy (RASP) was described (3, 4), some technical modifications (5-7) and different approaches to reach the adenoma have been proposed (8,9). The aim of this video is to demonstrate three different techniques of RASP. Materials and Methods: The first procedure begins with a transversal incision over the bladder neck, the second is a transvesical approach and the last one is a Retzius-sparing RASP. All techniques were performed with a vesico-urethral anastomosis.Results: Three patients underwent RASP, each one with a different approach. Patients presented mean age of 66±4.4 years, PSA baseline level of 7.8±3ng/mL, IPSS score of 17.7±4.5, maximum urine flow of 8.3±1.5mL/seg and 122.3±11.2cm3 of prostate volume. The mean operative time was 63±8 minutes, estimated blood loss of 106.7±11.5mL, prostate weight of the surgical specimen of 106.3±8 grams and 1 day of length of stay. No continuous bladder irrigation was required and there was no complication. The mean postoperative PSA and IPSS were 0.7±0.3ng/mL, 4.7±1.5. The maximum urine flow raised to 20±4.4mL/seg. Conclusions: RASP with vesico-urethral anastomosis allowed minimal blood loss, short length of stay and great functional outcomes. All the three approaches allowed to perform this technique in a safe way, while showing different alternatives to reach the adenoma.

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A Novel Technique for Robotic Simple Prostatectomy: An Evolution of Retzius-sparing Technique

Cited by 8 publications

References 0 publications

Perioperative Outcome of Thulium Laser Enucleation of the Prostate versus Robot-Assisted Simple Prostatectomy: A Propensity Score-Matched Analysis

Perioperative Outcome of Thulium Laser Enucleation of the Prostate versus Robot-Assisted Simple Prostatectomy: A Propensity Score-Matched Analysis

Retzius-sparing Robot-assisted Simple Prostatectomy: Perioperative and Short-term Functional Outcomes Assessed via Validated Questionnaires

Robot-assisted simple prostatectomy: the evolution of a surgical technique

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