Athermal Division and Selective Suture Ligation of the Dorsal Vein Complex During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of Technique and Outcomes

Li, Yin; Alemozaffar, Mehrdad; Williams, Stephen B.; Hevelone, Nathanael D.; Lipsitz, Stuart R.; Plaster, Blakely A.; Amarasekera, Channa; Ulmer, William D.; Huang, Andy C.; Kowalczyk, Keith; Hu, Jim C.

doi:10.1016/j.eururo.2010.08.043

Cited by 89 publications

(61 citation statements)

References 30 publications

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“…Yin Lei et al [16] further improved the selective suture ligation during robot-assisted laparoscopic radical prostatectomy. Both techniques can contribute to early recovery of continence without compromising either the safety or the oncologic effectiveness.…”

Section: Dvc Was First Mentioned By the Italian Anatomist Giovannimentioning

confidence: 98%

“…However, standard ligation increases the surgical steps and therefore increases the total operative time which will aggravate burdens on multiple organs, especially the heart and the lung [14], as a result of increasing risk of delayed discharge. Even more important is that the suture itself may injure the urethra and external sphincter [15,16], thereby decreasing the functional urethral length and delaying postoperative functional recovery.…”

Section: Dvc Was First Mentioned By the Italian Anatomist Giovannimentioning

confidence: 99%

“…Our team adopted a combination of both self-administered questionnaires and objective assessment including the EPIC urinary assessment, the ICIQ-SF questionnaire, and a 24-h pad tests (see Appendix A and B). All the data were taken into account to define urinary continence as previously reported [10] [16]. It is worth noting that if some patients used one pad per 24 h for fear of incontinence or because of the leakage of a few drops of urine, they were also considered continent [11].…”

Section: Preoperative and Postoperative Variablesmentioning

confidence: 99%

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Ligation-free technique for dorsal vascular complex control during laparoscopic radical prostatectomy: a single-center experience from China

Chen

et al. 2016

World J Urol

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This present ligation-free technique showed a statistically significant shorter interval to recovery of continence and higher continence rates in short-term postoperative results by contrast to conventional suture ligation, but no significant difference was revealed in long-term urinary control. We offer this technique and the correlative data to provide more information for deeply understanding the precise construction of the dorsal vascular complex and the mechanism of urinary control.

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Section: Dvc Was First Mentioned By the Italian Anatomist Giovannimentioning

confidence: 98%

Section: Dvc Was First Mentioned By the Italian Anatomist Giovannimentioning

confidence: 99%

Section: Preoperative and Postoperative Variablesmentioning

confidence: 99%

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Ligation-free technique for dorsal vascular complex control during laparoscopic radical prostatectomy: a single-center experience from China

Chen

et al. 2016

World J Urol

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“…A method in which sharp transection of the DVC is carried out before ligation was recently reported for RARP. This method is associated with a decreased apical margin-positive rate and earlier return of postoperative continence [26,27]. Recently in our institute, we first loosely stitch the DVC at the apex so as not to disturb the structure of the urethral sphincter complex.…”

Section: Discussionmentioning

confidence: 99%

The Role of Staging MRI in Predicting Apical Margin Positivity for Robot-Assisted Laparoscopic Radical Prostatectomy

Yao

Iwamoto²,

Masago³

et al. 2014

Urol Int

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Purpose: To investigate the association between apical margin positivity and preoperative magnetic resonance imaging (MRI) in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RARP). Patients and Methods: From September 2010 through November 2012, we treated 84 Japanese men with clinically localized prostate cancer with RARP. The excised specimens, which were divided into right and left fragments, were evaluated for the presence of positive surgical margins (PSMs) and preoperative MRI findings. Results: The overall PSM rate was 21.4% (18 of 84 patients), 83.3% (15 of 18 cases) of which were situated in the apex. Evaluating the prostate divided into right and left fragments, the PSM rate was 10.7% at the apex (18 of 168 fragments). Cancer was suspected via preoperative MRI in 39 fragments (23.2%) and detected in the prostatic apex by prostate biopsy in 67 fragments (39.9%). Multiple regression analysis revealed that MRI and nerve-sparing procedures significantly indicate apical margin positivity (p = 0.005). Conclusions: The prostatic apex is the most common location of PSMs after RARP. Our results demonstrate that preoperative MRI for cancer of the prostatic apex may provide substantial information and enable complete cancer clearance.

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“…Lei ve ark. 'ları atermal olarak dorsal venöz kompleksinin kesilmesi yöntemi ile yaptıkları çalışmada, 6. ayda hastalarında anlamlı olarak daha yüksek kontinans oranları bildirilmişler, ancak 12. ayda kontinans açısından aradaki fark istatistiksel olarak anlamlı saptanmamıştır (25).…”

Section: Rylp Sonrası Kontinansı Sağlamaya Etki Eden Cerrahi Yaklaşımlarunclassified

Robot Yardımlı Laparoskopik Radikal Prostatektomide Tam Kontinans İçin Neler Yapılmalı?

Tavukçu¹,

Aytaç²,

Atug³

2015

Endouroloji

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A çık radikal prostatektomi (ARP) sonrası idrar kaçırma, hastaların yaşam kalitesini ve hasta memnuniyetini bozan en önemli etkenlerden biri olarak karşımıza çıkmak-tadır (1). Yıllar boyunca radikal prostatektomi ameliyatlarındaki gelişmelere rağmen ARP ve laparoskopik radikal prostatektomi (LRP) serilerinde %60 ile %95 arasında kontinans oranları bildirilmiştir (2,3,4). Robotik teknolojinin optik büyütme, üç boyutlu görüntü ve 7 derece harekete imkan tanıyan robotik kolları; kontinans ve erektil fonksiyonda etkili anatomik noktaların korunmasına ve perioperatif komplikasyonların azalmasına imkan sağlamaktadır. İlk yıllarda yapılan robot yardımlı laparoskopik radikal prostatektomi (RYLP) operasyonları, açık ve konvansiyonel laparoskopik seriler ile karşılaştırıldığında, kontinans iyileşmesi açısından anlamlı farklılık ve teknikler arasında birbirlerine üstünlük-ler görülmemesine karşın, son yıllarda bildirilen RYLP serilerinde, ameliyat tekniklerindeki gelişmelere paralel olarak kontinans oranlarında oldukça anlamlı iyileşmeler rapor edilmektedir (2). Bu derlememizde RYLP' de tam kontinans elde edilmesi için neler yapılması gerektiğini literatür eşli-ğinde tartışacağız. RYLP Sonrası İdrar Kaçırma Oranları ve İdrar Kaçırmayı Öngören ÖzelliklerGüncel RYLP serilerindeki kontinans durumu Tablo 1'de verilmiştir. Tablo'daki çalışmalarda görüldüğü üzere 12 ay sonunda hiç ped kullanmama temel alındığında kontinans

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Athermal Division and Selective Suture Ligation of the Dorsal Vein Complex During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of Technique and Outcomes

Cited by 89 publications

References 30 publications

Ligation-free technique for dorsal vascular complex control during laparoscopic radical prostatectomy: a single-center experience from China

Ligation-free technique for dorsal vascular complex control during laparoscopic radical prostatectomy: a single-center experience from China

The Role of Staging MRI in Predicting Apical Margin Positivity for Robot-Assisted Laparoscopic Radical Prostatectomy

Robot Yardımlı Laparoskopik Radikal Prostatektomide Tam Kontinans İçin Neler Yapılmalı?

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