Retzus-sparing robotic-assisted laparoscopic radical prostatectomy: a step–by-step technique description of this first brazilian experience

Abstract

_______________________________________________________________________________________Introduction: Retzus-sparing robotic-assisted radical prostatectomy(RARP) is a newly approach that preserve the Retzus structures and provide better recovery of continence and erectile function. In Brazil, this approach has not yet been previously reported. Objective: Our goal is to describe Step-by-Step the Retzus-sparing RARP surgical technique and report our first Brazilian experience.Methods: We present a case of a 60-year-old white man with low risk prostate cancer. Surgical materials were four arms Da Vinci robotic platform system, six transperitoneal portals, two prolene wires and Polymer Clips. This surgical technique was step-by-step described according to Galfano et al. One additional step was added as a modification of Galfano et al. Primary technique description: The closure of the Denovellier fascia. Results: We have operated one patient with this technique. The operative time was 180minutes, console time was135 min, the blood loss was 150ml, none perioperative or postoperative complications was found, hospital stay of 01 day. The anatomopathological classification revealed a pT2aN0M0 specimen with free surgical margins. The patient achieved continence immediately after bladder stent retrieval. Full erection reported after 30 days of surgery. Conclusion: Retzus-sparing RARP approach is feasible and reproducible. However, further comparative studies are necessary to demonstrate potential benefits in continence and sexual outcomes over the standard approaches. ARTIcLE InfO

Predictors of biochemical recurrence after Retzius‐sparing robot‐assisted radical prostatectomy: Analysis of 359 cases with a median follow‐up period of 26 months

“…Recently, several researchers have reported their early experience with RS-RARP, and we expect widespread use of this approach soon. 30,31 1.0 (a) Log-rank, P < 0.001…”

“Maximum Preservation Radical Prostatectomy”: Oncological, functional and other contemporary aspects of Retzius Sparing Robotic Assisted Radical Prostatectomy

“…One author reported that one disadvantage of RS-RARP is that it is more challenging than the conventional technique [28] but this is not consensual [49]. The potential dif iculties of this approach include a small workspace, no lateral aiming point when dissecting the lateral pedicles of the prostate, an inability to look into the bladder after bladder neck division to check the position of ureteric ori ices, and an inverted relationship between the bladder and prostate during dissection and reconstruction -large anterior tumors might be better performed by C-RARP [38].…”

Selection of best videos of the year for 2016

“…Retzus-sparing robotic-assisted laparoscopic radical prostatectomy: A step-by-step technique description of this first Brazilian experience by Tobias-Machado M et al from the Departmento de Urologia, Faculdade de Medicina do ABC, Santo Andre, SP, Brazil and other centers of excellence in Sao Paulo, SP, Brazil published in volume 42(6):1250, November-December 2016 (available at: http://www.intbrazjurol.com.br/video-section/tobias-machado_1250_1250) ( 3 ). This surgical video is quite elegant in its demonstration that Retzus sparing RRP is not only feasible and reproducible but can enhance continence recovery following initial catheter removal.…”