Third Prize: Perineal Robot-Assisted Laparoscopic Radical Prostatectomy: Feasibility Study in the Cadaver Model

Laydner, Humberto; Akça, Oktay; Autorino, Riccardo; Eyraud, Rémi; Zargar, Homayoun; Brandão, Luis Felipe; Khalifeh, Ali; Panumatrassamee, Kamol; Long, Jean-Alexandre; Isac, Wahib; Stein, Robert J.; Kaouk, Jihad

doi:10.1089/end.2014.0244

Cited by 35 publications

(9 citation statements)

References 25 publications

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“…One limitation of the perineal route is that surgeons are relatively less familiar with the pelvic anatomy, and this may lead to cavernous nerve injury and rectal penetration; also, there is anatomical variation in different individuals, according to the literature [11]. Taking the surgical techniques of Laydner et al [12] and Tuğcu et al [13] as our reference, we were able to identify key anatomical landmarks before placement of the single-site port. The perineal body, or central tendon of the perineum, was first identified after dissection of the subcutaneous tissue.…”

Section: Discussionmentioning

confidence: 99%

Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System

Chang

et al. 2020

Urol Int

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To investigate the feasibility and surgical technique of robotic perineal radical prostatectomy (RPRP). Materials and Methods: We retrospectively analyzed 6 consecutive patients diagnosed with prostate cancer from December 2018 to May 2019 who underwent RPRP at our center. Perioperative outcomes were recorded for safety and feasibility analysis. Results: Six patients successfully underwent RPRP with no conversion to open procedures. Operative time was 140 (interquartile range [IQR] 123.75-148.75) min, console time was 70 (IQR 62.5-70) min, with an estimated blood loss of 125 (IQR 100-187.5) mL. Patients were discharged 2 days postoperatively (IQR range 1-3) with pelvic drainages removed. The Foley catheter was removed 2 weeks after surgery. Postoperative pathology revealed 5 patients with locally advanced disease (apical margin-positive prostate cancer [pT3a]bNx). Two patients had a positive surgical margin (33.3%). No complications of Clavien grade 3 and above were recorded; 1 patient had a delay in woundhealing of 1 week. Postoperative continence was achieved for 2 patients immediately after Foley catheter removal, 2 recovered 1-month postoperatively, and 1 recovered within 3 months, and 1 still had mild incontinence at the latest follow-up 1-month postoperatively. Conclusion: RPRP is a safe and feasible alternative for the transperitoneal route in selected patients. Further investigation is required to assess its oncological and quality-of-life results.

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Section: Discussionmentioning

confidence: 99%

Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System

Chang

et al. 2020

Urol Int

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“…[11] The studies showed that RRP was not superior to RPP in terms of cancer control and continence rates, even though RPP is related with shorter hospital stay, lesser blood loss, lower transfusion rates, lesser amount of analgesic use, and lower postoperative incidence of anastomotic stenosis compared with RRP. [8] In addition, RPP is performed in the extraperitoneal compartment, which also reduces patient discomfort and the possibility of postoperative ileus and provides an early return of appetite and bowel movements. Another advantage of RPP is that it protects the deep dorsal vein complex by retracting it upwards.…”

Section: Discussionmentioning

confidence: 99%

“…Also, the surgeon's vision is restricted which complicates the surgery. r-RPP, defined by Kaouk et al [8,9] , overcomes such difficulties and allows for better maneuverability inside the narrow area with robotic instruments and renders magnified 3D image of the operative field. It seems that robotic surgery is increasing the interest in the perineal approach.…”

Section: Discussionmentioning

confidence: 99%

“…RALP was first applied by Binder and Kramer [7] in Europe in 2000 and its use has spread rapidly in recent years. Robotic perineal RP (r-RPP) was first performed by Kaouk et al [8,9] in a cadaver model and then in 4 living cases. Then, we published our experience on 15 patients in whom we performed r-RPP and showed that r-RPP was feasible and effective.…”

Section: Introductionmentioning

confidence: 99%

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Gasless robotic perineal radical prostatectomy: An initial experience

Taşçı

Şimşek

Şam

et al. 2019

Turkish Journal of Urology

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Radical prostatectomy (RP) is the gold standard treatment method of localized prostate cancer. Today, this surgery is performed with open or minimally invasive methods. The history of open perineal RP (RPP) is very old, but it is not often preferred by urologists. The use of robot-assisted laparoscopic RP (RALP) is very frequently applied today. Robotic perineal RP (r-RPP) by using a Gel-Point and insufflating CO 2 into the perineal region was first described in 2014. In this case report, we report a 68-year-old patient with localized prostate cancer in whom we successfully performed gasless r-RPP, and according to our knowledge, this is the first case of gasless r-RPP to be reported.

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“…It is known from the open perineal approach literature that urine control postoperatively is mostly immediate due to preserved urethra–sphincter complex anatomy [20] , [21] , [22] , [23] , [24] .…”

Section: Surgical Approaches To the Prostatementioning

confidence: 99%

Different approaches to the prostate: The upcoming role of a purpose-built single-port robotic system

Kaouk

Bertolo

2018

Arab Journal of Urology

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With the aim of minimising the patient’s postoperative pain, expediting recovery and improving cosmesis, the idea of performing a laparoscopic procedure through a single abdominal incision was introduced. In the present report, we describe five different access routes to the prostate that may be at the surgeon’s disposal with the potential of decreasing patient’s perioperative morbidity. Robotic radical prostatectomy has been refined and became a standard of care in surgery for localised prostate cancer. The advent of single-port robotic surgery has prompted the re-discovery of different access routes to the prostate and ideally all of them are feasible. The potential for avoiding the abdominal cavity will decrease the surgical morbidity and minimise the surgical dissection. In the near future, each of the described approaches could be chosen on the basis of the patient’s preoperative comorbidities, body habitus, anatomy, and disease characteristics and location.

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Third Prize: Perineal Robot-Assisted Laparoscopic Radical Prostatectomy: Feasibility Study in the Cadaver Model

Abstract: P-RALP is feasible in the cadaver. Future studies should evaluate the feasibility of lymph node dissection through the same incision, clinical feasibility, and prospective comparisons with standard techniques.

Cited by 35 publications

References 25 publications

Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System

Robotic Perineal Radical Prostatectomy: Initial Experience with the da Vinci Si Robotic System

Gasless robotic perineal radical prostatectomy: An initial experience

Different approaches to the prostate: The upcoming role of a purpose-built single-port robotic system

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