Use of fourth arm in da Vinci robot-assisted extraperitoneal laparoscopic prostatectomy: Novel technique

Esposito, Michael; Ilbeigi, Pedram; Ahmed, Mutahar; Lanteri, Vincent

doi:10.1016/j.urology.2005.03.061

Cited by 54 publications

(24 citation statements)

References 10 publications

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“…Histopathology revealed transitional cell carcinoma in all the patients (pT2a-1, pT2b-3, pT3a-2). The mean number of nodes removed was 12 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). One patient had a node-positive disease.…”

Section: Resultsmentioning

confidence: 99%

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First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

2008

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One of the recent developments in the da Vinci robot surgical system is the introduction of a more ergonomic four-arm robot. We report our experience of robotic radical cystectomy (RRC) for bladder cancer using the four-arm da Vinci(®) S(TM) robot (Intuitive Surgical, Sunnyvale, CA, USA). Beginning September 2006, we performed robotic radical cystectomy and bilateral pelvic lymphadenectomy in six patients with muscle-invasive bladder cancer using da Vinci(®) S(TM) robot. Ileal conduit diversion was made in five patients, and sigmoid orthotopic neobladder in one patient. The operating surgeon used the fourth arm for various steps such as bladder retraction for defining vascular pedicles, separating cystoprostatectomy specimen off the rectum, and while performing urethroneovesicostomy. The mean operative time was 12, 148, 44, and 126 min for docking, cystectomy, lymphadenectomy, and urinary diversion, respectively. Median blood loss was 200 ml. Mean hospital stay was 9.2 days. Surgical margins were negative in all the patients. The mean number of nodes removed was 12 (4-19). Histopathology revealed transitional cell carcinoma in all the patients (pT2a-1, pT2b-3, pT3a-2). Robotic radical cystectomy is feasible with new four-arm da Vinci(®) S(TM) surgical system. The operating surgeon can use the fourth arm of the robot as a substitute for the second assistant during the procedure. However, a patient-side surgeon with adequate training in laparoscopic skills is mandatory.

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Section: Resultsmentioning

confidence: 99%

“…Sundaram et al [17] and Esposito et al [18] have described the utility of the fourth arm for performing da Vinci assisted laparoscopic radical prostatectomy (RP). While the former used the fourth arm on the left side of the patient for performing transperitoneal RP, the latter used it on the right side during extraperitoneal RP.…”

Section: Discussionmentioning

confidence: 99%

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

2008

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“…Some studies suggested that the fourth arm and a very well-trained scrubbed nurse could partially replace the assistant surgeon [4,6,[14][15][16]. In this paper, we tried to identify the key role of the bedside assistant in various moments of the procedure, showing that many of the maneuvers performed require both surgical and robotic training.…”

Section: Discussionmentioning

confidence: 99%

The decisive role of the patient-side surgeon in robotic surgery

Sgarbură

Vasilescu

2010

Surg Endosc

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“…Likewise, most series utilize the transperitoneal approach as it provides a larger working space, particularly important during lymph-node dissection and urethrovesical anastomosis (15)(16)(17)(18)(19)(20). However, some series utilizing the extraperitoneal approach have beend escribed (21)(22)(23). Proponents of this alternative route claim that advantages include ad ecreased risk for intra-abdominal complications such as bowel injury, postoperative ileus and development of incisional hernia.…”

Section: Surgical Techniquementioning

confidence: 99%

Evolution of Robot-Assisted Radical Prostatectomy

Orvieto

Patel

2009

Scand J Surg

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Introduction and Objective: Open radical prostatectomy (RRP) is the gold standard and most widespread treatment for clinically localized prostate cancer.H owever,i nr ecent years robot-assisted laparoscopic prostatectomy (RARP) is rapidly gaining acceptance among urologists worldwide. We sought to outline our surgical technique of robotic radical prostatectomy and provide practical recommendations based on available reports and personal experience. We also critically review the current experience on RARP worldwide and compare the available data with the gold standard open RRP series.Material and Methods: As ystematic review of the literature was performed for all published manuscripts between 1997 and 2008 using the keywords -' robotic radical prostatectomy, 'robot-assisted radical prostatectomy', 'laparoscopic radical prostatectomy' and 'robotic' using the Medline database.Results: At otal of 226 original manuscripts on RARP were identified. Manuscripts were selected according to their relevance to the current topic (i.e. original articles, number of patients in the series, prospective data collection) and incorporated into this review.Conclusions: Eight years after the first RARP,m ultiple series are mature enough to demonstrate safety,efficiency and reproducibility of the procedure, as well as oncologic and functional outcomes comparable to its open counterpart. Further prospective, randomized studies comparing both surgical techniques are necessary in order to draw more definitive conclusions.

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Use of fourth arm in da Vinci robot-assisted extraperitoneal laparoscopic prostatectomy: Novel technique

Cited by 54 publications

References 10 publications

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

First case series of robotic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and urinary diversion with the da Vinci S system

The decisive role of the patient-side surgeon in robotic surgery

Evolution of Robot-Assisted Radical Prostatectomy

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