Modified technique of robotic-assisted simple prostatectomy: Advantages of a vesico-urethral anastomosis

Coelho, Rafael F., Chauhan, Sanket, Sivaraman, Ananthakrishnan, Palmer, Kenneth J., Orvieto, Marcelo A., Rocco, Bernardo, Coughlin, Geoff and Patel, Vipul R. (2012) Modified technique of robotic-assisted simple prostatectomy: Advantages of a vesico-urethral anastomosis. BJU International, 109 3: 426-433. doi:10.1111/j.1464-410X.2011.010401.x

Author Coelho, Rafael F.
Chauhan, Sanket
Sivaraman, Ananthakrishnan
Palmer, Kenneth J.
Orvieto, Marcelo A.
Rocco, Bernardo
Coughlin, Geoff
Patel, Vipul R.
Title Modified technique of robotic-assisted simple prostatectomy: Advantages of a vesico-urethral anastomosis
Journal name BJU International   Check publisher's open access policy
ISSN 1464-4096
Publication date 2012-02
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1464-410X.2011.010401.x
Volume 109
Issue 3
Start page 426
End page 433
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract
The technical demands of Laparoscopic Simple Prostatectomy (LSP) have prevented the widespread adoption of this technique by most urologic surgeons. In an effort to decrease the protracted learning curve related for this procedure, Robotic-Assisted Simple Prostatectomy (RASP) has been described in 2008, demonstrating encouraging perioperative and functional outcomes with a potentially reproducible surgical procedure. Nevertheless, significant morbidities, as the need of blood transfusion and prostoperative bladder irrigation, are still reported in current LASP and LSP series.

We described here a technical modification during RASP aiming to decrease perioperative blood loss, shorter the length of hospital stay and also eliminate the need of postoperative continuous bladder irrigation (CBI). Following resection of the prostatic adenoma, instead of performing the classical ‘trigonization’ of the bladder neck and closure of the prostatic capsule, we proposed three modified surgical steps: plication of the posterior prostatic capsule, modified van Velthoven continuous vesico-urethral anastomosis and, finally, suture of the anterior prostatic capsule to the anterior bladder wall. Using this technical modification, all patients in our series were discharged on postoperative day 1 without the need of continuous bladder irrigation at any time after RASP. No blood transfusion or perioperative complications were reported.
Keyword Benign prostatic hyperplasia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ
Additional Notes Article first published online: 18 AUG 2011

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
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Created: Mon, 12 Dec 2011, 13:28:17 EST by Matthew Lamb on behalf of School of Medicine