Robotic transrectal ultrasonography during robot-assisted radical prostatectomy

Andrew J. Hung, André Luís De Castro Abreu, Sunao Shoji, Alvin C. Goh, Andre K. Berger, Mihir M. Desai, Monish Aron, Inderbir S. Gill, Osamu Ukimura

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

We evaluate the use of robotically manipulated transrectal ultrasound (TRUS) for real-time monitoring of prostate and periprostatic anatomy during robot-assisted prostatectomy (RAP). Ten patients with clinically organ-confined prostate cancer undergoing RAP underwent preoperative and real-time intraoperative biplanar TRUS evaluation using a robotically manipulated TRUS device (ViKY System; EndoControl Medical, Grenoble, France). Median patient age was 66 yr (range: 54-88), baseline prostate-specific antigen (PSA) was 5.3 (range: 1.3-17.9), and four patients (40%) had clinical high-grade and high-stage disease. Bilateral or unilateral nerve sparing was performed in nine patients (90%). Median time for ViKY System setup to insertion of the TRUS probe was 7 min (range: 4-12). Complete robotic TRUS evaluation was successful in all patients. Five patients (50%) had TRUS-visible hypoechoic lesions, confirmed cancerous on preoperative biopsy. Relevant intraoperative TRUS findings were relayed in real time to the robotic surgeon, particularly during dissection of the bladder neck and prostatic apex, during neurovascular bundle preservation, and when hypoechoic prostate lesions approximated nerve-preserving dissection. Negative margins were achieved in nine patients (90%), including cases where significant intraprostatic lesions abutted or extended through the prostate capsule. No complications occurred. We concluded that real-time robotic TRUS guidance during RAP is feasible and safe. Robotic TRUS can provide the console surgeon with valuable anatomic information, thus maximizing functional preservation and oncologic success.

Original languageEnglish (US)
Pages (from-to)341-348
Number of pages8
JournalEuropean Urology
Volume62
Issue number2
DOIs
StatePublished - Aug 2012
Externally publishedYes

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Keywords

  • Prostate neoplasm
  • Robot
  • Surgical guidance
  • Ultrasound

ASJC Scopus subject areas

  • Urology

Cite this

Hung, A. J., De Castro Abreu, A. L., Shoji, S., Goh, A. C., Berger, A. K., Desai, M. M., Aron, M., Gill, I. S., & Ukimura, O. (2012). Robotic transrectal ultrasonography during robot-assisted radical prostatectomy. European Urology, 62(2), 341-348. https://doi.org/10.1016/j.eururo.2012.04.032