Transvesical robotic radical prostatectomy

Mihir M. Desai, Monish Aron, Andre Berger, David Canes, Robert Stein, Georges Pascal Haber, Kazumi Kamoi, Sebastien Crouzet, Rene Sotelo, Inderbir S. Gill

Research output: Contribution to journalArticle

55 Scopus citations

Abstract

OBJECTIVE: To report the technical feasibility of performing transvesical robotic radical prostatectomy (TRRP) in a cadaver. MATERIALS AND METHODS: TRRP was performed in two fresh male cadavers (prostate volume 46 and 30 mL). In the first procedure we used four laparoscopic transvesical trocars and in the second a single-port device was placed percutaneously into the bladder. Pneumovesicum was established in both cases and the da Vinci-S robotic system (Intuitive Surgical, Sunnyvale, CA, USA) was used for the TRRP. All steps of the procedure, including dissection of the seminal vesicles and vas deferens, ligation of prostatic pedicles, release of neurovascular bundles, apical dissection, urethral transection, and urethro-vesical anastomosis, were done transvesically and robotically. Real time transrectal ultrasonography monitoring was used in the first cadaver. RESULTS: Both procedures were technically successful transvesically with no need for additional ports or conversion to standard laparoscopy. The operative duration for the multi-port procedure was 3 h and for the single-port procedure was 4.2 h. Clashing of the da Vinci arms was the primary technical difficulty with the single-port procedure, but did not occur in the multi-port procedure. CONCLUSIONS: TRRP under pneumovesicum is technically feasible using multiple-port or a single-port approach in the cadaver. The clinical application of this novel approach is imminent. Further refinement of technique and instruments might lead to an increasing role of percutaneous intraluminal surgery in various surgical disciplines.

Original languageEnglish (US)
Pages (from-to)1666-1669
Number of pages4
JournalBJU International
Volume102
Issue number11
DOIs
StatePublished - Dec 2008
Externally publishedYes

    Fingerprint

Keywords

  • Radical prostatectomy
  • Robotics
  • Single-port
  • Transvesical

ASJC Scopus subject areas

  • Urology

Cite this

Desai, M. M., Aron, M., Berger, A., Canes, D., Stein, R., Haber, G. P., Kamoi, K., Crouzet, S., Sotelo, R., & Gill, I. S. (2008). Transvesical robotic radical prostatectomy. BJU International, 102(11), 1666-1669. https://doi.org/10.1111/j.1464-410X.2008.08004.x