DESCRIPTIVE TECHNIQUE AND INITIAL RESULTS FOR ROBOTIC RADICAL PERINEAL PROSTATECTOMY

To minimize technical challenges of radical perineal prostatectomy (RPP), we conceived and applied the robotic approach to this technique in an aim to improve surgical applicability of RPP. Radical prostatectomy via the perineal route, avoiding the intra-abdominal cavity has been shown to be oncologically safe, with excellent functional outcomes and a short hospital stay. We report our initial results with this novel approach.

We performed the procedure in four patients. With the patient in the exaggerated lithotomy position, following a 3cm perineal incision the initial perineal dissection using Belt's approach is performed followed by single port placement and docking of the robot.

The median age for patients was 64 years (60-69). Two patients had no rectum because of the AP resection due to inflammatory bowel diseases. One of the other two patients had a past surgical history of aborted RALP and one patient had no past surgical history. There were no perioperative complications and the patients were discharged within 16-48 hours. Urethral catheter was removed within 10 days in three patients, three weeks in one patient. Two patients were immediately continent when foley was removed. The final pathology revealed focally positive margin in those three patients who had past surgical histories and it was margin negative in the patient with native anatomy. All patients had undetectable PSA postoperatively.

RPP was successfully completed in four cases applying a single port robotic perineal approach. Initial results are encouraging with short hospital stay and minimal postoperative pain.

Urology. 2016 May 24 [Epub ahead of print]

Jihad H Kaouk, Oktay Akca, Homayoun Zargar, Peter Caputo, Daniel Ramirez, Hiury Andrade, Selami Albayrak, Humberto Laydner, Kenneth Angermeier

Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA. Electronic address: ., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Medipol University Hospital, Istanbul, Turkey., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA., Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic, USA.

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe