BILATERAL INTRAFASCIAL NERVE SPARING ROBOT ASSISTED RADICAL PROSTATECTOMY IN 3D

WOS: 000308488205175

Nerve-sparing techniques and results in robot-assisted radical prostatectomy

WOS: 000390992200009PubMed ID: 27995221Nerve-sparing techniques in robot-assisted radical prostatectomy (RARP) have advanced with the developments defining the prostate anatomy and robotic surgery in recent years. In this review we discussed the surgical anatomy, current nerve-sparing techniques and results of these operations. It is important to define the right and key anatomic landmarks for nerve-sparing in RARP which can demonstrate individual variations. The patients' risk assessment before the operation and intraoperative anatomic variations may affect the nerve-sparing technique, nerve-sparing degree and the approach. There is lack of randomized control trials for different nerve-sparing techniques and approaches in RARP, therefore accurate preoperative and intraoperative assessment of the patient is crucial. Current data shows that, performing the maximum possible nerve-sparing using athermal techniques have better functional outcomes

Editorial Comment on: Utilizing Machine Learning and Automated Performance Metrics to Evaluate Robot-Assisted Radical Prostatectomy Performance and Predict Outcomes by Hung et al.

WOS: 000430992000001PubMed ID: 29631446

Robot-Assisted Laparoscopic Bladder Diverticulectomy Combined with Photoselective Vaporization of Prostate: A Case Report and Review of Literature

WOS: 000268700000009PubMed ID: 19591613Purpose: Open surgery, endoscopic technique, and standard laparoscopic technique are surgical options for the management of bladder diverticuli. In this article, we report robot-assisted bladder diverticulectomy ( RABD) and photoselective vaporization of prostate ( PVP) in the same patient sequentially. To the best of our knowledge, this is the first case report of RABD combined with PVP. Materials and Methods: A 63-year-old patient with benign prostatic hyperplasia and a secondary large bladder diverticulum underwent sequential PVP and RABD. Cystoscopic examination revealed obstructing prostate lobes and a large diverticulum at posterior wall of bladder. After completion of PVP procedure, a 16F urethral catheter was inserted into the diverticulum via outer sheath of optic urethrotome and another 16F urethral catheter was left in bladder for urinary drainage. A transperitoneal approach was preferred. The diverticulum was distended with saline infusion via the Foley catheter inside the diverticulum. The distended diverticulum was seen easily and dissected from the surrounding tissue. The bladder was closed in two separate layers. Results: Total operative time, including diverticulectomy with PVP procedure, was 230 minutes, and console time was 90 minutes. The length of stay was 7 days. Conclusions: There has been always concern about the high intravesical pressures secondary to irrigant instillation that may disrupt the bladder repair. To avoid this problem we combined robotic diverticulectomy with PVP. Because of hemostatic properties of potassium-titanyl-phosphate laser, we did not encounter with bleeding after prostatectomy procedure. Moreover, we did not use irrigation, and the suture line of the bladder was kept safe. Therefore, we recommend to use greenlight laser in combined prostate and RABD operations. RABD is a feasible and safe procedure. RABD and PVP can be performed safely in the same patient sequentially

ROBOT ASSISTED EXCISION OF A PELVIC MASS LOCATED AT LEFT OBTURATOR FOSSA

WOS: 000296792201419

Robot-Assisted Partial Nephrectomy Versus Laparoscopic Partial Nephrectomy: Comparison of Outcomes

26th World Congress of Endourology -- 2008 -- Shanghai, PEOPLES R CHINAWOS: 000269633000023PubMed ID: 19694519Purpose: We report our initial experience with laparoscopy- and robot-assisted partial nephrectomy (RAPN) operations. Materials and Methods: Between November 2003 and April 2009, laparoscopic partial nephrectomy (LPN) was performed in 20 patients (hand-assisted procedure in one patient) and RAPN in 11 patients. Transperitoneal approach was used in both groups. Results: The patient demographics were similar in both groups. The groups were statistically comparable for body mass index (BMI), gender, and American Society of Auesthesiologists (ASA) scores. The mean tumor size was 32.1mm (range 20-41mm) in the RAPN group and 31.45mm (range 15-70mm) in the LPN group. The operative time was 226 minutes (range 120-420) in the LPN group and 185 minutes (range 120-270) in the RAPN group; the difference was not statistically significant (p=0.07). The mean warm ischemia time was significantly shorter in the RAPN group (27.3 minutes for the RAPN group and 35.8 for the LPN group) (p=0.02). The mean estimated blood loss was 286.4mL in the RAPN group and 387.5mL in the LPN group (p=0.3). One patient (5%) had focal positive margin in the LPN group. No patient had positive surgical margins in the RAPN group. Conclusions: In this pilot study, we found that RAPN and LPN are feasible and safe operations in T1 renal tumors. The advantages for RAPN are excision of the tumor under three-dimensional vision and easy suturing with the articulated instruments of the robotic system. The cost and the need for two experienced laparoscopic surgeons are the disadvantages of robotic surgery. Larger randomized studies are needed to evaluate whether RAPN has any advantages over LPN

A NOVEL LOOP KNOT FOR FIXATION OF RUNNING SUTURES DURING ROBOTIC SURGERY

WOS: 000296792201354