Posterior, anterior and peri-urethral surgical reconstruction of urinarycontinence mechanisms in robot-assisted radical prostatectomy. A description and video compilation of commonly performed surgical techniques

Objective: Endoscopic extraperitoneal radical prostatectomy (EERPE) and robot-assisted laparoscopic prostatectomy (RALP) are minimally invasive surgical techniques to treat localized prostate cancer. We report the outcome and complications of these two techniques conducted by one individual surgeon. Patients and Methods: 86 patients underwent EERPE between January 2008 and June 2011, and 100 patients underwent RALP between August 2011 and October 2012. All surgeries were performed by one single surgeon. Results: The patients of the EERPE and RALP groups had similar clinical characteristics in PSA, prostate volume and D'Amico classification, and were significantly different in their age and BMI as well as in the number of prior surgeries. RALP surgeries were significantly slower (183 vs. 157 min) but also involved lower blood loss (147 vs. 245 ml). Pathological stages and positive surgical margins were similar in both groups. Complications were assessed by the Clavien-Dindo classification. 6 patients in the EERPE group and 3 patients of the RALP group suffered major complications (IIIb-IV). Conclusion: Altogether our results indicate that the learning curve for RALP was short after experience with EERPE. We hypothesize that this is more a result of the surgical experience of the surgeon with the EERPE than on the robotic technique.

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Surgical techniques to optimise early urinary continence recovery post robot assisted radical prostatectomy for prostate cancer

European Urology Supplements ◽

10.1016/s1569-9056(17)31517-8 ◽

2017 ◽

Vol 16 (6) ◽

pp. e2379

Author(s):

A.N. Sridhar ◽

A. Mohammed ◽

G. Mazzon ◽

G. Busuttil ◽

J. Thompson ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Surgical Techniques ◽

Urinary Continence ◽

Robot Assisted

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Robotic radical prostatectomy in the 21 st century: evolution of experience

Medical Research Archives ◽

10.18103/mra.v9i5.2408 ◽

2021 ◽

Vol 9 (5) ◽

Author(s):

Jesus Moreno Sierra

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Functional Outcomes ◽

Surgical Techniques ◽

Current Evidence ◽

Perioperative Outcomes ◽

Robot Assisted ◽

Keywords Prostate Cancer ◽

Novel Technologies ◽

Open Radical Prostatectomy

The advent of novel technologies and surgical techniques has revolutionized urological surgery in recent years. Robot-assisted radical prostatectomy (RARP) has become the most widely used surgical approach for radical prostatectomy (RP) in the treatment of localized prostate cancer. However, the current available evidence on the benefit of RARP compared to open radical prostatectomy (ORP) is still under debate. Moreover, recent studies have proposed technical modifications of RARP to improve functional outcomes and postoperative quality of life of prostate cancer patients. The aim of this review was to summarize the current evidence on oncological, functional and perioperative outcomes of RARP, considering the results of our series of 408 RARP performed between October 2006 and February 2015 at Clínico San Carlos Hospital, and to provide a framework on the latest and most relevant updates on RARP surgical technique modifications. Keywords Prostate cancer; robot-assisted radical prostatectomy; oncological outcomes; functional outcomes; robotic surgical techniques.

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Surgical Techniques to Optimize Early Urinary Continence Recovery Post Robot Assisted Radical Prostatectomy for Prostate Cancer

Current Urology Reports ◽

10.1007/s11934-017-0717-4 ◽

2017 ◽

Vol 18 (9) ◽

Cited By ~ 23

Author(s):

Ashwin N. Sridhar ◽

Mohammed Abozaid ◽

Prabhakar Rajan ◽

Prasanna Sooriakumaran ◽

Greg Shaw ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Surgical Techniques ◽

Urinary Continence ◽

Robot Assisted

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Laparoscopic radical prostatectomy

Herald Urology ◽

10.21886/2308-6424-2018-6-3-57-72 ◽

2018 ◽

Vol 6 (3) ◽

pp. 57-72

Author(s):

V. A. Perepechay ◽

O. N. Vasiliev

Keyword(s):

Radical Prostatectomy ◽

Bladder Neck ◽

Surgical Techniques ◽

Retention Mechanism ◽

Medical Rehabilitation ◽

Urinary Continence ◽

Complex Mechanism ◽

Robot Assisted ◽

Urine Retention ◽

The Social

Laparoscopic (including robot-assisted) radical prostatectomy has become an alternative to open radical retropubic surgery. The main surgical techniques for reducing the period of urinary incontinence after radical prostatectomy are aimed at preserving, reconstructing and strengthening the structures that provide a complex mechanism for urine retention, namely, the pubo-prostate-vesicular ligaments, bladder neck, Denonvilliers` fascia, in procuring the functional length of the urethra, etc. Despite advances in the study of urinary continence mechanism there exists a large number of problems that need to be discussed. Therefore, researchers continue to search for solutions to create an optimal technique that ensures the earliest possible of urine retention, which is one of the main tasks in the social and medical rehabilitation of a patient who has undergone radical prostatectomy. This article describes the main modern techniques and methods for performing radical laparoscopic prostatectomy, which are aimed at achieving the earliest possible recovery of the urine retention mechanism.

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