V02-01 ADOPTION OF A NEW ROBOTIC PLATFORM. KEY TECHNICAL MODIFICATIONS

Abstract

INTRODUCTION AND OBJECTIVE: The adoption of new robotic surgical technology requires appreciation and adaptation to the mechanical nuances. We adopted the usage of the DaVinci SP (single port) system. We described the many technical and procedural modifications necessary for safe adoption of the technology while maintaining good surgical outcomes. METHODS: In this video compilation we illustrated our step-by step technique and key points during a radical prostatectomy using the da Vinci SP robot. The surgery was performed with a transperitoneal technique by the same surgeon and tableside assistant. One robotic trocar was placed above the umbilicus and one additional trocar was placed in the right lower quadrant (single port plus one). RESULTS: (1) Patient positioning and trocar placement. (2) Instrument configuration: Cadiere-Bipolar-Scissors. (3) Bladder dropping and Retzius space access illustrating the relocation pedal and scope angulation. (4) Bladder neck and seminal vesicles approach describing the instruments use and scope working angle. (5) Denonvilliers dissection technique during the posterior access and nerve sparing. (6) Endopelvic fascia opening and lateral prostatic fascia preservation. (7) Apical anatomy preservation during the minimal apical dissection. (8) Needle-drive configuration to apply the hemostatic running suture at the DVC complex. (9) Urethral transection technique. (10) Posterior reconstruction with barbed suture and anastomosis with bidirectional running suture. CONCLUSIONS: Robotic-assisted radical prostatectomy with da Vinci SP console is feasible and safe. Therefore, we believe that with the steps described in this video compilation, we were able to safely adopt the SP robot, maintaining a technique similar to the one we have developed with the Xi console. Also, these steps are crucial to a complication-free procedure with quality outcomes. Source of Funding: No source of Funding