V07-06 SINGLE-PORT ROBOTIC TRANSVESICAL SIMPLE PROSTATECTOMY STEP BY STEP

Abstract

You have accessJournal of UrologyCME1 Apr 2023V07-06 SINGLE-PORT ROBOTIC TRANSVESICAL SIMPLE PROSTATECTOMY STEP BY STEP Joshua Jue, Alexa Meyer, and Lee Richstone Joshua JueJoshua Jue More articles by this author , Alexa MeyerAlexa Meyer More articles by this author , and Lee RichstoneLee Richstone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003288.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The single-port robotic transvesical simple prostatectomy was first described in 2020, but the operation has not been widely adopted. With promising early results, the single-port robotic transvesical simple prostatectomy is an alternative approach to this operation with distinct advantages. METHODS: We detail the instruments required for this procedure, as well as the surgical technique to perform a simple prostatectomy using the single-port robot. Intraoperative and robotic video demonstrates all aspects of the technique, and postoperative photos illustrate the healed wound. RESULTS: A 3 cm transverse incision is made 3 fingerbreadths above the pubic symphysis and a longitudinal cystotomy is made. The Roll Wound Retractor rolling ring is inserted into the bladder lumen, with the Access Port, SP Short Entry Guide and AirSeal trocar within it. The robot is then docked to the SP cannula, and the bladder is insufflated to 8 mmHg. A semilunar incision is made through the bladder mucosa using the monopolar scissors along the posterior aspect of the bladder neck or median lobe. The forceps can be used to retract the prostatic adenoma, while using the monopolar scissors to further bluntly dissect the adenoma from the capsule. The prostatic adenoma can be removed en bloc, but is usually removed en lobe. A vesicourethral mucosal advancement flap is performed with 3-0 V-lock suture from apex to base at 3 o-clock and 9 o-clock; a double-arm 3-0 v-clock suture is then used to approximate the bladder and urethral mucosa, by running from 6-o-clock to 12-o-clock. The cystotomy is closed in 2 layers with 3-0 vicryl suture. The patient is observed for 2 hours on continues bladder irrigation to determine ambulatory discharge eligibility. Follow up is in 3-7 days for trial of void. CONCLUSIONS: Single-port robotic transvesical simple prostatectomy is a safe and effective way to surgically remove benign glands larger than 80 cc. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e597 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Jue More articles by this author Alexa Meyer More articles by this author Lee Richstone More articles by this author Expand All Advertisement PDF downloadLoading ...