Robot assisted endoscopic extraperitoneal seminal vesical tip and nerve sparing radical prostatectomy
Müntener M. (1), Schmid D.-M. (*1), Strebel R. T. (*1), Hauri D. (1), John H.A. (1)
(1) Universitätsspital Zürich, Urologische Klinik, Zürich, Switzerland
Introduction and Objectives: Since the laparoscopic approach for radical surgical treatment of localized prostate cancer has emerged, an increasing number of specialized centers report good results with this new technique. More recently robot assisted report good results with traduced to facilitate the techniqually very demanding procedure and may allow an even better visualization of the anatomy and a more precise dissection of vital structures. In our video we show a robot assisted endoscopic extraperitoneal seminal vesical tip and nerve sparing radical prostatectomy as it is performed in our institution.
Methods: Since September 2002 we performed 140 robot assisted laparoscopic radical prostatectomies using a DaVinci robotic system. We initially adopted the Montsouris technique and in 64 of the most recent 67 procedures we used an extraperitoneal approach. With growing experience slight modifications have constantly been made to optimize our surgical technique. The seminal vesical tips as well as the neurovascular bundles were spared when this was oncologically acceptable.
Results: Mean operative time including installation of the robotic system was 250 minutes. No procedure had to be converted to open surgery. Our early oncological results are comparable to the results that are known from large series of open retropubic radical prostatectomies. However, in regard to bloodloss, postoperative pain and hospital stay the endoscopic approach is superior to open surgery.
Conclusion: As shown in our video, the robot assisted endoscopic extraperitoneal approach allows a very precise anatomical prostatectomy. It offers patients the benefits of minimal invasive surgery without compromising oncological or functional results.