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Robotic adenomectomy using a laparoscopic dissector
INTRODUCTION: Only few reports are known about the use of robotic surgery for prostate benign enlargement. The robotic surgery can be improved by laparoscopic tricks. We show a video of robotic adenomectomy where a laparoscopic dissector is used to help create the plan between prostatic capsule and...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237514/ https://www.ncbi.nlm.nih.gov/pubmed/29617077 http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0609 |
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author | Gonçalves, Lessandro Curcio Lott, Felipe Monnerat Rosa, Rafael |
author_facet | Gonçalves, Lessandro Curcio Lott, Felipe Monnerat Rosa, Rafael |
author_sort | Gonçalves, Lessandro Curcio |
collection | PubMed |
description | INTRODUCTION: Only few reports are known about the use of robotic surgery for prostate benign enlargement. The robotic surgery can be improved by laparoscopic tricks. We show a video of robotic adenomectomy where a laparoscopic dissector is used to help create the plan between prostatic capsule and adenoma. MATERIALS AND METHODS: A 62 years old male had severe urinary flow outlet obstruction. Medical therapy was not effective. Ultrasound detected a 92gr enlarged prostate with a large middle lobe. Robotic assisted adenomectomy was scheduled. The procedure followed this sequence: opening of Retzius space, superficial suture of the Dorsal vein complex, horizontal cistotomy. The plan was created with electrocautery and blunt dissection with the laparoscopic dissector. Haemostatic sutures were placed between prostate fossa and the posterior bladder neck and closure of the cistotomy. RESULTS: Whole operation time was 160 minutes, with a blood loss of 80cc. There was no perioperative or post-operative complication. Catheter was removed after 4 days. Post-operatory uroflowmetry shows a peak flow of 30ml/sec. Pathological examination is negative for tumor. After 60 days IPSS was 8. CONCLUSION: Robotic prostate adenomectomy using the laparoscopic dissector is a safe and effective minimally invasive treatment for benign prostatic enlargement. It is a novel technique to find and dissect the plane between prostatic adenoma and capsule. This could be one more use of laparoscopic technology to improve surgical outcomes in robotic field. |
format | Online Article Text |
id | pubmed-6237514 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-62375142018-11-19 Robotic adenomectomy using a laparoscopic dissector Gonçalves, Lessandro Curcio Lott, Felipe Monnerat Rosa, Rafael Int Braz J Urol Video Section INTRODUCTION: Only few reports are known about the use of robotic surgery for prostate benign enlargement. The robotic surgery can be improved by laparoscopic tricks. We show a video of robotic adenomectomy where a laparoscopic dissector is used to help create the plan between prostatic capsule and adenoma. MATERIALS AND METHODS: A 62 years old male had severe urinary flow outlet obstruction. Medical therapy was not effective. Ultrasound detected a 92gr enlarged prostate with a large middle lobe. Robotic assisted adenomectomy was scheduled. The procedure followed this sequence: opening of Retzius space, superficial suture of the Dorsal vein complex, horizontal cistotomy. The plan was created with electrocautery and blunt dissection with the laparoscopic dissector. Haemostatic sutures were placed between prostate fossa and the posterior bladder neck and closure of the cistotomy. RESULTS: Whole operation time was 160 minutes, with a blood loss of 80cc. There was no perioperative or post-operative complication. Catheter was removed after 4 days. Post-operatory uroflowmetry shows a peak flow of 30ml/sec. Pathological examination is negative for tumor. After 60 days IPSS was 8. CONCLUSION: Robotic prostate adenomectomy using the laparoscopic dissector is a safe and effective minimally invasive treatment for benign prostatic enlargement. It is a novel technique to find and dissect the plane between prostatic adenoma and capsule. This could be one more use of laparoscopic technology to improve surgical outcomes in robotic field. Sociedade Brasileira de Urologia 2018 /pmc/articles/PMC6237514/ /pubmed/29617077 http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0609 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Video Section Gonçalves, Lessandro Curcio Lott, Felipe Monnerat Rosa, Rafael Robotic adenomectomy using a laparoscopic dissector |
title | Robotic adenomectomy using a laparoscopic dissector |
title_full | Robotic adenomectomy using a laparoscopic dissector |
title_fullStr | Robotic adenomectomy using a laparoscopic dissector |
title_full_unstemmed | Robotic adenomectomy using a laparoscopic dissector |
title_short | Robotic adenomectomy using a laparoscopic dissector |
title_sort | robotic adenomectomy using a laparoscopic dissector |
topic | Video Section |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6237514/ https://www.ncbi.nlm.nih.gov/pubmed/29617077 http://dx.doi.org/10.1590/S1677-5538.IBJU.2017.0609 |
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