Robot-Assisted Laparoscopic Radical Prostatectomy: Management of the Difficult Case

  • Geoff Coughlin
  • Vipul R. PatelEmail author
Part of the Current Clinical Urology book series (CCU)


Robot-assisted laparoscopic radical prostatectomy (RALP) can present unique challenges to the entire operating team. While the level of complexity of individual cases can be difficult to estimate preoperatively, several patient characteristics and variations in prostate anatomy can indicate that intraoperative challenges are likely to be encountered. These include obese and morbidly obese patients, patients with prior major abdominal surgery, large prostate size, and the presence of a median lobe or prior transurethral resection of the prostate (TURP). This chapter outlines these and other challenging scenario encountered during RALP and illustrates the techniques we use to overcome them. The accompanying video gives narrated examples of these scenarios.


Bladder Neck Median Lobe Ureteral Orifice Large Prostate Endopelvic Fascia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 6.1 Obese patients bmi 30 (12.6 MB)

Video 6.2 Prior laparotomy (14.5 MB)

Video 6.3 Post bilaterial inguinal mesh hernia repair (9.79 MB)

Video 6.4 Prior laparoscopic preperitoneal hernia repair (22.3 MB)

Video 6.5 Accessory pudendal (24.8 MB)

Video 6.6 Large prostate control of the dvc (25.1 MB)

Video 6.7 Difficult anatomy median lobe (24 MB)

Video 6.8 Difficult anatomy post turp (25 MB)

Video 6.9 Bladder neck reconstruction (21.9 MB)


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Florida HospitalCelebrationUSA

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