Advertisement

Technical Modifications for Salvage and Complex Radical Prostatectomy

  • Hariharan Palayapalayam GanapathiEmail author
  • Gabriel Ogaya-Pinies
  • Eduardo Hernandez
  • Rafael Coelho
  • Vipul R. Patel
Chapter

Abstract

Robotic radical prostatectomy is a procedure that has evolved considerably in the last 15 years as one of the main treatments for localized prostate cancer. Published literature currently describes in detail the procedure and outcomes. However, as widespread as it may be, we believe that certain technical modifications have greatly improved our technique, hence improving early and medium-term outcomes. After having performed close to 10,000 cases (single surgeon series—VP), our technique has evolved significantly, including several refinements to reduce patient morbidity and further improve the functional outcomes. In the present manuscript, we perform a detailed description of our surgical technique of Robotic-Assisted Laparoscopic Radical Prostatectomy and provide practical recommendations based on available reports and personal experience.

Keywords

Robotic-assisted laparoscopic radical prostatectomy Salvage radical prostatectomy Nerve sparing Technical modifications 

References

  1. 1.
    Walsh PC. Anatomical radical prostatectomy: evolution of the surgical technique. J Urol. 1998;160:2418–24.CrossRefPubMedGoogle Scholar
  2. 2.
    Tewari A, Peabody J, Sarle R, Balakrishnan G, Hemal A, Shrivastava A, et al. Technique of da Vinci robot-assisted anatomic radical prostatectomy. Urology. 2002;60(4):569–72.CrossRefPubMedGoogle Scholar
  3. 3.
    Noguchi M, Kakuma T, Suekane S, Nakashima O, Mohamed ER, Matsuoka K. A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy. BJU Int. 2008;102(8):958–63.CrossRefPubMedGoogle Scholar
  4. 4.
    Campenni MA, Harmon JD, Ginsberg PC, Harkaway RC. Improved continence after radical retropubic prostatectomy using two pubo-urethral suspension stitches. Urol Int. 2002;68:109–12.CrossRefPubMedGoogle Scholar
  5. 5.
    Patel VR, Coelho RF, Palmer KJ, Rocco B. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol. 2009;56(3):472–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Kalan S, Coughlin G, Palmer KJ, Patel VR. Robot-assisted laparoscopic radical prostatectomy: an athermal anterior approach to the seminal vesicle dissection. J Robot Surg. 2008;2(4):223–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Dubble men YD, Dohle GR, Schroder FH. Sexual function before and after radical retropubic prostatectomy: a systematic review of prognostic indicators for a successful outcome. Eur Urol. 2006;50(4):711–8.CrossRefGoogle Scholar
  8. 8.
    Patel VR, Shah K, Thaly R, Lavery H. Roboticassisted laparoscopic radical prostatectomy: the Ohio State University technique. J Robot Surg. 2007;1:51–60.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Coughlin G, Dangle PP, Palmer KJ, Samevedi S, Patel VR. Athermal early retrograde release of the neurovascular bundle during nerve-sparing robotic-assisted laparoscopic radical prostatectomy. J Robot Surg. 2009;3(1):13–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Schatloff O, Chauhan S, Sivaraman A, Kameh D, Palmer KJ, Patel VR. Anatomic grading of nerve sparing during robot-assisted radical prostatectomy. Eur Urol. 2012;61(4):796–802.CrossRefPubMedGoogle Scholar
  11. 11.
    Patel VR, Schatloff O, Chauhan S, Sivaraman A, Valero R, Coelho RF, et al. The role of the prostatic vasculature as a landmark for nerve sparing during robot-assisted radical prostatectomy. Eur Urol. 2012;61(3):571–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Lin VC, Coughlin G, Savamedi S, Palmer KJ, Coelho RF, Patel VR. Modified transverse plication for bladder neck reconstruction during robotic-assisted laparoscopic prostatectomy. BJU Int. 2009;104(6):878–81.CrossRefPubMedGoogle Scholar
  13. 13.
    Rocco F, Carmignani L, Acquati P, Gadda F, Dell'Orto P, Rocco B, et al. Early continence recovery after open radical prostatectomy with restoration of the posterior aspect of the rhabdosphincter. Eur Urol. 2007;52:376–83.CrossRefPubMedGoogle Scholar
  14. 14.
    Rocco B, Gregori A, Stener S, Santoro L, Bozzola A, Galli S, et al. Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal video laparoscopic radical prostatectomy. Eur Urol. 2007;51:996–1003.CrossRefPubMedGoogle Scholar
  15. 15.
    Coelho RF, Chauhan S, Orvieto MA, Sivaraman A, Palmer KJ, Coughlin G, et al. Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol. 2011;59(1):72–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Patel VR, Samavedi S, Bates AS, Kumar A, Coelho R, Rocco B, et al. Dehydrated human amnion/chorion membrane allograft nerve wrap around the prostatic neurovascular bundle accelerates early return to continence and potency following robot-assisted radical prostatectomy: propensity score-matched analysis. Eur Urol. 2015;67(6):977–80.CrossRefPubMedGoogle Scholar
  17. 17.
    van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 2003;61:699.CrossRefPubMedGoogle Scholar
  18. 18.
    Ogaya-Pinies G, Kadakia Y, Palayapalayam-Ganapathi H, Woodlief T, Jenson C, Patel V. Use of scaffolding tissue biografts to bolster vesicourethral anastomosis during salvage robot-assisted prostatectomy reduces leak rates and catheter times. Eur Urol. 2016. [Epub ahead of print].  https://doi.org/10.1016/j.eururo.2016.10.004.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Hariharan Palayapalayam Ganapathi
    • 1
    Email author
  • Gabriel Ogaya-Pinies
    • 1
  • Eduardo Hernandez
    • 1
  • Rafael Coelho
    • 2
    • 3
    • 4
  • Vipul R. Patel
    • 1
  1. 1.Department Center for Urologic Cancer, Global Robotics Institute at Florida Hospital Celebration HealthUniversity of Central Florida College of MedicineCelebrationUSA
  2. 2.Department of UrologyHospital Israelita Albert EinsteinSão PauloBrazil
  3. 3.Department of UrologyState of Sao Paulo Cancer Institute, University of Sao Paulo School of MedicineSão PauloBrazil
  4. 4.Department of UrologyGlobal Robotics Institute at Florida Hospital Celebration HealthCelebrationUSA

Personalised recommendations