Abstract
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.
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References
Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody JO et al (2002) Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol 168(3):945–9
Ahlering TE, Skarecky D, Lee D et al (2003) Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: Initial experience with laparoscopic radical prostatectomy. J Urol 170:1738–1741
Hugh JL, Thaly R, Shah K, Patel V. (2007) The advanced learning curve in robotic prostatectomy: a multi-institutional survey: AUA abstract, presented 05/20/07
Laungani RG, Kaul S, Muhletaler F et al (2007) Impact of previous inguinal hernia repair on transperitoneal robotic prostatectomy. Can J Urol 14(4):3635–9
Mulhall JP, Slovick R, Hotaling J et al (2002) Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile dysfunction. J Urol 167:1371–1375
Rogers CG, Trock BP, Walsh PC (2004) Preservation of accessory pudendal arteries during radical retropubic prostatectomy: surgical technique and results. Urology 64:148–151
Matin SF (2006) Recognition and preservation of accessory pudendal arteries during laparoscopic radical prostatectomy. Urology 67:1012–1015
Secin FP, Touijer K, Mulhall J et al (2007) Anatomy and preservation of accessory pudendal arteries in laparoscopic radical prostatectomy. Eur Urol 51:1229–1235
Zorn KC, Orvieto MA, Mikhail AA et al (2007) Effect of prostate weight on operative and postoperative outcomes of robotic-assisted laparoscopic prostatectomy. Urology 69(2):300–305
Boczko J, Erturk E, Golijanin D et al (2007) Impact of prostate size in robot-assisted radical prostatectomy. J EndoUrol 21(2):184–188
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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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Coughlin, G., Patel, V.R. (2011). Robot-Assisted Laparoscopic Radical Prostatectomy: Management of the Difficult Case. In: Su, LM. (eds) Atlas of Robotic Urologic Surgery. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60761-026-7_6
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DOI: https://doi.org/10.1007/978-1-60761-026-7_6
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