To describe the surgical management of patients who had radical prostatectomy previously attempted but aborted due to diverse causes. Patients who underwent an “aborted prostatectomy” were extracted from the institutional prostatectomy database. A description of the tailored robotic approach was reported for each case. Tips and tricks for the accomplishment of robotic prostatectomy after aborted prostatectomy were reported. Six clinical cases were analyzed. Three patients had aborted prostatectomy due to complicated dissection hindered by pelvic mesh and bowel adhesions; one prostatectomy was aborted due to anesthesiology/respiratory matters; one for narrow pelvis; one due to abnormal pelvic vascular anatomy. All patients successfully underwent robotic prostatectomy at our institution. In five patients, standard transperitoneal robotic approach was performed. In one patient, robotic transperineal approach was mandatory. Median operative time was 282 min (86–460). Median estimated blood loss was 325 mL (50–1000). Two patients had positive surgical margins. One patient was found with nodal metastasis at final pathology. Neither perioperative nor postoperative complications were reported. At last follow-up, PSA was undetectable in 5/6 patients. Even after previous aborted prostatectomy, robot-assisted prostatectomy is feasible, with acceptable results. The case-by-case tailoring of the technique is the key for a successful intervention.
Aborted Radical prostatectomy Robot-assisted Alternative approach Surgical technique Redo
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Conflict of interest
Jihad H. Kaouk declares that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or material discussed in the manuscript (e.g., employment/affiliation, grants or fundings, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patient filed, received or pending), are the following: Endocare, Inc, and Intuitive Surgical. J. H. Kaouk (consultant). Jaya Chavali, Juan Garisto, Riccardo Bertolo, Jose Agudelo, Julien Dagenais declare they have no conflict of interest.
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