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Journal of Robotic Surgery

, Volume 13, Issue 3, pp 407–412 | Cite as

Robotic radical prostatectomy after aborted prostatectomy: still feasible? The experience from a tertiary care center

  • Jaya Sai Chavali
  • Juan Garisto
  • Riccardo Bertolo
  • Jose Agudelo
  • Julien Dagenais
  • Jihad KaoukEmail author
Original Article

Abstract

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.

Keywords

Aborted Radical prostatectomy Robot-assisted Alternative approach Surgical technique Redo 

Notes

Compliance with ethical standards

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.

References

  1. 1.
    Sanda MG, Dunn RL, Michalski J et al (2008) Quality of life and satisfaction with outcomes among prostate cancer survivor. N Engl J Med 358:1250–1261CrossRefGoogle Scholar
  2. 2.
    American Cancer Society (2014) Cancer facts and figures. American Cancer Society, AtlantaGoogle Scholar
  3. 3.
    Garisto J. Klotz L (2017) Active surveillance: how to do it right? Oncology (Williston Park) 31(5):333–340Google Scholar
  4. 4.
    Sanda MG, Cadeddu JA, Kirkby E et al (2018) Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. Part II: recommended approaches and details of specific care options. J Urol 199(4):990–997.  https://doi.org/10.1016/j.juro.2018.01.002 CrossRefGoogle Scholar
  5. 5.
    Duffey B, Varda B, Konety B (2011) Quality of evidence to compare outcomes of open and robot-assisted laparoscopic prostatectomy. Curr Urol Rep 12:229–236CrossRefGoogle Scholar
  6. 6.
    Mayer E, Darzi A (2016) Innovation and surgical clinical trials. Lancet 388(10049):1027–1028CrossRefGoogle Scholar
  7. 7.
    Mikhail AA, Stockton BR, Orvieto MA et al (2006) Robotic-assisted laparoscopic prostatectomy in overweight and obese patients. Urology 67(4):774–779CrossRefGoogle Scholar
  8. 8.
    Ginzburg S, Hu F, Staff I et al (2010) Does prior abdominal surgery influence outcomes or complications of robotic-assisted laparoscopic radical prostatectomy? Urology 76(5):1125–1129CrossRefGoogle Scholar
  9. 9.
    Mustafa M, Pettaway CA, Davis JW et al (2015) Robotic or open radical prostatectomy after previous open surgery in the pelvic region. Korean J Urol 56(2):131–137CrossRefGoogle Scholar
  10. 10.
    Siddiqui SA, Krane LS, Bhandari A et al (2010) Laparoscopy and robotics the impact of previous inguinal or abdominal surgery on outcomes after robotic radical prostatectomy. Urology 75(5):1079–1082CrossRefGoogle Scholar
  11. 11.
    Tucci M, Leone G, Buttigliero C et al (2017) Hormonal treatment and quality of life of prostate cancer patients: new evidences. Minerva Urol Nefrol.  https://doi.org/10.23736/S0393-2249.17.03066-1 Google Scholar
  12. 12.
    Kowalczyk KJ, Huang AC, Williams SB, Yu HY, Hu JC (2013) Robotic-assisted laparoscopic radical prostatectomy after aborted retropubic radical prostatectomy. J Robot Surg 7(3):301–304.  https://doi.org/10.1007/s11701-012-0377-9 (Epub 2012 Aug 19) CrossRefGoogle Scholar
  13. 13.
    Kaouk JH, Akca O, Zargar H et al (2016) Descriptive technique and initial results for robotic radical perineal prostatectomy. Urology 94:129–138CrossRefGoogle Scholar
  14. 14.
    Weibel MA, Majno G (1973) Peritoneal adhesions and their relation to abdominal surgery: a postmortem study. Am J Surg 126:345–353CrossRefGoogle Scholar
  15. 15.
    Siddiqui SA, Krane LS, Bhandari A et al (2010) The impact of previous inguinal or abdominal surgery on outcomes after robotic radical prostatectomy. Urology 75(5):1079–1082CrossRefGoogle Scholar
  16. 16.
    Katz EE, Patel RV, Sokoloff MH et al (2002) Bilateral laparoscopic inguinal hernia repair can complicate subsequent radical retropubic prostatectomy. J Urol 167(2 Pt 1):637–638CrossRefGoogle Scholar
  17. 17.
    Lallas CD, Pe ML, Patel JV et al (2009) Transperitoneal robotic assisted laparoscopic prostatectomy after prosthetic mesh herniorrhaphy. JSLS 13:142–147Google Scholar
  18. 18.
    Ellimoottil C, Roghmann F, Blackwell R et al (2015) Open versus robotic radical prostatectomy in obese men. Curr Urol 8(3):156–161CrossRefGoogle Scholar
  19. 19.
    Ramirez D, Maurice MJ, Kaouk JH (2016) Robotic perineal radical prostatectomy and pelvic lymph node dissection using a purpose build single-port robotic platform. BJU Int 118(5):829–833CrossRefGoogle Scholar
  20. 20.
    Bertolo R, Garisto J, Gettman M, Kaouk J (2018) Novel system for robotic single-port surgery: feasibility and state of the art in urology. Eur Urol Focus.  https://doi.org/10.1016/j.euf.2018.06.004 Google Scholar
  21. 21.
    Kaouk J, Garisto J, Bertolo R (2018) Different approaches to the prostate: the upcoming role of a purpose-built single-port robotic system. Arab J Urol.  https://doi.org/10.1016/j.aju.2018.04.003 Google Scholar

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Glickman Urological and Kidney Institute, Cleveland ClinicClevelandUSA

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