Advertisement

Transperitoneal Robot-Assisted Laparoscopic Radical Prostatectomy: Posterior Approach

  • Ryan Turpen
  • Hany Atalah
  • Li-Ming SuEmail author
Chapter
Part of the Current Clinical Urology book series (CCU)

Abstract

Since its initial description in 2000, robot-assisted laparoscopic radical prostatectomy (RALP) has rapidly grown in popularity with the majority of men with prostate cancer seeking this approach over other surgical techniques. As compared to conventional laparoscopic radical prostatectomy, RALP has experienced more rapid adoption by a broader range of urologists including those with limited laparoscopic training and in a brief few years has virtually supplanted the laparoscopic approach in the US. While debate still remains as to its relative superiority over open surgery, its minimally invasive approach, superior optics, three dimensional visualization, and intuitive ergonomic movements of the wristed robotic instrumentation have made RALP more attractive to patients and surgeons alike. The technique of RALP has undergone considerable modifications since its early description that was based upon the original standardized approach of laparoscopic radical prostatectomy. Herein, we describe the transperitoneal posterior approach to RALP.

Keywords

Bladder Neck Urethral Catheter Cavernous Nerve Vesicourethral Anastomosis Prostatic Apex 
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 4.1 Robot-assisted laparoscopic radical prostatectomy (18.4 MB)

Video 4.2 Lay of the land (2.57 MB)

Video 4.3 Vas and seminal vesicle dissection (17.1 MB)

Video 4.4 Vas and seminial vesicle dissection posterior (11.4 MB)

Video 4.5 Entering retropubic space (10.8 MB)

Video 4.6 Endopelvic fascia and puboprostatics (19.1 MB)

Video 4.7 Dorsal venous complex ligation (11.1 MB)

Video 4.8 Anterior bladder neck (16.7 MB)

Video 4.9 Posterior bladder neck (27.8 MB)

Video 4.10 Bladder neck dissection anterior approach (27.4 MB)

Video 4.11 Neurovascular bundle dissection (23.9 MB)

Video 4.12 Division of dvc and apical dissection (14.3 MB)

Video 4.13 Pelvic lymph node dissection (19.8 MB)

Video 4.14 Entrapment of prostate and lymph nodes (3.98 MB)

Video 4.15 Instrumentation (14.1 MB)

Video 4.16 Vesicourethral anastomosis (17.7 MB)

Video 4.17 Extraction of specimen (4.82 MB)

References

  1. 1.
    Kaouk JH, Hafron J, Goel R, Haber GP, Jones JS (2008) Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results. BJU Int 102(1):93–96PubMedCrossRefGoogle Scholar
  2. 2.
    Boris RS, Bhandari A, Krane LS, Eun D, Kaul S, Peabody JO (2009) Salvage robotic-assisted radical prostatectomy: initial results and early report of outcomes. BJU Int 103(7):952–956PubMedCrossRefGoogle Scholar
  3. 3.
    Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 163(2):418–422PubMedCrossRefGoogle Scholar
  4. 4.
    Smith JA (2004) Robotically assisted laparoscopic prostatectomy: an assessment of its contemporary role in the surgical management of localized prostate cancer. Am J Surg 188(4A Suppl):63S–67SPubMedCrossRefGoogle Scholar
  5. 5.
    Kaul S, Savera A, Badani K, Fumo M, Bhandari A, Menon M (2006) Functional outcomes and ­oncological efficacy of Vattikuti Institute prostatectomy with Veil of Aphrodite nerve-sparing: an analysis of 154 consecutive patients. BJU Int 97(3):467–472PubMedCrossRefGoogle Scholar
  6. 6.
    Ong AM, Su LM, Varkarakis I, Inagaki T, Link RE, Bhayani SB, Patriciu A, Crain B, Walsh PC (2004) Nerve sparing radical prostatectomy: effects of hemostatis energy sources on the recovery of cavernous nerve function in a canine model. J Urol 172(4 Pt 1):1318–1322PubMedCrossRefGoogle Scholar
  7. 7.
    Ahlering TE, Eichel L, Chou D, Skarecky DW (2005) Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation. Urology 65(5):994–997PubMedCrossRefGoogle Scholar
  8. 8.
    Rocco F, Carmignani L, Acquati P, Gadda F, Dell’Orto P, Rocco B, Bozzini G, Gazzano G, Morabito A (2006) Restoration of posterior aspect of rhabdosphincter shortens continence time after ­radical retropubic prostatectomy. J Urol 175(6):2201–2206PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of UrologyUniversity of Florida College of MedicineGainesvilleUSA

Personalised recommendations