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International braz j urol

Print version ISSN 1677-5538On-line version ISSN 1677-6119

Int. braz j urol. vol.44 no.5 Rio de Janeiro Sept./Oct. 2018

http://dx.doi.org/10.1590/s1677-5538.ibju.2017.0609 

Video Section

Robotic adenomectomy using a laparoscopic dissector

Lessandro Curcio Gonçalves1 

Felipe Monnerat Lott2 

Rafael Rosa1 

1Serviço de Urologia, Hospital Federal de Ipanema, Rio de Janeiro, RJ, Brasil

2Departamento de Urologia, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brasil

ABSTRACT

Introduction:

Only few reports are known about the use of robotic surgery for prostate benign enlargement. The robotic surgery can be improved by laparoscopic tricks. We show a video of robotic adenomectomy where a laparoscopic dissector is used to help create the plan between prostatic capsule and adenoma.

Materials and methods:

A 62 years old male had severe urinary flow outlet obstruction. Medical therapy was not effective. Ultrasound detected a 92gr enlarged prostate with a large middle lobe. Robotic assisted adenomectomy was scheduled. The procedure followed this sequence: opening of Retzius space, superficial suture of the Dorsal vein complex, horizontal cistotomy. The plan was created with electrocautery and blunt dissection with the laparoscopic dissector. Haemostatic sutures were placed between prostate fossa and the posterior bladder neck and closure of the cistotomy.

Results:

Whole operation time was 160 minutes, with a blood loss of 80cc. There was no perioperative or post-operative complication. Catheter was removed after 4 days. Post-operatory uroflowmetry shows a peak flow of 30ml/sec. Pathological examination is negative for tumor. After 60 days IPSS was 8.

Conclusion:

Robotic prostate adenomectomy using the laparoscopic dissector is a safe and effective minimally invasive treatment for benign prostatic enlargement. It is a novel technique to find and dissect the plane between prostatic adenoma and capsule. This could be one more use of laparoscopic technology to improve surgical outcomes in robotic field.

ARTICLE INFO

Available at: http://www.intbrazjurol.com.br/video-section/20170609_Goncalves_et_al

Int Braz J Urol. 2018; 44 (Video #17): 1051-1051

Published as Ahead of Print: March 15, 2018

Received: November 15, 2017; Accepted: February 18, 2018

Correspondence address: Lessandro Curcio Gonçalves, MD, Serviço de Urologia, Hospital Federal de Ipanema, R. Antônio Parreiras, 67 - Ipanema, Rio de Janeiro - RJ, 22411-020, Brasil, Telephone: + 55 21 3259-3275 E-mail: lessandrocg@ig.com.br

CONFLICT OF INTEREST

None declared.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.