Robot-assisted laparoscopic radical prostatectomy: four cases

Abstract

The role of the da Vinci robot is being defined in minimally invasive urologic surgery. Robot-assisted laparoscopic radical prostatectomy (rLRP) has emerged as a feasible treatment option for patients with organ-confined prostate cancer. We performed the first four rLRPs on four prostate cancer patients in the Republic of Korea. This is a report of its techniques and outcomes. In all four cases, the surgery was successfully completed with a mean operative time of 392.5 minutes. The mean estimated blood loss was 312.5mL, and catheterization lasted 14 to 21 days. There were no major intraoperative or postoperative complications. The mean hospital stay was 11 days. The rLRP is a safe and feasible approach. It will become one of the standard options for the management of localized prostate cancer.

Fig. 1

Port placement: 12-mm robot camera port [A]; 8-mm robot arm port for monopolar, bipolar instruments [B,C]; 12-mm first assistant non-dominant hand port [D]; 5-mm first assistant dominant hand port [E]; and 5-mm second assistant hand port [F].

Fig. 2

View of peritoneoscopy carried out with a 00 laparoscope.

Fig. 3

Bladder neck dissection. (A) divided anterior bladder neck. (B) posterior bladder neck dissection.

Fig. 4

Urethrovesical anastomosis. (A) a single suture by tying the tails of two 3-0 monocryl sutures, (B) suturing on right semicircle with 3-0 monocryl.