PURPOSE: We have performed more than 250 radical prostatectomies using the da Vinci (Intuitive Surgical, Mountain View, California) surgical system. Our initial cases were done using the classic Montsouris approach. However, after gaining familiarity with the robot we modified our technique to reflect our experience with open radical retropubic prostatectomy. We detail the Vattikuti Institute prostatectomy technique that we currently use. MATERIALS AND METHODS: The robotic technique requires 2 teams, namely a skilled laparoscopic team at the patient and a skilled open surgeon at the console. Dissection is started anterior to the bladder and it continues extraperitoneally. The endopelvic fascia is opened and the dorsal vein complex is secured. The apex of the prostate is dissected free, releasing the neurovascular bundles at the apex. The bladder neck is then incised, and the seminal vesicles and vasa are transected. Posterior dissection is done within the posterior layer of Denonvilliers' fascia, preserving the neurovascular bundles and lateral prostatic fascia. The apex is transected and frozen sections are obtained from the parietal margins. Vesicourethral anastomosis is formed with 2 continuous sutures. RESULTS: In the last 100 cases mean operative time was 2.5 hours and average blood loss was 150 ml. (range 25 to 525 cc.). Median specimen Gleason score was 7 and mean tumor volume was 7 cc. Four patients had a positive surgical margin, which was focal in 3. Of the patients 95% were discharged home within 23 hours. Mean catheterization time was 4.2 days. CONCLUSIONS: Vattikuti Institute prostatectomy is a precise and safe minimally invasive technique of radical retropubic prostatectomy.
PURPOSE: We have performed more than 250 radical prostatectomies using the da Vinci (Intuitive Surgical, Mountain View, California) surgical system. Our initial cases were done using the classic Montsouris approach. However, after gaining familiarity with the robot we modified our technique to reflect our experience with open radical retropubic prostatectomy. We detail the Vattikuti Institute prostatectomy technique that we currently use. MATERIALS AND METHODS: The robotic technique requires 2 teams, namely a skilled laparoscopic team at the patient and a skilled open surgeon at the console. Dissection is started anterior to the bladder and it continues extraperitoneally. The endopelvic fascia is opened and the dorsal vein complex is secured. The apex of the prostate is dissected free, releasing the neurovascular bundles at the apex. The bladder neck is then incised, and the seminal vesicles and vasa are transected. Posterior dissection is done within the posterior layer of Denonvilliers' fascia, preserving the neurovascular bundles and lateral prostatic fascia. The apex is transected and frozen sections are obtained from the parietal margins. Vesicourethral anastomosis is formed with 2 continuous sutures. RESULTS: In the last 100 cases mean operative time was 2.5 hours and average blood loss was 150 ml. (range 25 to 525 cc.). Median specimen Gleason score was 7 and mean tumor volume was 7 cc. Four patients had a positive surgical margin, which was focal in 3. Of the patients 95% were discharged home within 23 hours. Mean catheterization time was 4.2 days. CONCLUSIONS: Vattikuti Institute prostatectomy is a precise and safe minimally invasive technique of radical retropubic prostatectomy.
Authors: Antonio B Porcaro; Alberto Molinari; Alessandro Terrin; Nicolò De Luyk; Roberto Baldassarre; Matteo Brunelli; Stefano Cavalleri; Maria Angela Cerruto; Matteo Gelati; Gian Luca Salvagno; Gian Cesare Guidi; Walter Artibani Journal: J Robot Surg Date: 2015-07-24
Authors: A Breda; L Gausa; A Territo; J M López-Martínez; O Rodríguez-Faba; J Caffaratti; J Ponce de León; L Guirado; H Villavicencio Journal: World J Urol Date: 2015-08-28 Impact factor: 4.226
Authors: Antonio Benito Porcaro; Marco Sebben; Alessandro Tafuri; Nicolò de Luyk; Paolo Corsi; Tania Processali; Marco Pirozzi; Riccardo Rizzetto; Nelia Amigoni; Daniele Mattevi; Maria A Cerruto; Matteo Brunelli; Giovanni Novella; Vincenzo De Marco; Filippo Migliorini; Walter Artibani Journal: J Robot Surg Date: 2018-05-08
Authors: T R Herrmann; R Rabenalt; J U Stolzenburg; E N Liatsikos; F Imkamp; H Tezval; A J Gross; U Jonas; M Burchardt Journal: World J Urol Date: 2007-03-13 Impact factor: 4.226
Authors: John E Musser; Melissa Assel; Giuliano B Guglielmetti; Prachee Pathak; Jonathan L Silberstein; Daniel D Sjoberg; Melanie Bernstein; Vincent P Laudone Journal: J Endourol Date: 2014-07-24 Impact factor: 2.942