V12-08 Special Scenarios in Transvesical Single-Port Radical Prostatectomy

You have accessJournal of UrologyProstate Oncology/Penile & Testis Oncology/Misc. Oncology II (V12)1 May 2024V12-08 SPECIAL SCENARIOS IN TRANSVESICAL SINGLE-PORT RADICAL PROSTATECTOMY Carter Mikesell, Jaya Chavali, Adriana Pedraza, Nicolas Soputro, Roxanna Ramos-Carpinteyro, and Jihad Kaouk Carter MikesellCarter Mikesell , Jaya ChavaliJaya Chavali , Adriana PedrazaAdriana Pedraza , Nicolas SoputroNicolas Soputro , Roxanna Ramos-CarpinteyroRoxanna Ramos-Carpinteyro , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001009480.90141.21.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Single-Port (SP) robotic platform has been increasingly utilized for various urological procedures, including for robot-assisted radical prostatectomy (RARP) using a transvesical (TV) approach. The SP system has many advantages including shorter hospital stay, decreased post-operative pain, and an extraperitoneal approach through a single incision. We aim to demonstrate our technique, as well as tips and tricks, for SP TV RARP in patients with history of prior prostate interventions, significantly enlarged prostates, severe obesity, and history of open abdominal surgeries. METHODS: Certain patient demographics add complexity to the operation and may require a modification of the previously described surgical steps in order to complete a successful case. The following surgical scenarios and tips for a successful SP TV RARP are described: (1) Previous transurethral resection of the prostate, (2) Previous prostatic urethral lift, (3) Previous photovaporization of the prostate, (4) Intra-operative management of bladder stones and enlarged prostate, (5) Bladder closure in an obese patient, (6) SP TV RARP in a patient with hostile abdomen. RESULTS: Since 2020, we have performed SP TV RARP in 220 patients. Within our cohort 6 had prior prostate surgery for benign prostate hyperplasia, 12 had enlarged prostate >80 g on final pathology, 77 had a body mass index greater than 30, and 83 had a history of open abdominal surgery. Each of these groups had median length of stay less than 24 hours, low pain scores at the time of discharge, and low intra-operative complication rate. No cases required conversion from a TV approach or an additional port. CONCLUSIONS: SP TV RARP can be safely performed in complex surgical patients, such as those with previous prostate interventions, enlarged prostate, obesity, and history of open abdominal surgery. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e997 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Carter Mikesell More articles by this author Jaya Chavali More articles by this author Adriana Pedraza More articles by this author Nicolas Soputro More articles by this author Roxanna Ramos-Carpinteyro More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...