Icahn School of Medicine at The Mount Sinai Hospital
Introduction: In this video, we present the outcomes of patients treated with robotic transvesical simple prostatectomy and demonstrate our technique.
Methods: We performed robotic transvesical simple prostatectomy on 68 consecutive patients. Patients were evaluated in terms of age, body mass index (BMI), prostate volume, prostate specific antigen (PSA), operative time, estimated blood loss, length of hospital stay and catheter removal time. Our technique is demonstrated in a 75 year old male with 300 cc prostate. After achieving pneumoperitoneum and placing the trocars, bladder is insufflated with air and a vertical cystotomy incision is made. Marionette sutures are placed on four quadrants to secure the bladder opening during the procedure. Then, median lobe is grasped and mucosa overlying the median lobe is incised. After identifying the appropriate plane between prostate adenoma and capsule, dissection is carried out circumferentially and adenoma is removed. After achieving hemostasis, complete circumferential mucosa to mucosa anastomosis between the bladder neck and the urethra is completed. Marionette sutures are then removed and the cystotomy is closed in 2 layers.
Results: We used the same robotic transvesical simple prostatectomy technique in 68 consecutive patients with benign prostatic hyperplasia. The demographic and outcome data are presented in Table 1
Conclusions: Robotic transvesical simple prostatectomy is a safe and effective procedure for the treatment of large benign prostatic hyperplasia, with very low complication rates and short hospitalization.
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