[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate

Objective: To demonstrate robot-assisted transvesical prostatectomy for a very large prostate. The management of benign prostatic hyperplasia (BPH) has developed quickly in the last few years. Modern minimally invasive surgical methods are continuously gaining a fixed status in the therapy. The tran...

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Autores principales:	Samer Schakaki, Hermann van Ahlen
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/cc2b910011984ea29e8f0607e2265ebf
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spelling	oai:doaj.org-article:cc2b910011984ea29e8f0607e2265ebf2021-12-02T10:11:40Z[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate2090-598X10.1016/j.aju.2018.10.046https://doaj.org/article/cc2b910011984ea29e8f0607e2265ebf2018-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18301402https://doaj.org/toc/2090-598XObjective: To demonstrate robot-assisted transvesical prostatectomy for a very large prostate. The management of benign prostatic hyperplasia (BPH) has developed quickly in the last few years. Modern minimally invasive surgical methods are continuously gaining a fixed status in the therapy. The transurethral approach is currently the ‘gold standard’, but what can we do with a very large prostate? Does robot-assisted surgery play, as a minimally invasive method, any role in the treatment of BPH? Methods: An 80-year-old man with severe lower urinary tract symptoms without relevant comorbidities. His International Prostate Symptom Score (IPSS) was 21, quality of life score was 4, and his prostate-specific antigen level was 4.8 ng/mL. Transrectal ultrasonography showed a very large prostate (volume 240 mL). The residual urine volume was ∼200 mL. He had no previous abdominal surgery and the preoperative cystoscopy showed no abnormalities. Results: We performed a robot-assisted transvesical prostatectomy. We used zero optic and three robotic arms. The patient was in Trendelenburg position. The operation duration was 88 min, without significant blood loss. We used a morcellator to aid the removal of the prostate and avoid a big incision to extract the specimen. Irrigation was only required for the first 24 h after the operation. The patient was discharged on the fourth postoperative day. The transurethral catheter was removed on the sixth postoperative day and voiding was excellent. Conclusion: The management of a very large prostate remains very difficult. The robot-assisted technology allows us to perform this difficult operation in a minimally invasive way and without significant blood loss. Despite the size of the prostate, we did not need to make a big incision for extraction and the operation could be performed without any complications. Try always to be innovative and think about using some gynaecological instruments to be more minimally invasive.Samer SchakakiHermann van AhlenTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss , Pp S42-S43 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Samer Schakaki Hermann van Ahlen [92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
description	Objective: To demonstrate robot-assisted transvesical prostatectomy for a very large prostate. The management of benign prostatic hyperplasia (BPH) has developed quickly in the last few years. Modern minimally invasive surgical methods are continuously gaining a fixed status in the therapy. The transurethral approach is currently the ‘gold standard’, but what can we do with a very large prostate? Does robot-assisted surgery play, as a minimally invasive method, any role in the treatment of BPH? Methods: An 80-year-old man with severe lower urinary tract symptoms without relevant comorbidities. His International Prostate Symptom Score (IPSS) was 21, quality of life score was 4, and his prostate-specific antigen level was 4.8 ng/mL. Transrectal ultrasonography showed a very large prostate (volume 240 mL). The residual urine volume was ∼200 mL. He had no previous abdominal surgery and the preoperative cystoscopy showed no abnormalities. Results: We performed a robot-assisted transvesical prostatectomy. We used zero optic and three robotic arms. The patient was in Trendelenburg position. The operation duration was 88 min, without significant blood loss. We used a morcellator to aid the removal of the prostate and avoid a big incision to extract the specimen. Irrigation was only required for the first 24 h after the operation. The patient was discharged on the fourth postoperative day. The transurethral catheter was removed on the sixth postoperative day and voiding was excellent. Conclusion: The management of a very large prostate remains very difficult. The robot-assisted technology allows us to perform this difficult operation in a minimally invasive way and without significant blood loss. Despite the size of the prostate, we did not need to make a big incision for extraction and the operation could be performed without any complications. Try always to be innovative and think about using some gynaecological instruments to be more minimally invasive.
format	article
author	Samer Schakaki Hermann van Ahlen
author_facet	Samer Schakaki Hermann van Ahlen
author_sort	Samer Schakaki
title	[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
title_short	[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
title_full	[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
title_fullStr	[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
title_full_unstemmed	[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
title_sort	[92] be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/cc2b910011984ea29e8f0607e2265ebf
work_keys_str_mv	AT samerschakaki 92beinnovativemakeyourincisionsmallerrobotassistedtransvesicalprostatectomyforaverylargeprostate AT hermannvanahlen 92beinnovativemakeyourincisionsmallerrobotassistedtransvesicalprostatectomyforaverylargeprostate
_version_	1718397533142646784

[92] Be innovative; make your incision smaller, robot-assisted transvesical prostatectomy for a very large prostate

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