Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report

Background: Anatomical abnormalities in kyphoscoliosis [KS] is a huge challenge in patient positioning for robotic prostatectomy. The narrow pelvis limits the range of movement of the robotic instruments’ and port placing could be an issue. Second, carful preoperative assessment prior to administrat...

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Autores principales:	Nabeel Kuwaijo, Mohammed AbiElmagd, Nicholas Hegarty, Kiaran O'Malley, Thomas Lynch
Formato:	article
Lenguaje:	EN
Publicado:	Al-Azhar University, Faculty of Medicine (Damietta) 2020
Materias:	robotic radical prostatectomy kyphoscoliosis ankylosing spondylitis case report Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/ee53cb940b364617bc4fe6076056cdcb
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spelling	oai:doaj.org-article:ee53cb940b364617bc4fe6076056cdcb2021-12-02T15:22:18ZRobotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report2636-41742682-378010.21608/ijma.2020.27024.1116https://doaj.org/article/ee53cb940b364617bc4fe6076056cdcb2020-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_100628_e80ebeadcbff06f40d16a1f29386f8b4.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Anatomical abnormalities in kyphoscoliosis [KS] is a huge challenge in patient positioning for robotic prostatectomy. The narrow pelvis limits the range of movement of the robotic instruments’ and port placing could be an issue. Second, carful preoperative assessment prior to administration of anesthesia and pneumoperitoneum in robot-assisted radical prostatectomy [RRP] is crucial to reduce peri-operative cardio-pulmonary complications. The Case: We report a successful use of robot in a patient with sever kyphoscoliosis for radical prostatectomy. He was a 58 years old male, overweight, with KS and history of cardiac stenting, bilateral total hip replacement. He had prostatic carcinoma. He is on antihypertensive medications, statins and bronchodilator inhalers. Auscultation revealed bronchovascular breathing with left base inspiratory crepitation. He was Mallampati score III [difficult intubation], recurrent chest infection, and severe restriction of respiratory function. The management had been performed under general anesthesia, in the supine-Trendelenburg-Lithotomy position before engaging the robot. The operative intervention showed stability of the patient except an episode of hypertension [an hour after starting surgery]. The total operative time [3 hours, 50 minutes]; the patient then transferred to intensive treatment unit for the next 12 hours. Postoperatively, backache is absent, drain removed 24 hours later; patient discharged after 48 hours, and catheter removed 10 days later. Histological examination showed adenocarcinoma of prostate, 35% of the gland with negative surgical margin. Conclusion: We confirmed that, robotic assisted radical prostatectomy could be handled in Kyphoscoliosis,Ankylosing Spondylitis with satisfactory outcome, irrespective of both technical and anaesthetic difficultiesNabeel KuwaijoMohammed AbiElmagdNicholas HegartyKiaran O'MalleyThomas LynchAl-Azhar University, Faculty of Medicine (Damietta)articleroboticradical prostatectomykyphoscoliosisankylosing spondylitiscase reportMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 2, Iss 4, Pp 718-721 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	robotic radical prostatectomy kyphoscoliosis ankylosing spondylitis case report Medicine (General) R5-920
spellingShingle	robotic radical prostatectomy kyphoscoliosis ankylosing spondylitis case report Medicine (General) R5-920 Nabeel Kuwaijo Mohammed AbiElmagd Nicholas Hegarty Kiaran O'Malley Thomas Lynch Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
description	Background: Anatomical abnormalities in kyphoscoliosis [KS] is a huge challenge in patient positioning for robotic prostatectomy. The narrow pelvis limits the range of movement of the robotic instruments’ and port placing could be an issue. Second, carful preoperative assessment prior to administration of anesthesia and pneumoperitoneum in robot-assisted radical prostatectomy [RRP] is crucial to reduce peri-operative cardio-pulmonary complications. The Case: We report a successful use of robot in a patient with sever kyphoscoliosis for radical prostatectomy. He was a 58 years old male, overweight, with KS and history of cardiac stenting, bilateral total hip replacement. He had prostatic carcinoma. He is on antihypertensive medications, statins and bronchodilator inhalers. Auscultation revealed bronchovascular breathing with left base inspiratory crepitation. He was Mallampati score III [difficult intubation], recurrent chest infection, and severe restriction of respiratory function. The management had been performed under general anesthesia, in the supine-Trendelenburg-Lithotomy position before engaging the robot. The operative intervention showed stability of the patient except an episode of hypertension [an hour after starting surgery]. The total operative time [3 hours, 50 minutes]; the patient then transferred to intensive treatment unit for the next 12 hours. Postoperatively, backache is absent, drain removed 24 hours later; patient discharged after 48 hours, and catheter removed 10 days later. Histological examination showed adenocarcinoma of prostate, 35% of the gland with negative surgical margin. Conclusion: We confirmed that, robotic assisted radical prostatectomy could be handled in Kyphoscoliosis,Ankylosing Spondylitis with satisfactory outcome, irrespective of both technical and anaesthetic difficulties
format	article
author	Nabeel Kuwaijo Mohammed AbiElmagd Nicholas Hegarty Kiaran O'Malley Thomas Lynch
author_facet	Nabeel Kuwaijo Mohammed AbiElmagd Nicholas Hegarty Kiaran O'Malley Thomas Lynch
author_sort	Nabeel Kuwaijo
title	Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
title_short	Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
title_full	Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
title_fullStr	Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
title_full_unstemmed	Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
title_sort	robotic-assisted laparoscopic radical prostatectomy (ralrp) in a patient with sever kyphoscoliosis, ankylosing spondylitis: a case report
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2020
url	https://doaj.org/article/ee53cb940b364617bc4fe6076056cdcb
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Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report

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