V1025: Robot-Assisted Laparoscopic Simple Prostatectomy: An Initial Experience
VideoIntroduction and Objectives
Simple Prostatectomy is an effective treatment modality in men with severe lower urinary tract symptoms (LUTS) secondary to bladder outlet obstruction from a very large prostate (>75g). Retropubic robot-assisted laparoscopic simple prostatectomy (RALSP) has been reported as a minimally-invasive treatment option for these men with favorable peri-operative outcomes compared to traditional open simple prostatectomy. We report our initial experience with suprapubic RALSP for the treatment of men with severe LUTS secondary to obstruction from a very large prostate.
3 men age 57, 64, and 77 presented with severe LUTS secondary to obstruction from benign prostatic hyperplasia. All men had failed medical therapy with alpha-blockers and 5-alpha reductase inhibitors and requested definitive treatment. Prostate volumes measured by transrectal ultrasound were 104, 116, and 213 cubic centimeters.
All men underwent successful RALSP via a suprapubic approach. There were no intra-operative complications. Urinary diversion was achieved with a urethral catheter only. Operative times were 118, 155, and 327 minutes. Estimated blood loss was 100, 400, and 500 mL. The three men were discharged on post-operative days 1,2, and 3. Foley catheters were removed between 7 and 9 days post-operatively. All men were continent with a good urinary stream upon foley removal.
RALSP is a safe and feasible treatment modality for men with severe LUTS secondary to bladder outlet obstruction from a very large prostate. Estimated blood loss and length of hospital stay may compare favorably to traditional open simple prostatectomy.