V3-05: Robot-Assisted Laparoscopic Radical Prostatectomy in a 2 Years Old Children with Rhabdomyosarcoma
VideoIntroductions and Objectives
Prostate rhabdomyosarcoma in children is an aggressive, uncommon entity that represents a challenge for physicians. The tumor arises from a wide variety of primary sites, therefore physicians must be aware of local invasion patterns, lymph node involvement and therapeutic response. Optimal treatment is multimodal and requires surgery, chemotherapy and usually radiotherapy. The robotic system was recently introduced in Panama. We present the first robot-assisted laparoscopic radical prostatectomy performed in a 2 years old patient en Latin America.
A 2 years old patient with a history of pain and perineal mass is evaluated. A CT-Scan demonstrated a big, rounded prostatic mass of approximate 8 cms. A transrectal needle biopsy is performed and the diagnosis of anaplasic prostate rhabdomyosarcoma is done. The patient received 14 cycles of Vincristine, Adriamycin and Cisplatin with notable reduction in tumoral size. A robot-assisted laparoscopic radical prostatectomy is performed at our institution.
The patient is positioned in 25° Trendelemburg, with careful attention to pressure points and with proper fixation to the table. Trocar placement is the traditional for robotic prostatectomy. Trocar placement time was 15 minutes. Docking time was 8 minutes. Total surgery time was 490 minutes, console time being 326 minutes. Estimated blood loss was 325 cc. Surgical margins were negative and all lymph nodes were negative. There were no intra operative complications. The patient was discharged home at 72 hours. Foley catheter was removed at 10 days.
Robot-Assisted laparoscopic radical prostatectomy is a safe and feasible procedure in children. In our case, there was no need for blood transfusion and the recovery period was shorter than expected. Oncological control was optimal.