V3-11: Robotic-Assisted Epigastric Artery Harvest: A Novel Approach to Penile Revascularization

Video

Introductions and Objectives
Penile revascularization procedures are performed in select urology patients with demonstrated arteriogenic insufficiency following pelvic trauma. Revascularization with epigastric vessels has traditionally been performed with an open abdominal incision. Newer studies have begun describing minimally invasive robotic approaches for this procedure. We sought to report our institution’s experience with robotic-assisted epigastric artery harvesting for penile revascularization.

Methods
Our case involves a 55 year old male trauma patient presenting following pelvic crush injury with subsequent development of a urethral stricture. Duplex doppler penile ultrasound demonstrated inflow arterial insufficiency. Arteriogram demonstrated occlusion of pudendal arteries with no evidence of flow to the penile shaft. Decision was made to perform revascularization of epigastric artery to dorsal artery of the penis using the novel robotic-assisted approach.

Results
Following his procedure, the patient went out to have successful buccal urethroplasty one month later with subsequent voiding cystourethrogram without evidence of stricture recurrence. Follow-up duplex doppler ultrasound of the penis demonstrated greatly improved arterial penile inflow.

Conclusions
Robotic-assisted epigastric artery harvesting is a novel, minimally invasive approach to penile revascularization which allows for improved cosmetic results, quicker recovery time and shorter hospital stay compared to traditional open surgical approaches.

Funding: None