Transvesical robot-assisted simple prostatectomy with 360° circumferential reconstruction: step-by-step technique

Area of Science:

• Urology
• Surgical Techniques
• Robotic Surgery

Background:

• Transvesical robot-assisted simple prostatectomy (RASP) is a minimally invasive procedure for benign prostatic hyperplasia.
• Standard RASP techniques can lead to postoperative complications such as bleeding and irritative voiding symptoms.

Purpose of the Study:

• To describe a novel 360° mucosal reconstruction technique following transvesical RASP.
• To evaluate the feasibility and safety of this 360° reconstruction method.

Main Methods:

• Analysis of the first 23 patients undergoing RASP with the 360° reconstruction technique.
• Circumferential approximation of bladder and urethral mucosa using barbed sutures after adenoma enucleation.

Main Results:

• Mean operative time was 160.6 minutes with minimal blood loss (98.6 mL).
• No conversions to open surgery or intra-operative complications occurred.
• Mean hospital stay was 2.1 days, with one postoperative complication unrelated to the surgical technique.

Conclusions:

• The 360° mucosal reconstruction in RASP is a feasible and safe technique.
• This method aims to minimize electrocautery use and reduce the prostate's raw surface area, potentially decreasing postoperative bleeding and irritative symptoms.
• Further comparative studies and longer follow-up are warranted.