[ROBOT-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY WITHOUT TRANSCATHETER ARTERIAL EMBOLIZATION FOR A PATIENT WITH...

We performed robot-assisted laparoscopic radical prostatectomy (RARP) without transcatheter arterial embolization (TAE) for a 72-year-old male patient with prostate cancer and pelvic arteriovenous malformation (AVM). Though lymphatic dissection was made contralateral to the AVM, the operation time (robotic: 2h 40 min, and total: 3h 2 min) was not long. Moreover, the blood loss amount of 250 ml was less than those in the past reports of preoperative TAE. Robotic surgery, a dissection of an abnormal arterial branch from the internal iliac artery before the division of the bladder neck, bunching of the deep dorsal vein complex, and resection of the vascular pedicle connecting with AVM in the final step of prostatectomy, contributed to the safe operation. Moreover, the surgical margin was negative in the pathological report,and the prostate specific-antigen was 0.006 ng/ml 3months following the operation. In addition, CT revealed the same size of AVM and no postoperative complication. It has been demonstrated that in the absence of TAE for pelvic AVM, RARP for prostate cancer is safe and effectively controls cancer.