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Vattikuti Institute prostatectomy: technique.
J Urol. 2003 Jun; 169(6):2289-92.JU

Abstract

PURPOSE

We have performed more than 250 radical prostatectomies using the da Vinci (Intuitive Surgical, Mountain View, California) surgical system. Our initial cases were done using the classic Montsouris approach. However, after gaining familiarity with the robot we modified our technique to reflect our experience with open radical retropubic prostatectomy. We detail the Vattikuti Institute prostatectomy technique that we currently use.

MATERIALS AND METHODS

The robotic technique requires 2 teams, namely a skilled laparoscopic team at the patient and a skilled open surgeon at the console. Dissection is started anterior to the bladder and it continues extraperitoneally. The endopelvic fascia is opened and the dorsal vein complex is secured. The apex of the prostate is dissected free, releasing the neurovascular bundles at the apex. The bladder neck is then incised, and the seminal vesicles and vasa are transected. Posterior dissection is done within the posterior layer of Denonvilliers' fascia, preserving the neurovascular bundles and lateral prostatic fascia. The apex is transected and frozen sections are obtained from the parietal margins. Vesicourethral anastomosis is formed with 2 continuous sutures.

RESULTS

In the last 100 cases mean operative time was 2.5 hours and average blood loss was 150 ml. (range 25 to 525 cc.). Median specimen Gleason score was 7 and mean tumor volume was 7 cc. Four patients had a positive surgical margin, which was focal in 3. Of the patients 95% were discharged home within 23 hours. Mean catheterization time was 4.2 days.

CONCLUSIONS

Vattikuti Institute prostatectomy is a precise and safe minimally invasive technique of radical retropubic prostatectomy.

Authors+Show Affiliations

Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12771773

Citation

Menon, Mani, et al. "Vattikuti Institute Prostatectomy: Technique." The Journal of Urology, vol. 169, no. 6, 2003, pp. 2289-92.
Menon M, Tewari A, Peabody J, et al. Vattikuti Institute prostatectomy: technique. J Urol. 2003;169(6):2289-92.
Menon, M., Tewari, A., & Peabody, J. (2003). Vattikuti Institute prostatectomy: technique. The Journal of Urology, 169(6), 2289-92.
Menon M, et al. Vattikuti Institute Prostatectomy: Technique. J Urol. 2003;169(6):2289-92. PubMed PMID: 12771773.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vattikuti Institute prostatectomy: technique. AU - Menon,Mani, AU - Tewari,Ashutosh, AU - Peabody,James, AU - ,, PY - 2003/5/29/pubmed PY - 2003/6/11/medline PY - 2003/5/29/entrez SP - 2289 EP - 92 JF - The Journal of urology JO - J Urol VL - 169 IS - 6 N2 - PURPOSE: We have performed more than 250 radical prostatectomies using the da Vinci (Intuitive Surgical, Mountain View, California) surgical system. Our initial cases were done using the classic Montsouris approach. However, after gaining familiarity with the robot we modified our technique to reflect our experience with open radical retropubic prostatectomy. We detail the Vattikuti Institute prostatectomy technique that we currently use. MATERIALS AND METHODS: The robotic technique requires 2 teams, namely a skilled laparoscopic team at the patient and a skilled open surgeon at the console. Dissection is started anterior to the bladder and it continues extraperitoneally. The endopelvic fascia is opened and the dorsal vein complex is secured. The apex of the prostate is dissected free, releasing the neurovascular bundles at the apex. The bladder neck is then incised, and the seminal vesicles and vasa are transected. Posterior dissection is done within the posterior layer of Denonvilliers' fascia, preserving the neurovascular bundles and lateral prostatic fascia. The apex is transected and frozen sections are obtained from the parietal margins. Vesicourethral anastomosis is formed with 2 continuous sutures. RESULTS: In the last 100 cases mean operative time was 2.5 hours and average blood loss was 150 ml. (range 25 to 525 cc.). Median specimen Gleason score was 7 and mean tumor volume was 7 cc. Four patients had a positive surgical margin, which was focal in 3. Of the patients 95% were discharged home within 23 hours. Mean catheterization time was 4.2 days. CONCLUSIONS: Vattikuti Institute prostatectomy is a precise and safe minimally invasive technique of radical retropubic prostatectomy. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/12771773/Vattikuti_Institute_prostatectomy:_technique_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000067464.53313.dd?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -