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The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy.
BJU Int. 2004 Apr; 93(6):715-9.BI

Abstract

OBJECTIVE

To describe the technique of dissecting the apex of the prostate and a modified single running-suture urethrovesical anastomosis in patients undergoing robot-assisted radical prostatectomy for organ-confined prostate cancer.

PATIENTS AND METHODS

Over 550 robot-assisted radical prostatectomies have been undertaken using Vattikuti Institute Prostatectomy (VIP) technique in patients with localized carcinoma of the prostate. We present a critical analysis of the first 120 procedures by one surgeon (M.M.) at our institution using this newly developed technique of urethrovesical anastomosis preceded by dissecting the apex of the prostate.

RESULTS

The mean time for the urethrovesical anastomosis was 13 min. All but 24 patients had their catheter removed 4 days after surgery, as indicated by a cystogram. The catheter was removed successfully at 7 days in the remaining 24 patients who had a mild leak on cystography. Two patients had urinary retention within a week of removing the catheter and had to be re-catheterized. Continence was evaluated using standardized criteria before and after the procedure. The patients also replied to a mailed validated questionnaire survey; 96% were continent at 3 months and the remaining 4% used a thin pad for security.

CONCLUSIONS

We report a technique of dissecting the apex of the prostate and prostatovesical junction for dividing the bladder neck, and a modified single running-suture urethrovesical anastomosis, in patients undergoing robot-assisted radical prostatectomy for organ-confined cancer of the prostate. The same principles can also be applied for the anastomosis during pure laparoscopic procedures and for urethro-neovesical anastomosis in patients undergoing robotic radical cystoprostatectomy for carcinoma of the bladder.

Authors+Show Affiliations

Vattikuti Urology Institute, Henry Ford Health System, 2799 W. Grand Boulevard, Detroit, MI 48202, USA. mmenon1@hfhs.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

15049978

Citation

Menon, M, et al. "The Technique of Apical Dissection of the Prostate and Urethrovesical Anastomosis in Robotic Radical Prostatectomy." BJU International, vol. 93, no. 6, 2004, pp. 715-9.
Menon M, Hemal AK, Tewari A, et al. The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU Int. 2004;93(6):715-9.
Menon, M., Hemal, A. K., Tewari, A., Shrivastava, A., & Bhandari, A. (2004). The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU International, 93(6), 715-9.
Menon M, et al. The Technique of Apical Dissection of the Prostate and Urethrovesical Anastomosis in Robotic Radical Prostatectomy. BJU Int. 2004;93(6):715-9. PubMed PMID: 15049978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. AU - Menon,M, AU - Hemal,A K, AU - Tewari,A, AU - Shrivastava,A, AU - Bhandari,A, PY - 2004/3/31/pubmed PY - 2004/5/5/medline PY - 2004/3/31/entrez SP - 715 EP - 9 JF - BJU international JO - BJU Int VL - 93 IS - 6 N2 - OBJECTIVE: To describe the technique of dissecting the apex of the prostate and a modified single running-suture urethrovesical anastomosis in patients undergoing robot-assisted radical prostatectomy for organ-confined prostate cancer. PATIENTS AND METHODS: Over 550 robot-assisted radical prostatectomies have been undertaken using Vattikuti Institute Prostatectomy (VIP) technique in patients with localized carcinoma of the prostate. We present a critical analysis of the first 120 procedures by one surgeon (M.M.) at our institution using this newly developed technique of urethrovesical anastomosis preceded by dissecting the apex of the prostate. RESULTS: The mean time for the urethrovesical anastomosis was 13 min. All but 24 patients had their catheter removed 4 days after surgery, as indicated by a cystogram. The catheter was removed successfully at 7 days in the remaining 24 patients who had a mild leak on cystography. Two patients had urinary retention within a week of removing the catheter and had to be re-catheterized. Continence was evaluated using standardized criteria before and after the procedure. The patients also replied to a mailed validated questionnaire survey; 96% were continent at 3 months and the remaining 4% used a thin pad for security. CONCLUSIONS: We report a technique of dissecting the apex of the prostate and prostatovesical junction for dividing the bladder neck, and a modified single running-suture urethrovesical anastomosis, in patients undergoing robot-assisted radical prostatectomy for organ-confined cancer of the prostate. The same principles can also be applied for the anastomosis during pure laparoscopic procedures and for urethro-neovesical anastomosis in patients undergoing robotic radical cystoprostatectomy for carcinoma of the bladder. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/15049978/The_technique_of_apical_dissection_of_the_prostate_and_urethrovesical_anastomosis_in_robotic_radical_prostatectomy_ L2 - https://doi.org/10.1111/j.1464-410X.2003.04748.x DB - PRIME DP - Unbound Medicine ER -