Robot-assisted Laparoscopic Radical Prostatectomy

Yong Seong Lee; Woong Kyu Han; Seung Choul Yang; Koon Ho Rha

doi:10.4111/kju.2006.47.2.206

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Lee, Han, Yang, and Rha: Robot-assisted Laparoscopic Radical Prostatectomy

Case Report

Korean Journal of Urology

Korean Journal of Urology 2006; 47(2): 206-210.

Published online: 28 February 2006

DOI: https://doi.org/10.4111/kju.2006.47.2.206

Robot-assisted Laparoscopic Radical Prostatectomy

Yong Seong Lee, Woong Kyu Han, Seung Choul Yang, Koon Ho Rha

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (khrha@yumc.yonsei.ac.kr)

Received 9 August 2005 Accepted 20 October 2005

Abstract

In recent years, robot-assisted laparoscopic radical prostatectomy (rLRP) has emerged as a feasible treatment option for patients with organ-confined prostate cancer. We first performed rLRP in the republic of Korea and report our technique and outcome. Our patient was a 69-year-old man presenting with a T1a adenocarcinoma, a 4 (2+2) Gleason score and 1.37ng/ml preoperative serum prostate specific antigen. A rLRP was performed with the da Vinci™ robot system (Intuitive Surgical, Inc., Mountain View, USA) which has a total of seven degrees of motion (six degrees of freedom and grip) EndoWrist instrumentation. The total operative time was 420 minutes, and the robot set-up time including port insertion was 80 minutes. The estimated blood loss was 200ml. The pathological examination showed a stage T2a, with a 4 (2+2) Gleason score and negative surgical margins. A rLRP confers the benefits of enhanced precision and dexterity for complex laparoscopic work in the pelvic cavity.

Keywords: Robotics, Laparoscopy, Prostatectomy

Figures and Tables

Fig. 1

Port placement: 12mm robotic camera port (A): an 8mm robotic arm port for the monopolar, bipolar instrument (B, C): a 12mm assistant nondominant hand port (D): and a 5mm assistant dominant hand port (E).

Fig. 2

Surgical console: (A) view of operator performing rLRP while sitting at the surgical console, (B) view of using the EndoWrist. rLRP: robot- assisted laparoscopic radical prostatectomy.

Fig. 3

Bladder neck dissection: (A) divided anterior bladder neck, (B) posterior bladder neck dissection.

Fig. 4

Urethrovesical anastomosis: (A) a single suture by tying the tails of two 3-0 monocryl sutures, (B) suturing on the right semicircle with 3-0 monocryl.

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