Prostate: Robotic-Assisted Simple Prostatectomy

Abstract

Surgical approaches for large prostatic glands ≥80 g causing significant lower urinary tract symptoms have dramatically evolved over the past decades in urological advances. While open simple prostatectomy (OSP) has been losing ground due to longer hospitalization times and higher transfusion rates, robotic-assisted simple prostatectomy (RASP) is gaining popularity since it combines the outcomes of improved urinary flow with the minimally invasive benefits of robotic surgery. This chapter describes the contemporary variations of RASP including our Retzius-sparing technique where the operation is carried out via a vertical cystotomy allowing direct access to the prostate adenoma. We also show a 360° vesicourethral reconstruction that reduces time of convalescence and obviates the need for constant bladder irrigation postoperatively. Suggested patient selection and follow-up care are also described in this chapter.