Robotic Freyer's prostatectomy: Operative technique and single-center experience
Introduction: Transurethral resection of prostate replaced open surgery and remained the gold standard in surgical management of benign prostatic hyperplasia (BPH). Holmium laser enucleation and bipolar resection of prostate managed even larger glands. Open simple prostatectomy remains an option for...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Urology |
| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2021;volume=37;issue=3;spage=247;epage=253;aulast=Waigankar |
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| author | Santosh S Waigankar Thyavihally B Yuvaraja Preetham Dev Varun Agarwal Abhinav P Pednekar Bijal Kulkarni |
| author_facet | Santosh S Waigankar Thyavihally B Yuvaraja Preetham Dev Varun Agarwal Abhinav P Pednekar Bijal Kulkarni |
| author_sort | Santosh S Waigankar |
| collection | DOAJ |
| description | Introduction: Transurethral resection of prostate replaced open surgery and remained the gold standard in surgical management of benign prostatic hyperplasia (BPH). Holmium laser enucleation and bipolar resection of prostate managed even larger glands. Open simple prostatectomy remains an option for large glands and concurrent pathologies. Minimally invasive laparoscopic simple prostatectomy lacks general acceptance. Surgeons have now started exploring the robotic platform due to its advantages. Herein, we present the technique and initial outcomes of robotic Freyer's prostatectomy (RFP).
Materials and Methods: Thirteen transperitoneal RFPs were performed using the DaVinci Xi platform. We evaluated perioperative characteristics and functional outcomes.
Results: Median patient age was 67.8 years and the mean prostate volume was 105.8 ml. The median International Prostate Symptom Score (IPSS) and American Urological Association quality of life (AUA-QoL) score was 19.6 and 5.3. There were no intraoperative complications or conversion to open surgery. The mean console time and estimated blood loss were 107.30 min and 92.5 ml, respectively. One patient required redo-surgery by robotic technique due to urine leak (Clavien-Dindo Grade 3b complication). Mean hospital stay and catheter duration were 4.9 days and 5.2 days, respectively. Change (preoperative vs. postoperative) in IPSS (19.6 vs. 4.67 points), maximum flow rate (6.8 vs. 15.1 ml/s), AUA-QoL score (5.3 vs. 2.2 points) and PVR (179.4 vs 7.1 ml) were significant (P < 0001).
Conclusions: RFP is a safe and effective option for managing BPH, especially for large glands. It confers minimally invasive surgery benefits with good functional outcomes. |
| first_indexed | 2024-12-22T15:38:53Z |
| format | Article |
| id | doaj.art-80b26c4062674c128bbd4a5d25b93185 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-12-22T15:38:53Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-80b26c4062674c128bbd4a5d25b931852022-12-21T18:21:11ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242021-01-0137324725310.4103/iju.IJU_78_21Robotic Freyer's prostatectomy: Operative technique and single-center experienceSantosh S WaigankarThyavihally B YuvarajaPreetham DevVarun AgarwalAbhinav P PednekarBijal KulkarniIntroduction: Transurethral resection of prostate replaced open surgery and remained the gold standard in surgical management of benign prostatic hyperplasia (BPH). Holmium laser enucleation and bipolar resection of prostate managed even larger glands. Open simple prostatectomy remains an option for large glands and concurrent pathologies. Minimally invasive laparoscopic simple prostatectomy lacks general acceptance. Surgeons have now started exploring the robotic platform due to its advantages. Herein, we present the technique and initial outcomes of robotic Freyer's prostatectomy (RFP). Materials and Methods: Thirteen transperitoneal RFPs were performed using the DaVinci Xi platform. We evaluated perioperative characteristics and functional outcomes. Results: Median patient age was 67.8 years and the mean prostate volume was 105.8 ml. The median International Prostate Symptom Score (IPSS) and American Urological Association quality of life (AUA-QoL) score was 19.6 and 5.3. There were no intraoperative complications or conversion to open surgery. The mean console time and estimated blood loss were 107.30 min and 92.5 ml, respectively. One patient required redo-surgery by robotic technique due to urine leak (Clavien-Dindo Grade 3b complication). Mean hospital stay and catheter duration were 4.9 days and 5.2 days, respectively. Change (preoperative vs. postoperative) in IPSS (19.6 vs. 4.67 points), maximum flow rate (6.8 vs. 15.1 ml/s), AUA-QoL score (5.3 vs. 2.2 points) and PVR (179.4 vs 7.1 ml) were significant (P < 0001). Conclusions: RFP is a safe and effective option for managing BPH, especially for large glands. It confers minimally invasive surgery benefits with good functional outcomes.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2021;volume=37;issue=3;spage=247;epage=253;aulast=Waigankar |
| spellingShingle | Santosh S Waigankar Thyavihally B Yuvaraja Preetham Dev Varun Agarwal Abhinav P Pednekar Bijal Kulkarni Robotic Freyer's prostatectomy: Operative technique and single-center experience Indian Journal of Urology |
| title | Robotic Freyer's prostatectomy: Operative technique and single-center experience |
| title_full | Robotic Freyer's prostatectomy: Operative technique and single-center experience |
| title_fullStr | Robotic Freyer's prostatectomy: Operative technique and single-center experience |
| title_full_unstemmed | Robotic Freyer's prostatectomy: Operative technique and single-center experience |
| title_short | Robotic Freyer's prostatectomy: Operative technique and single-center experience |
| title_sort | robotic freyer s prostatectomy operative technique and single center experience |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2021;volume=37;issue=3;spage=247;epage=253;aulast=Waigankar |
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