Technical Features of Robot-Assisted Prostatectomy in Patients with Very Enlarged Prostates
https://doi.org/10.24060/2076-3093-2018-8-2-33-40
Abstract
Introduction. According to scientific studies, adenocarcinoma coincides with adenomatous tissue within the same prostate gland in 10–83.3 % of cases (including incidental cancer). Clinical situations in which the adenoma reaches a significant size (typically greater than 80 cm3 ) and thus creates considerable difficulties for surgeons occurs in not more than in 8–10 % of all cases of prostatectomy. Given the limitations of external beam radiotherapy and brachytherapy related with prostate volume and poor quality of urination, radical prostatectomy in this group of patients remains the treatment of choice. Features of adenoma, such as large median and lateral lobes, the presence of cystostomy and bladder stones, significantly complicate operational benefits. When an enlarged prostate is one of the factors prior to surgery, robotic technology may have certain advantages.
The main goal of this work is to demonstrate the technical advantages of robot-assisted prostatectomy associated with enlarged prostate.
Results and discussion. We describe the anatomical landmarks and possible surgical methods for overcoming different variations of benign hyperplasia of the prostate using robot-assisted prostatectomy. This information is particularly useful to surgeons aiming to master robotic surgical platforms. Robot-assisted prostatectomy can be effectively used in the treatment of prostate cancer associated with benign prostatic hyperplasia, and patients can have confidence in the results of such an operation.
Conclusion. If a surgeon is sufficiently experienced, robot-assisted prostatectomy may become the method of choice in the treatment of patients with enlarged prostates.
About the Authors
A. V. Zyryanov
Ural State Medical University
Russian Federation
Russian Federation
Doctor of Medical Sciences, Professor of Urology, Vice-rector for Academic Affairs,
3 Repin str., Yekaterinburg, 620028
A. V. Ponomarev
Regional Urological Center of the Medical Care Unit “Neftyanik”
Russian Federation
Russian Federation
Head of the Department of Oncology,
8/1 Yuriy Semovskikh str., Tyumen, 625000
V. O. Smirnov
Tyumen State Medical University
Russian Federation
Russian Federation
Post-graduate student of the Department of Oncology with the Course of Urology,
54 Odesskaya str., Tyumen, 625023
A. S. Surikov
Regional Urological Center of the Medical Care Unit “Neftyanik”
Russian Federation
Russian Federation
Urologist of the Department of Oncology,
8/1 Yuriy Semovskikh str., Tyumen, 625000
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Review
For citations:
Zyryanov A.V., Ponomarev A.V., Smirnov V.O., Surikov A.S. Technical Features of Robot-Assisted Prostatectomy in Patients with Very Enlarged Prostates. Creative surgery and oncology. 2018;8(2):117-124. (In Russ.) https://doi.org/10.24060/2076-3093-2018-8-2-33-40
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