Category: Robotic Surgery: Lower Tract - Benign

VS10-3 - Robotic-Assisted Retropubic (Millin) Simple Prostatectomy: The Extraperitoneal Technique

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

The rising trend in robotic-assisted simple prostatectomy for the management of BPH has resulted in reduced patient morbidity and improved convalescence. While the extraperitoneal retropubic approach has been well studied in pure laparoscopic surgery literature, the application of the robotics platform has not been clearly reported. We describe our approach to this technique . 


Methods :

An index patient with severe bothersome lower urinary tract symptoms refractory to alpha-blocker therapy was reviewed. After confirming no evidence of cancer on prostate biopsy, the patient underwent robotic-assisted retropubic (Millin) simple prostatectomy via an extraperitoneal approach.  Key steps of the technique and surgical pearls deemed helpful in overcoming the technical learning curve and minimizing patient morbidity were reviewed. 


Results :

Perioperative outcomes of our index patient was comparable to open, laparoscopic, and robotic transperitoneal approaches to simple prostatectomy reported elsewhere in the literature. 


Conclusions :

Robotic-assisted retropubic (Millin) simple prostatectomy performed via the extraperitoneal approach is a safe and feasible alternative for the management of BPH and it remains underutilize. Despite the limited working space, this approach is an excellent option for the treatment of large prostate glands.

Diane D. Lu

Assistant Professor of Clinical Urology
University of Rochester Medical Center
Rochester, New York

Ahmed Ghazi

Assistant professor of Urology , Director of Simulation Innovation Laboratory (SIL) , Co-Director-Fellowship In Endourology and Robotic Surgery
University of Rochester
Rochester, New York

Ahmed Ghazi MD, MSc, FEBU
Assistant professor of Urology
Director of Simulation Innovation Laboratory (SIL)
Co-Director-Fellowship In Endourology and Robotic Surgery
University of Rochester Medical Center

Jean Joseph

W.W. Scott Professor and Chairman Departement of Urology Professor of Oncology
University of Rochester
Rochester, New York