title: Extraperitoneal approach for robotic-assisted simple prostatectomy.
abstract: OBJECTIVE
  To present the experience with the extraperitoneal approach for robotic-assisted simple prostatectomy (RASP) in a technique replicating the vesicocapsular incision technique of open surgery.
  
  
  METHODS
  RASP was performed on patients with a prostate volume of >80 cm(3) with an indication for open enucleation of the prostate. Preoperatively, all patients were evaluated by uroflowmetry, prostate-specific antigen level, and postvoid residual measurement, as well as by the International Prostate Symptom Score questionnaire. All perioperative data were recorded in a prospective database. Follow-up appointments included the aforementioned measurements and were scheduled at 1 and 6 months postoperatively.
  
  
  RESULTS
  Ten RASP procedures were successfully performed by the extraperitoneal approach. Mean patient age and prostate volume were 63.1 years (range, 55-74 years) and 129.4 cm(3) (range, 90-170 cm(3)), respectively. Mean operative time was 122.5 minutes (range, 85-140 minutes) and represented the time from the first incision to the closure of the all incisions. The estimated blood loss was minimal (mean value, 230 mL). Transfusions were not necessary. Mean catheterization period was 7.4 days (range, 6-8 days). The symptomatology, as reported by the International Prostate Symptom Score, was improved at the follow-up appointments in comparison with the baseline values. One case of prolonged fever was noted postoperatively and managed by antibiotics.
  
  
  CONCLUSIONS
  The extraperitoneal approach for RASP proved to be efficient in the management of large prostates. The results are directly comparable with the current available experience with transperitoneal RASP. The extraperitoneal RASP seems to favorably compare with the open simple prostatectomy, while the results are at least comparable with those of conventional laparoscopic approach.
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany; Department of Urology, University of Patras, Patras, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kallidonis
authors.affiliation: Department of Urology, Gartnavel General Hospital, Glasgow, United Kingdom.
authors.forename: Hasan
authors.initials: H
authors.lastname: Qazi
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Phuc
authors.initials: P
authors.lastname: Ho Thi
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Dietel
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany; Department of Urology, University of Patras, Patras, Greece. Electronic address: liatsikos@yahoo.com.
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Liatsikos
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: Minh
authors.initials: M
authors.lastname: Do
mesh_terms: D000236:Adenoma / Q000601:surgery; D000368:Aged; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery; D011471:Prostatic Neoplasms / Q000601:surgery; D065287:Robotic Surgical Procedures; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen