This video describes step by step a new surgical technique for performing “Open Anterograde Anatomic Radical Retropubic Prostatectomy” (R2PA2) for the treatment of prostate cancer in the same way as performed by the robot, without the need for using the robotic platform, video or any equipment other than those used in the conventional open surgery described by Patrick Walsh in 1983. This prospective and randomized study is registered in the ClinicalTrials.gov identifier number: NCT02687308, and the full description of this technique was published in: Fabricio et al., Surgery Curr Res 2017, 7:5
DOI: 10.4172/2161-1076.1000304.
Authors: Borges Carrerette F. 1, Damião R. 1, Barberan J.P. 1, Mendes Miranda T. 1, Almeida Gazzoli R. 1, Lucio Carrasco C.H. 1, Alves Machado H. 1, Figueiredo Filho R.T. 1, Da Silva E.A.. 1, Costa Lara C. 1, Freire F. 1,
1 Pedro Ernesto University Hospital, Rio de Janeiro State University, Surgery, Urology, Rio de Janeiro, Brazil.
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The authors report no conflict of interest
We thank all the employees of the Pedro Ernesto Hospital of the University of the State of Rio de Janeiro doctors and technicians who did not measure efforts to carry out this work
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Partial penectomy is the surgical standard of care for invasive tumors of the mid to distal penis, but is utilized in cases of distal penile calciphylaxis due to pain. Partial Penectomy is advantageous compared to a total penectomy, as the patient is able to urinate in the standing position.
A 51-year-old man on dialysis for end stage renal disease presented to the emergency department with pain that was increasing in severity for over a month at the glans of the penis. On examination, the glans of the penis was firm with gangrenous necrosis extending distal to the corona, and the urethral meatus was not identified due to the extensive scarring. A clinical diagnosis of penile calciphylaxis was determined and a Partial Penectomy was subsequently performed. Calciphylaxis is a rare life-threatening systemic disease in patients with end stage renal disease due to medial calcification and fibrosis of blood vessels leading to infection and gangrene. The prognosis for penile calciphylaxis tends to be poor with an overall mortality of 64% with a mean time to death of 2.5 months.
In this video, we demonstrate the set-up, port configuration, and key steps involved in performing a robotic-assisted retroperitoneoscopic partial nephrectomy.
Contributors: Kristina Butler, MD and Javier Magrina, MD
Pelvic lymphadenectomy is part of most gynecologic malignancy staging procedures. Knowledge of the retroperitoneal anatomy is key to safely completing this procedure.
DOI: http://dx.doi.org/10.17797/5xzrp8fuk3
Editor Recruited By: Dennis S. Chi, MD, FACOG, FACS
Review Open Anterograde Anatomic Radical Retropubic Prostatectomy Technique R2PA2.