A new method for posterior pelvic reconstruction with autologous tissue in robot-assisted radical prostatectomy
- Authors: Mosoyan M.S.1,2, Shelipanov D.A.1, Fedorov D.A.1, Aysina N.A.1, Vasil'ev A.A.1
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Affiliations:
- Almazov National Medical Research Centre
- Academician I.P. Pavlov First St. Petersburg State Medical University
- Issue: Vol 12, No 1 (2022)
- Pages: 33-40
- Section: Original articles
- URL: https://journals.eco-vector.com/uroved/article/view/89659
- DOI: https://doi.org/10.17816/uroved89659
- ID: 89659
Cite item
Abstract
BACKGROUND: Despite the improvement of surgical techniques and a significant improvement in the functional results of surgical interventions for prostate cancer urinary incontinence after radical prostatectomy remains the most important factor that negatively affects the quality of life of patients.
AIM: Evaluation of the effectiveness and safety of a new technique for posterior reconstruction using autologous tissue an endopelvic fascia flap in robot-assisted radical prostatectomy.
MATERIALS AND METHODS: 28 patients with localized prostate cancer who underwent modified robot-assisted radical prostatectomy at one medical center were included in the study. During the operation after removal of the prostate a posterior reconstruction of the small pelvis was performed by excising a flap of the endopelvic fascia on one side, placing it behind the bladder neck and urethrocystoanastomosis, followed by fixing this flap to a similar structure on the opposite side in the form of a loop, strengthening the anastomosis from behind. The main intraoperative parameters, oncological and functional results were evaluated.
RESULTS: Analysis of the results of the study confirmed the high efficiency of the proposed surgical technique. The average operation duration was 145 min (120–170 min), average console time was 68 min (55–102 min), the average duration of the posterior reconstruction stage was 6 min (3.5–8.5 min). Average intraoperative blood loss was 55 ml (25–175 ml). The urethral catheter was removed on the 7th day after the operation in all patients. During surgery there were no conversions and any complications of III–V groups according to the Clavien – Dindo classification. Immediate urinary continence was noted in 23 (82.1%) patients (82,1%), early urinary continence was noted in 26 (92.8%) patients.
CONCLUSIONS: The results of the study showed that the use of a new technique for posterior reconstruction in robot-assisted radical prostatectomy using endopelvic fascia flaps is effective and safe, showing good early functional results, in particular, immediate urinary continence without compromising oncological outcomes.
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About the authors
Mkrtich S. Mosoyan
Almazov National Medical Research Centre; Academician I.P. Pavlov First St. Petersburg State Medical University
Email: moso03@yandex.ru
ORCID iD: 0000-0003-3639-6863
SPIN-code: 5716-9089
Scopus Author ID: 57208982777
Dr. Sci. (Med), Head of the Department of Urology with the Course of Robotic Surgery and the Clinic, Head of the Center for Robotic Surgery, Professor of the Department of Urology
Russian Federation, 2, Akkuratova St., Saint Petersburg, 191014; 6-8, Saint-PetersburgDenis A. Shelipanov
Almazov National Medical Research Centre
Email: shelipanov_da@almazovcentre.ru
Сand. Sci. (Med.), Head of Urology Division
Russian Federation, 2, Akkuratova St., Saint Petersburg, 191014Dmitriy A. Fedorov
Almazov National Medical Research Centre
Email: tvoiurolog@gmail.com
ORCID iD: 0000-0002-6371-4620
Assistant of the Department of Urology with the Course of Robotic Surgery and the Clinic
Russian Federation, 2, Akkuratova St., Saint Petersburg, 191014Nadezhda A. Aysina
Almazov National Medical Research Centre
Email: aysina1984@mail.ru
SPIN-code: 3168-2228
Assistant of the Department of Urology with the Course of Robotic Surgery and the Clinic
Russian Federation, 2, Akkuratova St., Saint Petersburg, 191014Artem A. Vasil'ev
Almazov National Medical Research Centre
Author for correspondence.
Email: scapoflow@gmail.com
Assistant of the Department of Urology with the Course of Robotic Surgery and the Clinic
Russian Federation, 2, Akkuratova St., Saint Petersburg, 191014References
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