2019 Volume 32 Issue 1 Pages 120-124
［Objective］ Robotic-assisted radical prostatectomy (RARP) is widely performed in Japan. Recently, it became possible for those who have yet to obtain the license of a specialist in urology to perform RARP under certain conditions. As a result, the number of surgeons for whom RARP is their first experience of radical prostatectomy is increasing. These beginners may sometimes cut into the prostate when dissecting the bladder neck or may open the bladder too widely. As it is difficult to identify seminal vesicles, the rectum can be damaged if detachment occurs in the wrong direction. Thus, robotic echography during RARP is useful in bladder neck dissection and seminal vesicle detachment, which are comparatively difficult for beginners. This report discusses the technique.
［Method］ Using intraoperative echography (linear probe for intraoperative use), sites of interest are confirmed before bladder neck dissection and seminal vesicle detachment.
［Results］ In cases of bladder neck dissection, it was possible to identify the dissection site after confirming the position of the urethral catheter and prostate with echography. Moreover, confirmation of the location made it possible to safely detach the seminal vesicles.
［Conclusion］ Intraoperative robotic echography is useful for bladder neck dissection and seminal vesicle detachment in RARP performed by beginners. For both beginners and experienced surgeons, the use of intraoperative echography is effective in cases of prostate protrusion into the bladder or when the seminal vesicles and ampulla of the deferent duct are difficult to locate.
