Martini Alberto, Tewari Ashutosh Kumar
Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
Department of Urology, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029, USA.
Ther Adv Urol. 2019 Jan 8;11:1756287218813789. doi: 10.1177/1756287218813789. eCollection 2019 Jan-Dec.
Urologic prostate surgery has changed dramatically over the past decades. Following the introduction of the robot, the surgical approach has been modified and thanks to the magnification allowed by the robot a further level of precision can be achieved. Moreover, advances in the anatomical studies have provided new evidence regarding the periprostatic anatomy. The aim of this review is to describe our approach to robot-assisted radical prostatectomy. Our holistic perspective towards patient selection, pre- and postoperative care is provided. In our center, robot-assisted radical prostatectomy is performed by means of an anterograde approach. A nonbladder-sparing dissection with a graded approach towards nerve preservation is carried out. The procedure is concluded with what we call 'total anatomical reconstruction'.
在过去几十年里,泌尿外科前列腺手术发生了巨大变化。随着机器人的引入,手术方式得到了改进,并且由于机器人提供的放大功能,可以实现更高水平的精准度。此外,解剖学研究的进展为前列腺周围解剖结构提供了新的证据。本综述的目的是描述我们进行机器人辅助根治性前列腺切除术的方法。我们提供了对患者选择、术前和术后护理的整体观点。在我们中心,机器人辅助根治性前列腺切除术采用顺行入路进行。采用分级保留神经的方法进行非保留膀胱的解剖。手术最后进行我们所谓的“全解剖重建”。