Boswell Timothy C, Hebert Kevin J, Tollefson Matthew K, Viers Boyd R
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Transl Androl Urol. 2020 Feb;9(1):121-131. doi: 10.21037/tau.2019.08.22.
Outlet procedures for benign prostatic hypertrophy, prostate cancer therapy, and trauma can result in stenosis of the posterior urethra, a complex reconstructive problem that often fails conservative endoscopic management, necessitating more aggressive and definitive reconstructive solutions. This is typically done with an open technique which may require a combined abdominoperineal approach, pubectomy, and/or flap interposition. Implementation of a robot-assisted platform affords several potential advantages including smaller incisions, magnified field of vision, near-infrared fluorescence (NIRF) imaging to characterize tissue integrity, enhanced dexterity within the deep and narrow confines of the male pelvis, sparing of the perineal planes, and shorter convalescence. Herein, we describe important surgical considerations for robotic posterior urethral reconstruction.
良性前列腺增生、前列腺癌治疗及创伤的出口手术可导致后尿道狭窄,这是一个复杂的重建问题,保守的内镜治疗往往失败,需要更积极、更明确的重建解决方案。这通常采用开放技术完成,可能需要联合腹会阴入路、耻骨切除术和/或皮瓣植入。机器人辅助平台的应用具有几个潜在优势,包括切口更小、视野放大、近红外荧光(NIRF)成像以表征组织完整性、在男性骨盆深部和狭窄范围内增强灵活性、保留会阴平面以及恢复期更短。在此,我们描述机器人辅助后尿道重建的重要手术注意事项。