Technique of da Vinci robot-assisted anatomic radical prostatectomy.

OBJECTIVES: Robotic radical prostatectomy is a new procedure for treating prostate cancer. Many centers are attempting this new modality but a detailed description of the technique has not yet been published. We report the technique as performed at the Vattikuti Urology Institute.

METHODS: At Vattikuti Urology Institute, we have performed more than 30 such operations and have standardized the technique for safe and reproducible treatment of prostate cancer. We collected the patient data and surgical logs to improve and standardize this procedure. We recorded the operation and made relevant modifications after reviewing the recordings to improve the outcome.

RESULTS: The operation was developed on the scientific foundations of anatomic radical prostatectomy as described by Walsh and the laparoscopic prostatectomy developed at Montsouris. Our technique differs from these procedures because of the need for two surgical teams and the use of fine, endo-wrist instruments with three-dimensional stereoscopic visualization. We describe the patient setup, positioning, port placement, preparation of the robot, docking of the arms, and the surgical steps of performing anatomic prostatectomy with robotic assistance.

CONCLUSIONS: This report describes the current technique of robotic prostatectomy as developed at the Vattikuti Urology Institute.