RESUMEN
ABSTRACT: Objective: The robotic-assisted approach to simple prostatectomy (RASP) was conceived, essentially reproducing the fundaments of open simple prostatectomy. Since the first report, RASP underwent several technical modifications. The study aims to identify and describe the current robotic surgery techniques to approach benign prostatic hyperplasia (BPH). METHODS: The paper performed a non-systematic literature review accessing PubMed and Embase databases for all full-text articles published from 2008 to May 2020, assessing robot-assisted surgical techniques for BPH treatment using the terms "robot-assisted simple prostatectomy" OR "robotic simple prostatectomy" OR "RASP" AND "surgical technique". RESULTS: After careful review of 180 studies in PubMed and 198 in Embase, 16 papers reporting different RASP techniques. After the first procedure described by Sotelo et al. [9], several authors contributed to the development of the RASP technique. John et al. [24] proposed the extraperitoneal access, and Yuh et al. [23] first reported the adenoma transcapsular dissection. Some modifications were proposed by Coelho et al. [31] on trigonization, posterior reconstruction, and urethro-vesical anastomosis. Other groups focused on urethral-preserving procedures. Moschovas et al. [28] and Clavijo et al. [32] recently described an intrafascial RASP with the removal of the entire prostatic tissue. Finally, Kaouk et al. [29] reported the feasibility and safety of the da Vinci Single Port approach. CONCLUSION: In the last eighteen years, the robotic-assisted approach to BPH disease has been evolved, and different techniques have been described. This review details all the technical developments on RASP that distinctive groups have proposed since the multiport robotic platforms until the new da Vinci Single Port.
RESUMEN
Techniques that attempt to further reduce the morbidity and improve cosmesis of laparoscopic surgery have particularly generated interest. Since its initial urologic description in 2007, there has been a surge of interest in laparoendoscopic single-site surgery, which is now an emerging technique within the field of minimally invasive urologic surgery. This report describes a preliminary experience with single-site video endoscopic inguinal lymphadenectomy (SSVEIL) compared with conventional video endoscopic inguinal lymphadenectomy (VEIL) on inguinal nodes management in a 45-year-old man with pT(2) grade 2 squamous cell penile carcinoma and impalpable inguinal nodes. VEIL with saphenous vein preservation in the left leg and SSVEIL on the other side presented no difference concerning operative time (100 vs 120 min), blood loss (50 mL), drainage volume, number of nodes retrieved (8), pain, and oncologic outcome. The patient had an uneventful postoperative course, was discharged 12 hours after the procedure, and preferred the aesthetic result of SSVEIL. Further refinements in technology will likely alleviate many of the persistent technical problems. Additional rigorous comparison studies are needed to evaluate the true benefits of the technique and the extent of its clinical application, mainly oncologic results, before the widespread adoption of SSVEIL. Ultimately, advance breakthroughs in fields of in-vivo instrumentation, robotics, and purpose-built robotic platforms will bring its potential to full clinical realization.