A novel technique of robotic radical prostatectomy with combined anterior-posterior approach to preserve early continence mechanism – A feasibility study


A major secondary goal of robotic radical prostatectomy (RARP) especially in Indian social context is continence. We report a new technique of RARP with a combined anterior-posterior approach involving anatomic preservation of continence mechanism.

Thirteen patients with localized prostate cancer underwent this procedure. Posterior dissection, bilateral lymphadenectomy, and bladder drop was done in a standard fashion; then bladder neck was divided without opening the endopelvic fascia. With subsequent division of prostate pedicles, rest of the dissection proceeded in the Bocciardi’s plane without division of puboprostatic collar or the Santorini’s plexus. Unilateral or bilateral nerve-sparing procedures were done depending upon the pre-operative and intra-operative findings. Anterior reconstruction was done at the end of the procedure. Complications were reported using the Clavien-Dindo classification.

This video erned the second prize for the best surgical video at North American Robotic Urology Symposium (NARUS) at Las Vegas, February, 2017. Robotic Surgery video with CT Scans, Photos, PPT’s, 07:54