Robotic Assisted Laparoscopic Pelvic Surgery in Patients with pre-existing Prosthetic Reservoir
Harish Talla MD, Naveen Kella MD, Urology San Antonio, San Antonio, TX
Robotic surgery is minimally invasive surgery, which has opened newer horizons of pelvic surgeries. It is widely accepted among surgeons that they often have to operate upon patients with prior pelvic surgeries, and such cases may become challenging when a foreign object is encountered. Establishing the usual landmarks becomes difficult and harm to the foreign object could occur. In this video we are suggesting a few key steps to manage the reservoir in a patient with a pre-existing inflatable penile prosthesis. Safe dissection minimizes risk of an infection or malfunction due to violation of the neocapsule surrounding the reservoir. The key points of the suggested technique are decompressing the bladder using a small Foley catheter and deflating the reservoir causing artificial erection prior to the start of surgery. Doing dissection away from the reservoir helps establish anatomical landmarks, which helps with orientation when dissecting around the reservoir. Towards the end of procedure, the reservoir is reinflated to confirm its integrity and reduce the artificial erection.
Harish Talla MD, Naveen Kella MD, Urology San Antonio, San Antonio, TX
Robotic surgery is minimally invasive surgery, which has opened newer horizons of pelvic surgeries. It is widely accepted among surgeons that they often have to operate upon patients with prior pelvic surgeries, and such cases may become challenging when a foreign object is encountered. Establishing the usual landmarks becomes difficult and harm to the foreign object could occur. In this video we are suggesting a few key steps to manage the reservoir in a patient with a pre-existing inflatable penile prosthesis. Safe dissection minimizes risk of an infection or malfunction due to violation of the neocapsule surrounding the reservoir. The key points of the suggested technique are decompressing the bladder using a small Foley catheter and deflating the reservoir causing artificial erection prior to the start of surgery. Doing dissection away from the reservoir helps establish anatomical landmarks, which helps with orientation when dissecting around the reservoir. Towards the end of procedure, the reservoir is reinflated to confirm its integrity and reduce the artificial erection.
