MARIONETTE TECHNIQUE FOR ROBOTIC TRANS-VESICAL SIMPLE PROSTATECTOMY

You have accessJournal of UrologyBPH & Bladder Outlet Obstruction (V08)1 Apr 2020V08-11 MARIONETTE TECHNIQUE FOR ROBOTIC TRANS-VESICAL SIMPLE PROSTATECTOMY Kirolos N. Meilika, Alp Tuna Beksac*, Kennedy Okhawere, Bheesham Dayal, Olajumoke Ige, and Ketan Badani Kirolos N. MeilikaKirolos N. Meilika More articles by this author , Alp Tuna Beksac*Alp Tuna Beksac* More articles by this author , Kennedy OkhawereKennedy Okhawere More articles by this author , Bheesham DayalBheesham Dayal More articles by this author , Olajumoke IgeOlajumoke Ige More articles by this author , and Ketan BadaniKetan Badani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000909.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In this video we demonstrate the Marionette Technique in robotic trans-vesical simple prostatectomy. METHODS: This technique is demonstrated in a 75-year-old male with 300 cc prostate undergoing a robotic trans-peritoneal and trans-vesical simple prostatectomy. After insufflation of bladder with air, the cystotomy incision is made, then 4 quadrant sutures were applied to the cystotomy edges and secured to the peritoneum using sliding hem-o-lok clips. The marionette technique allows for dynamic exposure of the bladder neck and prostatic fossa under control of the robotic console surgeon. After achieving a good trans-vesical exposure, the enlarged median prostatic lobe is grasped and the overlying mucosa is incised, the plane between the adenoma and the capsule is identified and carried out all around the gland. After removal of the adenoma the fossa is checked for any source of bleeding, and complete circumferential mucosa to mucosa anastomosis between the bladder neck and the urethra is completed. The 4 Marionette sutures are then removed one a time and the cystotomy is closed in 2 layers. RESULTS: We used this technique during robotic trans-vesical prostatectomy for 50 patients up to a prostate size of 400 cc.The demographic and outcome details are shown in the table. CONCLUSIONS: The Marionette Technique is very efficient approach for trans-vesical exposure during simple prostatectomy. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e738-e738 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kirolos N. Meilika More articles by this author Alp Tuna Beksac* More articles by this author Kennedy Okhawere More articles by this author Bheesham Dayal More articles by this author Olajumoke Ige More articles by this author Ketan Badani More articles by this author Expand All Advertisement PDF downloadLoading ...