Retroperitoneal Robotic and Laparoscopic Surgery

Transcription

1 Retroperitoneal Robotic and Laparoscopic Surgery

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3 Jean V. Joseph Hitendra R.H. Patel (Editors) Retroperitoneal Robotic and Laparoscopic Surgery

4 Editors Jean V. Joseph, M.D., M.B.A., Head-Section of Urologic Laparoscopy and Robotic Surgery, Department of Urology Wilmot Cancer Center, Center for Robotic Surgery and Innovation University of Rochester Medical Center Rochester, New York USA Hitendra R.H. Patel, Ph.D., FRCS, Director of Minimal Access Surgery Department of Surgery, Endocrine Women s Health and Urology University Hospital of North Norway N-9038 Tromsø, Norway ISBN e-isbn DOI / Springer Dordrecht Heidelberg London New York British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Control Number: Springer-Verlag London Limited 2011 Whilst we have made considerable efforts to contact all holders of copyright material contained in this book, we may have failed to locate some of them. Should holders wish to contact the Publisher, we will be happy to come to some arrangement with them. Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Cover design: estudiocalamar, Figueres/Berlin Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 Hitendra dedicates this book to all those wonderful people who support the wonderful world we live in by selfless living ( To the contributors to this text, and to our many colleagues who continue to innovate, and to redefine what is accepted as gold standard, for the betterment of our patients. Jean V. Joseph

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7 Foreword I Longevity allows for the witnessing of change and progress over an extended period of time. My personal focus incorporated a period of dramatic technologic advance. From a time when anticipated technology resided in the inventive mind of authors such as Jules Verne and cartoons such as Buck Rogers, the futurists visions have been exceeded by reality. Medicine has shared in an extraordinary evolution. Nowhere is this more apparent than in the realm of Urology. The introduction of the PSA determination has markedly improved the prognosis for a large population of men afflicted with the pervasive disorder of prostatic malignancy. The vistas for technologic innovation were opened by the introduction and rapid acceptance of minimally invasive surgical approaches to the removal of disease. The kidney, adrenal, and prostate presented as logical targets. Subsequently, robotic surgery was developed and advanced throughout the panorama of diverse surgical specialties. No specialty has had a more privileged position, in this regard, than Urology. The editors along with the contributors of this thoroughly current text share their expertise, which is based on a broad personal experience and the critical encounters that they have been exposed to in their pioneering work. As such, their words and accompanying lucid illustrations provide for the readership a compendium that charts a course, which expedites performance, minimizes hazard, and maximizes success in dealing with technical adversity. Seymour I. Schwartz Distinguished Alumni Professor of Surgery University of Rochester School of Medicine and Dentistry vii

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9 Foreword II I am honored that Doctors Joseph and Patel have asked me to write an introduction to their text, Retroperitoneal Robotic and Laparoscopic Surgery. They did so without knowledge of my experience with, or opinion of, robotic and minimally invasive surgery. With regard to the former, as an aging urologist, I have never performed a minimally invasive procedure and therefore can claim a neutral and unbiased stance concerning this technology. With regard to the latter, I can be counted among those in favor of the technology. I have had the opportunity to watch many minimally invasive and robotic procedures as demonstrated in conferences featuring live surgery and at my home hospital where four urologic oncologists in the department perform these procedures. They are all of an age whereby they were trained extensively, and some exclusively with open surgery, but all, specifically with regard to robotic radical prostatectomy, prefer this, and would rue a return to the open approach. This sentiment is virtually universal among open surgeons who have embarked on a minimally invasive/robotic- controlled approach. Minimally invasive surgery has brought all surgical procedures under a microscope demanding more precise recording of intra- and postoperative outcomes. In a relatively short period of time minimally invasive surgery has achieved results parallel to open surgery. I believe the promise for further improvement in outcomes is likely because, unlike open surgery, each step is clearly demonstrated and visualized by any number of viewers before the console, each step can be rigidly standardized, and the future of simulator surgery will provide greater opportunity for support of the adage practice makes perfect. Practice will demand more than performance of an occasional procedure; practice will lead to more adept and therefore more successful performance of surgery with better outcomes and reduction of the traumatic insult. The editors have brought together a timely piece of work, which will truly help current and future surgeons improve their patient outcomes, in the quest of delivering a minimally invasive procedure. Paul F. Schellhammer Professor of Urology Eastern Virginia Medical School ix

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11 Preface Minimally invasive surgery has experienced significant growth over the past decades. When compared to other disciplines, the growth in the urology arena has been unrivaled. Procedures that were routinely done using an open approach have been quickly converted to a laparoscopic approach. Nearly every urological procedure has been performed laparoscopically. From the simple to the most complex, the common theme has been the development of a minimally invasive approach to lessen the collateral damage to adjacent structures. There is hardly a laparoscopic urologic procedure where safety and reproducibility have not been demonstrated. Although laparoscopic urologic procedures are performed worldwide, the growth of minimally invasive urology took a different dimension with the arrival of robot assisted surgery over a decade ago. Many surgeons without laparoscopic skills have successfully made the transition from open to robotic surgery with the goal of providing their patients with an effective yet minimally invasive approach and decreasing the burden associated with surgical interventions. Open abdominal urological procedures evolved from a transabdominal to a retroperitoneal route. Currently the standard open approach to the prostate, whether for benign disease or malignancy, is through the retroperitoneum. Similarly in most open kidney, adrenal, and ureteral cases, the standard approach has been by way of the loin to the retroperitoneal region. However, the vast majority of present day minimally invasive urology is performed transperitoneally. Although these laparoscopic and robotic procedures were initially defined transperitoneally, extraperitoneal approaches have been thoroughly described, with several centers amassing large amount of experience with this technique. For many, the difficulty in adapting to the laparoscopic equipment is compounded by the unrecognizable anatomy of the retroperitoneal space, where the covering preperitoneal loose areolar or fatty tissue makes most structures similar. Our objective is to produce a manual focused on the extraperitoneal space, which has long been the domain of the urologist. We have assembled a number of authors who are leaders in the areas they have covered. Detailed descriptions of the retroperitoneal anatomy, and a variety of procedures, with first hand experiences, or how I do it are reported, followed by key points at the end of the chapters, to help urologists at every stage make the transition to working in the extraperitoneal space, shortening their learning curve. Whether one is using a laparoscopic or robot assisted approach, the extraperitoneal technique remains an excellent method, to approach the target organ avoiding the abdominal cavity. A number of individuals have contributed to bringing this manual to fruition. We are grateful to the contributing authors who have taken time from their busy lives as xi

12 xii Preface surgeons and teachers to share their talent and experience. It is our sincere hope that sharing their expertise will translate into many more of our urological colleagues learning the extraperitoneal technique for the laparoscopic and robot assisted procedures, as they did for open surgical cases. We also wish to express our gratitude to Barbara Lopez-Lucio, Melissa Morton, Denise Roland, and the Springer staff for their tireless support and editorial work they contributed in the preparation of this book. Jean V. Joseph Hitendra R.H. Patel

13 Contents 1 Anatomical Aspects of the Extra and Retroperitoneal Space Ahmed E. Ghazi and Jean V. Joseph 1 2 Essential Instruments in Laparoscopic and Robotic Surgery Ty T. Higuchi and Matthew T. Gettman 9 3 Upper Tract Retroperitoneal Access Techniques Ahmed E. Ghazi and Jean V. Joseph 23 4 Laparoscopic and Robotic Adrenalectomy Edmund Y. Ko, Richard T. Schlinkert, and Mitchell R. Humphreys 37 5 Retroperitoneoscopic Simple and Radical Nephrectomy Guillaume Ploussard, Andras Hoznek, Laurent Salomon, Claude C. Abbou, and Alexandre de la Taille 49 6 Laparoscopic and Robotic Partial Nephrectomy Lori M. Dulabon and Michael D. Stifelman 61 7 Retroperitoneal Robotic Partial Nephrectomy James R. Porter 71 8 Laparoscopic and Robotic Mid and Distal Ureteral Reconstructive Surgery Alireza Moinzadeh Robot-Assisted Laparoscopic Nephroureterectomy Sijo J. Parekattil, Hany N. Atalah, and Li-Ming Su 10 Laparoscopic Pelvic Lymphadenectomy in Prostate Cancer Evangelos Liatsikos, Minh Do, Panagiotis Kallidonis, Iason Kyriazis, Alan McNeil, Roman Ganzer, and Jens-Uwe Stolzenburg 97 xiii

14 xiv Contents 11 Laparoscopic Simple Prostatectomy Xavier Cathelineau, Rafael E. Sanchez-Salas, Eric Barret, Francois Rozet, Marc Galiano, and Guy Vallancien Extraperitoneal Laparoscopic Radical Prostatectomy Sarah P. Psutka and Douglas M. Dahl Robot-Assisted Extraperitoneal Laparoscopic Prostatectomy Thomas T. Hoang, Satya B. Allaparthi, and Ingolf A. Tuerk 141 Laparoendoscopic Single-Site Retroperitoneal Surgery Michael A. White and Jihad H. Kaouk On the Horizon Jean V. Joseph and Hitendra R.H. Patel 165 Index

15 Contributors Claude C. Abbou, M.D., Ph.D. Department of Urology, CHU Mondor, Créteil, France Satya B. Allaparthi, MRCS, M.D. Department of Urology, Caritas St. Elizabeth Hospital, Boston, MA, USA Hany N. Atalah, M.D. Department of Robotic and Minimally Invasive Surgery and Department of Urology, University of Florida, Gainesville, FL, USA Eric Barret, M.D. Department of Urology, Institut Montsouris, Paris, France Xavier Cathelineau, Paris, France M.D. Department of Urology, Institut Montsouris, Douglas M. Dahl, M.D. Department of Urology, Massachusetts General Hospital, Boston, MA, USA Alexandre de la Taille, M.D., Ph.D. Department of Urology, CHU Mondor, Créteil, France Minh Do, M.D., Ph.D. Department of Urology, University of Leipzig, Leipzig, Germany Lori M. Dulabon, D.O. Department of Urology, New York University School of Medicine, New York, NY, USA Marc Galiano, M.D. Department of Urology, Institut Montsouris, Paris, France Roman Ganzer, M.D., Ph.D. Department of Urology, University of Regensburg, Regensburg, Germany Matthew T. Gettman, M.D. Department of Urology, Mayo Clinic, Rochester, MN, USA Ahmed E. Ghazi, M.D., FEBU Department of Urology, University of Rochester Medical Center, Rochester, NY, USA Ty T. Higuchi, M.D., Ph.D. Department of Urology, Mayo Clinic, Rochester, MN, USA Thomas T. Hoang, M.D. Department of Urology, Caritas St. Elizabeth s Medical Center, Tufts University School of Medicine, Houston, TX, USA Andras Hoznek, M.D. Department of Urology, CHU Mondor, Créteil, France xv

16 xvi Mitchell R. Humphreys, M.D. Department of Urology, Mayo Clinic, Phoenix, AZ, USA Jean V. Joseph, M.D., M.B.A. Professor of Urology and Oncology, Head-Section of Urologic Laparoscopy and Robotic Surgery, Department of Urology, Wilmot Cancer Center, Center for Robotic Surgery and Innovation University of Rochester Medical Center, Rochester, New York NY, USA Panagiotis Kallidonis, M.D. Department of Urology, University of Patras, Rion, Patras, Greece Jihad H. Kaouk, M.D. Director, Robotic and Laparoscopic Surgery, Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA Edmund Y. Ko, M.D. Department of Urology, Mayo Clinic, Phoenix, AZ, USA Iason Kyriazis, M.D. Department of Urology, University of Patras, Rion, Patras, Greece Evangelos Liatsikos, M.D., Ph.D. Department of Urology, University of Patras, Rion, Patras, Greece Alan McNeil, M.D., Ph.D. Department of Urology, Western General Hospital, Edinburgh, UK Alireza Moinzadeh, M.D. Institute of Urology, Lahey Clinic Medical Center, Burlington, MA, USA Sijo J. Parekattil, M.D. Department of Urology, University of Florida, Gainesville, FL, USA Hitendra R.H. Patel, Ph.D., FRCS Director of Minimal Access Surgery, Department of Surgery, Endocrine, Women s Health and Urology University Hospital of North Norway, N-9038 Tromsø, Norway Guillaume Ploussard, M.D. Department of Urology, CHU Mondor, Créteil, France James R. Porter, M.D. Surgical Robotics, Department of Urology, Swedish Medical Center, Seattle, WA, USA Sarah P. Psutka, M.D. Department of Urology, Massachusetts General Hospital, Boston, MA, USA Francois Rozet, M.D. Department of Urology, Institut Montsouris, Paris, France Laurent Salomon, M.D., Ph.D. Department of Urology, CHU Mondor, Créteil, France Rafael E. Sanchez-Salas, M.D. Department of Urology, Institut Montsouris, Paris, France Richard T. Schlinkert, M.D. Department of Surgery, Mayo Clinic, Phoenix, AZ, USA Michael D. Stifelman, M.D. Department of Urology, NYU Langone Medical Center, New York University School of Medicine, New York, NY, USA Contributors

17 Contributors xvii Jens-Uwe Stolzenburg, M.D., Ph.D. Department of Urology, University of Leipzig, Leipzig, Germany Li-Ming Su, M.D. Department of Urology, University of Florida, Gainesville, FL, USA Ingolf A. Tuerk, M.D., Ph.D. Department of Urology, St. Elizabeth s Medical Center, Boston, MA, USA Guy Vallancien, M.D. Department of Urology, Institut Montsouris, Paris, France Michael A. White, D.O. Center for Laparoscopic and Robotic Surgery, Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA