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Falavolti et al. Early vascular control in robotic surgery

cases of pelvic ischemia manifestation. Nevertheless, prostate for prostate greater than 80 mL. Urology 2010;76:958-61.
robotic-assisted laparoscopic simple prostatectomy is 5. Alivizatos G, Skolarikos A, Chalikopoulos D, Papachristou C,
considered a new surgical approach and prospective Sopilidis O, Dellis A, Kastriotis I, Deliveliotis C. Transurethral
photoselective vaporization versus transvesical open enucleation
future comparative studies are needed to determine for prostatic adenomas > 80 mL: 12-mo results of a randomized
the efficacy of this procedure. Our paper showed the prospective study. Eur Urol 2008;54:427-37.
preliminary results of robotic assisted laparoscopic 6. Sergi F, Falavolti C, Bove AM, Buscarini M. Robotic-assisted
simple prostatectomy with temporary internal iliac laparoscopic simple prostatectomy and bladder diverticulectomy
arteries clamping and we believe that this approach with temporary clamping of internal iliac arteries. J Robot Surg
could be a safe surgical option for the treatment of large 2014;8:81-3.
prostatic adenomas (> 80 mL) reducing the estimated 7. Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M,
Fagin R. Robotic simple prostatectomy. J Urol 2008;179:513-5.
blood loss and decreasing needed postoperative care. 8. Madersbacher S, Alivizatos G, Nordling J, Sanz CR, Emberton M, de
la Rosette JJ. EAU 2004 guidelines on assessment, therapy and follow-
In conclusion, the surgical treatment of large prostatic up of men with lower urinary tract symptoms suggestive of benign
adenomas remains a controversial issue. The minimally prostatic obstruction (BPH guidelines). Eur Urol 2004;46:547-54.
invasive approach for BPH is replacing open surgery. 9. Tubaro A, Carter S, Hind A, Vicentini C, Miano L. A prospective study
Both laparoscopic and robotic techniques have of the safety and efficacy of suprapubic transvesical prostatectomy in
benefits. We propose robotic assisted laparoscopic patients with benign prostatic hyperplasia. J Urol 2001;166:172-6.
simple prostatectomy with early vascular control as 10. Jhanwar A, Sinha RJ, Bansal A, Prakash G, Singh K, Singh V.
Outcomes of transurethral resection and holmium laser enucleation in
technique able to associate the benefits of minimally more than 60 g of prostate: a prospective randomized study. Urol Ann
invasive surgery with those of minimal estimated blood 2017;9:45-50.
loss. We believe that this approach could be a safe 11. Naspro R, Gomez Sancha F, Manica M, Meneghini A, Ahyai S, Aho
surgical option for the treatment of large prostatic T, Fiori C, Vavassori I, DA Pozzo LF, Pansadoro V, Montorsi F,
adenomas (> 80 mL) especially for surgeons at the Herrmann TR. From “gold standard” resection to reproducible “future
beginning of their learning curve. standard” endoscopic enucleation of the prostate (EEP): what we
know about anatomical enucleation. Minerva Urol Nefrol 2017; doi:
10.23736/S0393-2249.17.02834-X.
Authors’ contributions 12. Reich O, Gratzke C, Stief CG. Techniques and long-term results of
Original idea and data collection: C. Falavolti surgical procedures for BPH. Eur Urol 2006;49:970-8.
Data and statistical analysis: T. Petitti 13. Mariano MB, Graziottin TM, Tefilli MV. Laparoscopic prostatectomy
Drafting of the text: M. Buscarini with vascular control for benign prostatic hyperplasia. J Urol
2002;167:2528-9.
Financial support and sponsorship 14. Porpiglia F, Terrone C, Renard J, Grande S, Musso F, Cossu M, Vacca
None. F, Scarpa RM. Transcapsular adenomectomy (Millin): a comparative
study, extraperitoneal laparoscopy versus open surgery. Eur Urol
2006;49:120-6.
Conflicts of interest 15. McCullough TC, Heldwein FL, Soon SJ, Galiano M, Barret E,
There are no conflicts of interest. Cathelineau X, Prapotnich D, Vallancien G, Rozet F. Laparoscopic
versus open simple prostatectomy: an evaluation of morbidity. J
Patient consent Endourol 2009;23:129-33.
The informed consent was obtained from all patients. 16. Oktay B, Koc G, Vuruskan H, Danisoglu ME, Kordan Y. Laparoscopic
extraperitoneal simple prostatectomy for benign prostate hyperplasia:
Ethics approval a two-year experience. Urol J 2011;8:107-12.
This article is waived for ethical approval in authors’ 17. Yuh B, Laungani R, Perlmutter A, Eun D, Peabody JO, Mohler
affiliations. JL, Stricker H, Guru KA. Robot-assisted Millin’s retropubic
prostatectomy: case series. Can J Urol 2008;15:4101-5.
18. John H, Bucher C, Engel N, Fischer B, Fehr JL. Preperitoneal robotic
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