Fabricio BC, Ronaldo D, Alexandro da Silva E, Figueiredo TF, Celso Lara C, Fernanda P, Emanuel FC and Henrique M
Background: This study aimed to reproduce the anterograde technique used in minimally invasive robotic and laparoscopic radical prostatectomy through an open retropubic approach without increasing procedural complexity or cost. The main surgical steps of this technique follow the recommendations of the 2012 Pasadena Consensus Panel for Robotic Surgery modified by the authors to adapt to open retropubic approach.
Methods: Ten consecutive eligible men with localized prostate cancer underwent open anterograde anatomic radical retropubic prostatectomy with urethrovesical anastomosis by running suture, consistent with the Pasadena consensus procedure for robotic radical prostatectomy.
Results: All procedures were completed as planned (mean procedure duration, 145.5 min; hospital stay, 3.4 days with 3 days of suction drainage; duration of indwelling vesical catheterization, 8 days). At the 1-year follow-up, all patients achieved oncological control. Eight patients (80%) achieved urinary continence within 90 days; five (50%) were continent immediately after indwelling catheter removal. Four minor complications occurred (Clavien-Dindo grade I and IIIa).
Conclusion: Open anterograde anatomic radical retropubic prostatectomy allowed the accomplishment of the same technique used in the minimally invasive surgery through the open approach. However, it is necessary to confirm these results through a study with an adequate number of patients comparing with the gold standard technique.