Robotic Simple Prostatectomy

Simple prostatectomy (SP) is performed for benign prostatic enlargement causing lower urinary tract symptoms (LUTS). While smaller glands requiring surgical treatment are usually addressed with an endoscopic approach in a procedure called transurethral resection of prostate (TURP), glands exceeding 100 grams are ideally suited for SP. There is no upper prostate size limit that is amenable to a robotic approach with glands greater than 300 grams being routinely treated in the fashion. During SP the entire overgrown prostate adenoma is enucleated in one piece leaving only the transition zone shell of the prostate. SP has been widely performed for more than a half century and remains the best surgical treatment for the massively enlarged prostate. It offers the greatest improvement in urine flow rate, complete bladder emptying and the most durable outcome. Like all major urologic surgery it was historically performed through an open approach. Since 2010 these surgeries are all performed by Dr. Berkman through a robotic approach. The many benefits of robotic surgery are seen as well during a robotic SP, however the impact the robotic approach on reduced blood loss as compared to open SP is most profound. Typically robotic SP results in only one-tenth the blood loss of a comparable open SP. This essentially eliminates the risk of blood transfusion. During a robotic approach bladder stones of any size can be easily removed directly from the bladder. Bladder diverticulum, which are commonly associated with the massively enlarged prostate and bladder outlet obstruction, can also be easily removed through a robotic approach at the same time as SP.