Radical Prostatectomy Surgical Perspectives 1st edition by James Eastham, Edward Schaeffer – Ebook PDF Instant Download/Delivery: 1493946579 , 978-1493946570
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ISBN 10: 1493946579
ISBN 13: 978-1493946570
Author: James Eastham, Edward Schaeffer
Radical Prostatectomy: Surgical Perspectives provides surgeons with a comprehensive overview of the anatomical approach to radical prostatectomy, whether done through an open (retropubic) or robotic-assisted laparoscopic approach. All chapters are structured to provide a step-by-step approach to the most technically demanding and most common oncologic procedure in urology surgery. The book includes highly practical presentations of typical surgical patients seen in the clinical practice of urology and relies heavily on illustrations and intraoperative photographs to clearly complement the text. In addition, the book includes a detailed description of the management of uncommon but potentially serious intraoperative complications, including major vascular injury, ureteral transaction, and rectotomy.
Written by authors from a variety of integrated disciplines, including anesthesia, cardiology, and nursing Radical Prostatectomy: Surgical Perspectives is a unique and valuable resource in the field of urology both for those currently in training and for those already in surgical practices.
Radical Prostatectomy Surgical Perspectives 1st Table of contents:
1: Surgical Anatomy
Surgical Neuroanatomy of the Male Pelvis
Sympathetic
Parasympathetic
Somatic
Pudendal Nerve
The Pelvic Plexus and Neurovascular Bundle (NVB)
Course of the NVB (Fig. 1.5)
Functional Compartmentalization of the NVB
Are There Parasympathetic Nerves Outside of the NVB?
Immunohistochemical Study of the Cavernous Nerves in the Periprostatic Region
Results
Parasympathetic Nerve Fibre Distribution (Table 1.1)
Do the Anterior Parasympathetic Nerves Innervate the Corpora Cavernosa?
Nerve Quantification: Numerical vs. Surface Area
Relationship of Pelvic Fascial Layers to Nerve-Sparing Prostatectomy
Endopelvic Fascia (EPF)
Periprostatic Fascia
Anterior Periprostatic Fascia (Visceral Endopelvic Fascia)
Lateral Periprostatic Fascia
Posterior Prostatic Fascia and Seminal Vesicles Fascia (Denonvilliers’ Fascia)
Prostate Capsule
Surgical Planes of Dissection
Intrafascial Dissection
Interfacial Dissection
Extrafascial Dissection
Non-nerve-Sparing Dissection
Vascular Anatomy
Arterial Supply of the Prostate
Accessory Pudendal Arteries (APA)
APA Can Be Divided into Two Categories: Apical APA or Lateral APA
Lateral Accessory Arteries
Apical Accessory Arteries
Must We Preserve the APA?
Dorsal Vascular Complex (DVC)
Urethral–Sphincter Complex
External Urethral Sphincter (EUS)
Inner Urethral Sphincter (IUS)
Relationship of Sphincters to Pelvic Floor
The Urogenital Diaphragm Does Not Exist
Innervation of the Membranous Urethra
Autonomic Innervation of the IUS
Somatic Innervation of the EUS
Does the Rhabdosphincter Have Autonomic Innervation?
Pubovesical (Puboprostatic) Ligaments
Variability of Prostate Apex and Impact on Preservation of Urethral Length
References
2: Anesthetic Considerations: Open Versus Minimally Invasive Surgery
Preoperative Evaluation
Preoperative History and Physical Examination
Cardiac Evaluation
Pulmonary Evaluation
Other Organ Systems
Reducing the Risk of Perioperative Infection
Preoperative Testing
Intraoperative Management
Anesthetic Concerns
Cerebral Effects
Cardiovascular Effects
Pulmonary Effects
Positioning Concerns in Steep Trendelenburg
Complications of Steep Trendelenburg and Pneumoperitoneum
References
3: Patient Positioning; Incision/Port Placement
Positioning
Positioning for RALRP
Positioning for Radical Retropubic Prostatectomy
Incisions
Port Placement for RALRP
Incision for RRP
References
4: Pelvic Lymph Node Dissection for Prostate Cancer
Introduction
Prostatic Lymphatic Drainage, Preoperative Imaging, and the Sentinel Node
Extent of Pelvic Lymph Node Dissection
Can Adequate PLND be Performed Using a Robotic Approach?
Complications
Who Should Receive a PLND?
Therapeutic Benefit of PLND
Surgical Technique of Robot-�Assisted Pelvic Lymph Node Dissection
References
5: The Transperitoneal Robotic-�Assisted Radical Prostatectomy
Preoperative Considerations
Transperitoneal Versus Extraperitoneal Approach
Instrumentation for Transperitoneal Robotic-Assisted Radical Prostatectomy
Robotic Instruments
Surgical Assistant Laparoscopic Instruments
Trocars
Sutures
Access and Trocar Configuration (Fig. 5.1)
Dropping the Bladder, Entry into the Space of Retzius
Bladder Neck Sparing Dissection
Seminal Vesicle and Posterior Dissection
Lateral Pelvic Fascia Separation and Development of the Anterior Prostatic Contour
Lateral Vascular Pedicle Ligation
Athermal, Antegrade Neurovascular Bundle Release
Apical Dissection and Selective Suture Ligation of the Dorsal Vein Complex
Anastomosis
Lymph Node Dissection
Wound Closure
References
6: Robotic-Assisted Radical Prostatectomy: A Surgical Guide to the Extraperitoneal Approach
Background
How-to-Guide
Patient Positioning and Port Placement
The Extraperitoneal Space
Pelvic Lymph Node Dissection
Radical Prostatectomy
Special Considerations
References
7: Open Radical Retropubic Prostatectomy
Introduction
Preoperative Assessment
Pelvic Lymph Node Dissection
Surgical Technique for RP
Dorsal Vascular Complex
Nerve Sparing
Early Lateral Release of the NVB
Retrograde Release of the NVB
Planes of Dissection of NVBs
Apical Dissection and Urethral Division (Anastomotic Sutures)
Posterior Dissection of Lateral Vascular Pedicle and Excision of Seminal Vesicles
Bladder Neck Division and Reconstruction
The Specimen
Postoperative Care
The Surgeon
Complications
Cancer Control After Radical Prostatectomy
Conclusion
References
8: Salvage Robotic-Assisted Laparoscopic Radical Prostatectomy
Introduction
Background
Patient Selection
Preoperative Patient Counseling and Preparation
Operative Technique
Exposure of the Prostate, Dissection of the Bladder Neck and Seminal Vesicles
Development of the Posterior Plane and Control of the Pedicle
Apical Dissection and Division of the Urethra
Node Dissection
Vesicourethral Anastomosis
Undocking of the Robot
Postoperative Care
Complications
Oncologic Outcomes
Functional Outcomes
Summary
References
9: Open Salvage Radical Prostatectomy for Recurrence of Prostate Cancer after Radiation Therapy
Introduction
Post-radiation Prostate Biopsy
Salvage Radical Prostatectomy
Technique of Open Salvage Radical Prostatectomy
Patient Positioning and Initial Incision
Pelvic Lymph Node Dissection
Mobilization of the Prostate and Control of the Dorsal Vein Complex
Lateral Dissection (Neurovascular Bundle)
Division of the Urethra, Placement of Anastomotic Sutures, Dissection of the Prostate Off the Rectum
Seminal Vesicles
Management of Rectal Injury
Conclusion
References
10: Challenging Cases in Robotic Radical Prostatectomy
Introduction
Obese Patient
Large Prostate
Bladder Neck Identification and Transection
Bladder Neck Reconstruction
Management of Median Lobe
Previous Bladder Outlet Surgery
Prior Hernia Repair
Prior Abdominal/GI Surgery
Extended Lymphadenectomy
References
11: Postoperative Management: Erectile Function
Introduction
Prevalence of Post-prostatectomy Erectile Dysfunction
Pathophysiology of Post-�prostatectomy ED
Measurement of Erectile Function
Post-prostatectomy ED Treatment
PDE-5 Inhibitors
Intracavernosal Injection Therapy
Vacuum Erection Device
Intraurethral Suppositories
Combination Therapy
Penile Prostheses
Penile Rehabilitation
Future Directions
Surgery
Medications
Other Strategies
Conclusion
References
12: Postoperative Management and Preoperative Considerations: Urinary Incontinence and Anastomotic
Introduction
Preoperative Evaluation
Natural History of Post-�prostatectomy Voiding Function
Urinary Incontinence
Risk Factors
Demographic Risk Factors
Disease Specific Risk Factors
Technique Related Risk Factors
Management of Post-�prostatectomy Urinary Incontinence
Conservative Management
Pelvic Floor Muscle Exercises/Behavior Modifications
Biofeedback
Management of UUI
Surgical Management of SUI
Endoscopic Management/Urethral Bulking Agents
Male Slings
Artificial Urinary Sphincter
Anastomotic Stricture
Risk Factors
Diagnosis
Management
Conclusion
References
Index
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Tags: James Eastham, Edward Schaeffer, Radical Prostatectomy