#Robotic simple #prostatectomy (Millin #technique). •How often do you consider it for #large prostates/#BPH? If this is the case, which is your PVol cut-off/indication? •Do you believe that the #tenaculum robotic #forceps substantially help? ▶️ the 🎥 below 👇🏼

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg I do HoLEP irrespective of prostate size… we have a robot but never needed to do simple robotic…

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg I get it, but you are a #master in HoLEP, Sir. Your results with HoLEP are rarely reproducible 😅

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg I use Freyer's technique and robotically the ease with which gland comes out gives u a great satisfaction. 🌀🌀 We take ⬆️ 150 gms as cut off. Never used tenaculum for this purpose. 😎

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg I usually use transvesical Retzius sparing approach for robotic simple prostatectomy. No cut off for volume. Biggest prostate has been 575 gr. We have been doing this for the past 8 years. More than 100 cases.

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg Great video 👏🏾👏🏼. Robotic simple prostatectomy is my favorite technique ( although transvesical using @TempleUrology @md_eun @MichaelStaehler technique ) when > 120cc. Tenaculum helps but I use it mostly at the end to pull the gland when doing the apex

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg @TempleUrology @md_eun @MichaelStaehler Thank you! Unfortunately I do not have the robotic tenaculum. I guess it helps a lot at avoiding injuries to the adenoma while grabbing/pulling it. I love the #minimallyinvasive duplication of the Millin’s technique that I learnt from Prof. @PorpigliaF.

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg I am an enucleation guy and don'thave a robot, so my response would be biased. But watching your great video I think that in very big glands (>150), w/wo big duverticula ) in the hands of experts, with the technology available it is an excellent indication. Congratulations!

Thank you very much 🙏🏻🙏🏻🙏🏻 Indeed I believe that the cut-off you mentioned is the perfect one. With >150 grams prostates, indication to endoscopic enucleation starts to be jarring. Costs of robotics are prohibitive versus endoscopy, but surgery is faster (no time consuming/boring morcellation needed), and postoperative course comparable at such grams.

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg Over 160-200ml. Yes #tenaculum helps.

@ERUSrobotics @MatteoVittori @CILR2024 @socroboticsurg @JRobotSurg @SocietySURS @EAU_uroluts @EstevaolimaLima @ab_medica @IntuitiveSurg Agree with you, Sir. Over 150 ml endoscopic enucleation is more likely to cause longer-term SUI.