An Extremely Difficult Radical Prostate Cancer Surgery Was Completed at Shanghai General Hospital

Recently, the team of Han Bang Min, director of our urology clinical center, performed an extremely difficult radical prostate cancer surgery using the "Da Vinci" robot. The patient had 11 surgical scars on the abdominal wall and chest wall due to various diseases. Conventional laparoscopic and robotic surgical approaches were not even accessible at the operative level. The surgical team used a single 3 cm hole as an access point to avoid the adhesions caused by the 11 scars, and completed this ultra-hard single-hole extraperitoneal "Da Vinci" robotic radical prostate cancer surgery in just one hour.

The patient was diagnosed with prostate cancer at early stage , but when he lifted his shirt, Dr. Jing Yifeng was surprised. The actual patient had 11 large and small surgical scars, like centipedes, all over his chest and abdomen because of repeated chest wall abscess incision and drainage, radical colon cancer surgery, colon stoma retraction and bilateral open hernia repair! It is foreseeable that the patient's abdominal cavity must be full of adhesions, and it is highly likely that the conventional access for radical prostate cancer surgery will not be able to enter the prostate operation level at all. Even if access is forced, the risk of intraoperative organ damage is greatly increased by separating the adherent tissues. In this case, should radical prostate cancer surgery still be performed?

Feeling the patient's strong desire to live, Han Bangmin, director of the Urology Clinical Medical Center, and Jing Yifeng, deputy director of the Prostate Department (North) of the Urology Clinical Medical Center, actively evaluated the patient's condition and agreed that the only way to perform the surgery was with the single-port "Da Vinci" robotic surgery, which has a small access point to avoid the adhesion scars. Of course, this posed higher demands on the operator, as the small single-port operating space would greatly limit the rotation and movement of the lumpectomy arm. After repeated communication with the patient and with the support of the relevant functional departments, operating room and anesthesia department, Han Bangmin's team finally decided to perform a single-port robotic laparoscopic radical prostate cancer surgery and to grip the hard bone!

On the day of surgery, with the cooperation of the operating room and the anesthesiology department, the patient quickly completed the preoperative preparation. After careful evaluation and preparation, the surgical team performed precise positioning through the field of view of the "Da Vinci" robot to fully expose the surgical field. In the patient's heavily adhered abdominal cavity, almost the only possible area of operation was found in the lower abdomen. The surgical team then entered the abdominal cavity through a small incision of only 3 cm, carefully avoiding the adhesive scar and precisely removing the patient's lesion. One hour later, the surgery was successfully completed with almost no bleeding and the patient's vital signs were stable during the operation. As of press time, the patient had recovered and was discharged from the hospital.

The operation demonstrated the superb diagnosis and treatment level of our urology clinical medical center and the highly responsible and responsible spirit for patients, and also fully reflected the advantages of multidisciplinary cooperation and the comprehensive disciplinary strength of our hospital. Since the first fourth-generation "Da Vinci" robotic surgery in Shanghai in 2019, our hospital has been at the forefront in the field of robotic-assisted laparoscopic surgery, and the successful performance of laparoscopic radical prostate cancer surgery under a single-hole pathway once again demonstrates our leading position in the field of prostate surgery.

Correspondent： Cui Di