ABSTRACT
Introduction In November 2000, the development of robotic radical prostatectomy using the da Vinci surgical system (Intuitive Surgical, Mountain View, CA) began at Henry Ford Hospital. The da VinciTM
combination of three-dimensional magnified vision and wristed instrumentation provided the rationale for incorporating this technology into radical prostatectomy surgery. A structured program was developed to accomplish this goal.1 The first step was to gain experience with the laparoscopic radical prostatectomy techniques developed by Guillonneau and Vallencien.2 Two surgeons from Henry Ford spent a month at L’Institut Mutualiste Montsouris learning laparoscopic skills from a trainer in the animal laboratory and observing 50 laparoscopic radical prostatectomy (LRP) cases performed without robotic assistance. The French surgeons then trained the Henry Ford team in Detroit for 50 additional LRP cases. Our initial robotic prostatectomy procedures closely mimicked the Montsouris laparoscopic procedure. We have, however, made several modifications to our technique over the past 4 years, the most significant being the abandonment of the initial dissection of the seminal vesicles, technique of apical dissection, neurovascular bundle dissection, and vesicourethral anastomosis.3-5 To date, we have performed about 1200 robotic surgeries at our medical center, of which over 1000 have been Vattikuti Institute prostatectomy (VIP). We describe our current technique and provide insight into the lessons we have learned developing robotic radical prostatectomy.
