Robotic Prostatectomy with Pelvic Lymph Node Dissection

Ports

• 8 mm da Vinci ports ×4
• 12 mm AirSeal port ×1
• 5 mm threaded trocar ×1
• First (camera) port: blunt black reusable obturator from the robot set. Remaining ports: bladeless obturators.
• 1% lidocaine plain for port sites.

Robotic instruments

Assistant (PA) instruments

Sutures, in order of use

1. 2-0 V-Loc 9 in, GS-21
2. 2-0 Vicryl SH, cut to 10 inches
3. 4-0 Vicryl RB-1, repair stitch (on call)
4. 3-0 Monocryl ×2 for the anastomosis

Other supplies

Gloves: MD and PA

MD

• Port placement: single 7.5 white.
• Closing: double glove, 7.5 blue under 7.5 white.

PA

• Aimee: 7 blue, 6.5 white
• Carras: 7 blue, 6.5 white
• Heather: 6.5 micro ×2
• John: 7.5 blue, 7 white
• Olivia: 7 blue, 6.5 white

Prep and drape

• Shave the abdomen from the xiphoid to just above the pubic bone.
• ChloraPrep from nipples to pubis, including penis, scrotum and inner thighs.
• Drape with five blue towels secured with Ioban strips.

Catheter and insufflation

• 20 Fr Foley placed on the field; have lubricant and a catheter bag ready.
• 0 Vicryl UR-6 available to limit air leak.
• AirSeal for insufflation in all robotic surgery suites.

Specimens

• 1) Prostate and seminal vesicles
• 2) Bilateral pelvic lymph nodes
• The surgeon personally inspects the specimen before it goes to pathology. Don't send it until then.
• Wound class: II (clean-contaminated).

Undocking and closure

• 12 mm assistant port: close with PMI and 0 Vicryl.
• Camera port: 0 Vicryl UR-6 (open 2, have 3 more on call).
• Skin: 4-0 Vicryl.