Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report
Kuwaijo, N., AbiElmagd, M., Hegarty, N., O'Malley, K., Lynch, T. (2020). Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report. EKB Journal Management System, 2(4), 718-721. doi: 10.21608/ijma.2020.27024.1116
Nabeel Joda Kuwaijo; Mohammed Sayed AbiElmagd; Nicholas Hegarty; Kiaran O'Malley; Thomas Lynch. "Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report". EKB Journal Management System, 2, 4, 2020, 718-721. doi: 10.21608/ijma.2020.27024.1116
Kuwaijo, N., AbiElmagd, M., Hegarty, N., O'Malley, K., Lynch, T. (2020). 'Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report', EKB Journal Management System, 2(4), pp. 718-721. doi: 10.21608/ijma.2020.27024.1116
Kuwaijo, N., AbiElmagd, M., Hegarty, N., O'Malley, K., Lynch, T. Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report. EKB Journal Management System, 2020; 2(4): 718-721. doi: 10.21608/ijma.2020.27024.1116

Robotic-Assisted Laparoscopic Radical Prostatectomy (RALRP) in a Patient with Sever Kyphoscoliosis, Ankylosing Spondylitis: A Case Report

International Journal of Medical Arts
Article 6, Volume 2, Issue 4, October 2020, Page 718-721  XML PDF (258.54 K)
Document Type: Case Report
DOI: 10.21608/ijma.2020.27024.1116
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Authors
Nabeel Joda Kuwaijo email orcid 1; Mohammed Sayed AbiElmagd2; Nicholas Hegarty3; Kiaran O'Malley2; Thomas Lynch2
1Department of Urology, Galway Clinic, Royal College of Surgeons, Ireland
2Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland
3Department of Urology, Mater Misericordiae University Hospital, Dublin, Irel
Abstract
Background: Anatomical abnormalities in kyphoscoliosis [KS] is a huge challenge in patient positioning for robotic prostatectomy. The narrow pelvis limits the range of movement of the robotic instruments’ and port placing could be an issue. Second, carful preoperative assessment prior to administration of anesthesia and pneumoperitoneum in robot-assisted radical prostatectomy [RRP] is crucial to reduce peri-operative cardio-pulmonary complications.
The Case: We report a successful use of robot in a patient with sever kyphoscoliosis for radical prostatectomy. He was a 58 years old male, overweight, with KS and history of cardiac stenting, bilateral total hip replacement. He had prostatic carcinoma. He is on antihypertensive medications, statins and bronchodilator inhalers. Auscultation revealed bronchovascular breathing with left base inspiratory crepitation.  He was Mallampati score III [difficult intubation], recurrent chest infection, and severe restriction of respiratory function.  The management had been performed under general anesthesia, in the supine-Trendelenburg-Lithotomy position before engaging the robot. The operative intervention showed stability of the patient except an episode of hypertension [an hour after starting surgery]. The total operative time [3 hours, 50 minutes]; the patient then transferred to intensive treatment unit for the next 12 hours. Postoperatively, backache is absent, drain removed 24 hours later; patient discharged after 48 hours, and catheter removed 10 days later. Histological examination showed adenocarcinoma of prostate, 35% of the gland with negative surgical margin.
Conclusion: We confirmed that, robotic assisted radical prostatectomy could be handled in Kyphoscoliosis,Ankylosing Spondylitis with satisfactory outcome, irrespective of both technical and anaesthetic difficulties
Keywords
Robotic; Radical Prostatectomy; Kyphoscoliosis; Ankylosing Spondylitis; Case report
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