Controlled regional hypothermia is a well-established technique that has been utilized to limit the inflammatory cascade common to all surgical procedures (1-7).
Pelvic hypothermia, achieved via an endorectal cooling device, has previously been shown to result in earlier pad-free urinary continence (8, 9). Here, we describe a novel method of achieving pelvic hypothermia. Additionally, a potential drawback of robot assisted radical prostatectomy (RARP) is the lack of tactile feedback and ability to assess possible tumor margins (10, 11). This might compromise the oncological control particularly in high-risk disease patients (12). In an effort to overcome this drawback, we developed a modified technique of RARP that allows immediate organ retrieval for intra-operative examination and targeted frozen-section biopsies. ICE (Intra-corporeal cooling and extraction) consists of a modification of the standard RARP technique (13-15) with the use of the GelPOINTTM (Applied Medical, Rancho Santa Margarita, CA), a hand access platform, which allows for delivery of ice-slush and rapid specimen extraction without compromising pneumoperitoneum. Here we narrate these modifications in a step-by-step manner.
Written by:
Jeong W, Sood A, Ghani KR, Pucheril D, Sammon JD, Gupta NS, Menon M, Peabody JO. Are you the author?
Vattikuti Urology Institute, Department of Urology, 2Department of Pathology, Henry Ford Health System, Detroit, MI, USA.
Reference: BJU Int. 2013 Nov 18. Epub ahead of print.
doi: 10.1111/bju.12573
PubMed Abstract
PMID: 24238369
UroToday.com Prostate Cancer Section
