Practical solutions for challenging robotic prostatectomy cases

Robot Assisted Laparoscopic Radical Prostatectomy (RALP) has gained widespread uptake as the most common technique in the surgical management of Prostate Cancer (PCa). RALP is currently applied to a broad range of patient phenotypes, and one may encounter challenging variants in normal anatomy but also past surgical scenarios that pose technical challenges. As the indications for RALP have also become broadened to the inclusion of high-risk disease and salvage scenarios, so too is the requirement for technical adaptation of the robotic surgeon. Herein we present challenging scenarios and practical solutions related to variations in normal anatomy, prior surgery, high risk prostate cancer and salvage RALP.