Robotic Millin's Prostatectomy: Revisiting an age-old technique for treating benign prostate hyperplasia in large glands

Abstract

The surgical management of large benign prostates above 100 ml remains a challenge. Various guidelines recommend Holmium laser enucleation of the prostate (HOLEP), Bipolar TURP, Thulium laser VapoEnucleation Prostate (ThuVEP), and open prostatectomy for gland size more than 80ml. 1 – 3 Open prostatectomy is less favoured due to increased transfusion rates, complications, and prolonged hospital stay. 4 As a result, the experience in open Millin ’ s prostatectomy has dwindled with most of the procedures being done by minimally invasive methods. Although laser enucleation of the prostate is established as a standard treatment option, the limitations are the steep learning curve, limited availability of the equipment, and prolonged stress urinary incontinence. 5