Application of 5-Aminolevulinic Acid-mediated Photodynamic Diagnosis to Robot-assisted Laparoscopic Radical Prostatectomy

ObjectiveTo determine the appropriate resection margin, we performed photodynamic diagnosis (PDD) mediated by 5-aminolevulinic acid (ALA; ALA-PDD) during robot-assisted laparoscopic radical prostatectomy (RALP).Materials and MethodsWe performed ALA-PDD during RALP using da Vinci S Surgical System in 6 patients. The function of TilePro multi-image stereo-viewer enables simultaneous 2-tiered display of the real surgical field by the da Vinci S Surgical System and the ALA-PDD endoscopic system in surgeon console. The resection margins of prostate were biopsied under the observation of ALA-PDD and assessed pathologically.ResultsThe process of ALA-PDD during RALP was proceeded favorably in all the 6 patients. All 22 biopsy specimens obtained from resection margin of prostate demonstrated fluorescence-negative inside the body and also pathologically confirmed negative findings in malignancy. Moreover, no perioperative complications were observed through all procedures of ALA-PDD in all the 6 patients.ConclusionWe presented particularly that application of ALA-PDD during RALP, as a novel and practical technique for decision of the correct resection margin.