Simple Prostatectomy (Open & Robotic)
Simple prostatectomy is the operation for the very large prostate — too big for TURP and a major endurance test even for laser enucleation — removing only the hyperplastic adenoma.
The big picture
Simple prostatectomy is the operation for the very large prostate — the gland too big for TURP and a major endurance test even for laser enucleation. It removes only the hyperplastic adenoma, shelling it out of the surgical capsule, and leaves the rest of the prostate behind — which is the crucial distinction from radical prostatectomy (a cancer operation that removes the whole gland). Once an open operation only, it is now also done robotically.
The framework: "simple" ≠ "radical," the indication (very large gland), the open approaches (suprapubic vs retropubic/Millin) and the robotic alternative.
Mechanism pathway
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Diagnostic algorithm
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Board traps
Simple ≠ radical: simple removes only the adenoma (benign); radical removes the whole gland (cancer).
Indication = very large prostate (>80 g), especially with concurrent bladder stones/diverticulum, or when HoLEP isn't available.
Open suprapubic enters the bladder (good for concurrent bladder pathology); retropubic (Millin) doesn't.
Robotic simple prostatectomy → less blood loss/shorter recovery than open.
Higher blood loss/transfusion risk than endoscopic options (most with open).