Aktuelle Urol 2003; 34(4): 231-233
DOI: 10.1055/s-2003-41602
Original Article
© Georg Thieme Verlag Stuttgart · New York

Laparoscopic Radical Retropubic Prostatectomy Combined with Approaches through a Small Open Incision

Laparoskopische radikale retropubische Prostatektomie kombiniert mit Zugang durch kleine offene InzisionH.  Ishida1 , T.  Yoshida1 , K.  Okada1 , Y.  Takimoto1
  • 1Department of Urology, Nihon University School of Medicine, Tokyo, Japan
Further Information

Publication History

Publication Date:
25 August 2003 (online)

Abstract

Purpose: The laparoscopic technique is now applied to radical prostatectomy. However, even in laparoscopic prostatectomy, we need a small open wound to remove the prostate from the abdomen. We have developed a modified technique of extraperitoneal laparoscopic radical prostatectomy, exploiting this small open wound as a route for surgical manipulations as well. Here, we described our technique and its initial outcomes. Patients and Methods: An extraperitoneal retropubic space was developed with finger manipulations through a 3- to 5-cm long suprapubic incision. Three or four trocar ports were set up. A specially designed abdominal wall-lifter was applied to create an endoscopic working space. The surgeons worked using open or endoscopic manipulations through the suprapubic incision or the trocar ports. From October 2000 to August 2001, 11 patients with prostate cancer underwent this surgery. Results: We completed surgery endoscopically without major complications except in one case in which we could not identify a bleeding source. Surgical time ranged from 229 to 469 min. Blood loss ranged from 550 to 3797 ml including urine spilled in the surgical field. Urinary continence returned in 10 cases at 1 to 8 months after surgery. One patient still needed pads at 3 months after surgery. Conclusion: Our technique allowed us to avoid insufflation of the abdomen with gas and intraperitoneal surgical intervention that are disadvantages of conventional laparoscopic prostatectomy, offering the same advantages as conventional laparoscopic prostatectomy.

References

  • 1 Guillonneau B, Cathelineau X, Barret E, Vallancien G. Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations.  Eur Urol. 1999;  36 14-20
  • 2 Lowe B A. Preservation of the anterior urethral ligamentous attachments in maintaining post-prostatectomy urinary continence: A comparative study.  J Urol. 1997;  158 2137-2141

Hajime Ishida,M. D. 

Department of Urology · Nihon University School of Medicine

Ohyaguchi kamimachi 30-1

Itabashi-ku

Tokyo, 173-8610

Japan

Phone: +81-3-3972-8111

Fax: +81-3-3972-5930

Email: porco@med.nihon-u.ac.jp

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