Imaging

Abstract

Results: Logistic regression demonstrated that body mass index, large prostate size and previous pelvic surgery did not affect margin status. The Kruskal-Wallis test was performed to analyze if body mass index, large prostate size and previous pelvic surgery had an effect on perioperative variables. Only prostate weight correlated with a delay in Foley catheter removal (3 days, p = 0.0005). The Wilcoxon rank sum test showed that patients with a higher body mass index had a slightly prolonged hospital stay (16 hours, p = 0.02). Patients with a prostate of more than 40 gm had slightly increased blood loss (56 cc, p = 0.03), which did not affect the transfusion rate. Conclusions: Laparoscopic extraperitoneal radical prostatectomy can be performed in complex surgical cases without increased perioperative morbidity. Obese patients and those with a large prostate who prefer surgery as a treatment option for localized prostate cancer may benefit from the advantages that laparoscopic extraperitoneal radical prostatectomy offers. Editorial Comment The new era of minimally invasive surgery demonstrates the feasibility of laparoscopic retropubic radical prostatectomy in patients with high body mass index, previous pelvic surgery or large prostate size. In general surgery laparoscopic procedures are highly encouraged for patients that are more complex due to better outcomes compared to open surgery. In urology, we are still taken "baby steps" demonstrating slowly the advances in minimally invasive surgery. The authors should be congratulated for the elegant manuscript demonstrating the feasibility and good outcome of laparoscopic surgery in complex surgical patients.