Extraperitoneal Laparoscopic Radical Prostatectomy

Bollens, Renaud; Bossche, Marc Vanden; Roumeguère, Thierry; Damoun, A.; Ekane, Samuel; Hoffmann, Paul; Zlotta, Alexandre R.; Schulman, Claude

doi:10.1159/000049750

Cited by 227 publications

(24 citation statements)

References 12 publications

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“…However, the follow-up of existing series is too short and includes too few patients for definitive conclusions to be drawn about the preservation of potency. Guillonneau and Valancien [15] were able to preserve the neurovascular bundles in 20 of 120 patients during LRP, and Bollens et al [16] in seven of 50 during EERPE. Interestingly, both groups reported a potency rate of 43-45% at 3 months after surgery.…”

Section: The Results Of Lrp and Eerpmentioning

confidence: 97%

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Technique of laparoscopic (endoscopic) radical prostatectomy

Stolzenburg

Truß

2003

BJU International

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SUMMARYDuring the last decade laparoscopy has become a standard technique available to the urologist, through constant technological advances and refinements. The progress of laparoscopic/endoscopic techniques allows the indications for this surgery to include complex oncological procedures like radical prostatectomy. Since the first description of laparoscopic radical prostatectomy (LRP) in the early 1990s the technique has undergone significant technical modifications. Transperitoneal LRP is now a standard procedure and can be used successfully and reproducibly, giving results comparable with those from the open retropubic procedure. Despite many advantages, transperitoneal laparoscopy is associated with potential intraperitoneal complications. Because of the limitations inherent in the transperitoneal route, a totally extraperitoneal endoscopic radical prostatectomy (EERPE) has been developed. The totally extraperitoneal endoscopic access provides a safe and minimally invasive approach to various urological procedures, including prostatectomy. This technical improvement completely obviates intra‐abdominal complications. EERPE combines the advantages of minimally invasive laparoscopy and the open retropubic approach. We review the surgical techniques of LRP and EERPE, and highlight the indications, contraindications and outcomes.

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Section: The Results Of Lrp and Eerpmentioning

confidence: 97%

“…The introduction of extraperitoneal guidance as an aid to radical prostatectomy by Raboy et al [4] resulted in an intensive effort to apply this technique routinely. To date two teams have reported the feasibility and reproducibility of EERPE [8,16]. Different terms have been reported to characterize the LRP/EERPE.…”

Section: The Extraperitoneal Approachmentioning

confidence: 99%

Technique of laparoscopic (endoscopic) radical prostatectomy

Stolzenburg

Truß

2003

BJU International

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“…This is longer than, but still the same order of magnitude as, the time taken for ORRP. The likelihood of conversion to open surgery and re-operation is clearly related to experience with the procedure (Table 2 [2,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]). …”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical prostatectomy: the initial UK series

et al. 2002

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Bilateral neurovascular bundle preservation was attempted in 58% of patients. The transfusion rate was 3%. The conversion and re-intervention rates were 1% and 2%, respectively. There were eight complications, six of which were in the initial 26 cases, i.e. bladder neck stenosis (two), and rectal injury, laparotomy for bleeding, premature drain removal leading to urinary peritonitis, ulnar nerve neuropraxia, port-site hernia and paralytic ileus in one each. The positive surgical margin rate was 16%. All patients had a PSA level of £ 0.1 ng/mL at 3 months. By 1 year 90% of patients were pad-free and 62% operated on using a bilateral nerve-sparing technique had erections. There were no biochemical failures. The mean (range) follow-up was 9.8 (1-24) months. Conclusion The present results are similar to those reported by other centres with greater experience and confirm that LRP is an effective, safe and precise technique. Once intial experience has been gained it offers advantages over open surgery in the form of a dry and magnified operative site, and a lower likelihood of blood transfusion, in addition to the generic advantages of laparoscopy.

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“…With the continuous refinements of operative techniques, laparoscopic radical prostatectomy (LRP) has had a worldwide diffusion with a complication rate continuously and significantly decreasing in recent years [1], [2], [3], [4], [5], [6] and [7]. Nevertheless, postoperative urinary incontinence (PUI) remains an important issue, with an incidence ranging from 1% to 50% [3] and [8].…”

Section: Introductionmentioning

confidence: 99%

“…Placing a selective suture as described by Walsh for radical retropubic prostatectomy (RRP) [13] and [14] is not always possible during LRP, and surgeons can place the suture deeply to avoid bleeding with the risk of involvement of some fibres of the US in the suture [4] and [16].…”

Section: Introductionmentioning

confidence: 99%