Laparoscopic radical prostatectomy: a review

Bove, Pierluigi; Asimakopoulos, Anastasios D.; Kim, Fernando J.; Vespasiani, Giuseppe

doi:10.1590/s1677-55382009000200002

Cited by 11 publications

(18 citation statements)

References 67 publications

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“…The biochemical recurrence rates, have amounted to 11% for patients with clinically localized disease and follow-up of 5 years, outperforming the statistics of large series of retropubic radical prostatectomies (2,6,9,11,12,15,19,20). If observed more closely, the rates of biochemical recurrence in LRP were 8.6% (4 to 15.3%) for pT2 and 17.5% (15 to 20.6%) for pT3 in periods of up to 5 years.…”

Section: Commentsmentioning

confidence: 98%

Laparoscopic radical prostatectomy: 10 years experience

et al. 2009

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Purpose:The authors assess the morbidity, functional results and oncologic follow-up of a series of laparoscopic radical prostatectomies performed in over a 10-year period. Materials and Methods:The data on 780 laparoscopic radical prostatectomies performed between September 1997 and December 2007 were stored in a personal database. The following parameters are described and critically analyzed: operative time, blood transfusions, conversions, length of hospital stay, complications, functional results of sexual potency and urinary continence, surgical margins and oncologic follow-up. Results: Operative time averaged 125 minutes, with a mean bleeding volume of 335 mL and mean hospital stay of 4.3 days. The rate of conversion to open surgery was 1.36% and the overall complication rate was 14.24%. The pathology analysis showed pT2 tumors in 82.60% and pT3 tumors in 17.39% of cases. The overall positive margin rate was 19.58%, with a biochemical recurrence of 10.27% at a mean follow-up of 62.5 months. Urinary continence and sexual potency yielded rates of 88% and 61%, respectively, 12 months after surgery. Conclusions: Laparoscopic radical prostatectomy is a technically well-defined procedure that provides good oncologic and functional results after proper training.

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Section: Commentsmentioning

confidence: 98%

Laparoscopic radical prostatectomy: 10 years experience

et al. 2009

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“…As well it enables the use of this technique for Radical Prostatectomy in the treatment of prostate cancer, with comparable results to the standard retropubic open surgery (52). However with an increase in the frequency of this surgical approach it is expected to find also an increase in the number of complications (53,54).…”

Section: Urologic Laparoscopy Drainagementioning

confidence: 87%

The final stage of the laparoscopic procedure: exploring final steps

et al. 2012

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INTRODuCTIONUrologic surgery continues to evolve focusing efforts on adequate treatment of pathologic urologic conditions in a safe and minimally invasive manner (1).Laparoscopic surgery has well defined benefits for the patient and has, over time, become accepted as a standard of care access strategy for the management of benign and malignant Urologic diseases. Despite significant advances in laparoscopic technique and technologies, laparoscopic Urologic surgery remains technically demanding. Unlike open surgery, at the end of laparoscopic extirpative procedures, the Urologist is often faced with the additional challenges of specimen retrieval and extraction.Laparoscopic specimen entrapment and extraction occur at what is falsely considered the "end of the procedure". During open surgery, after the specimen has been mobilized, the specimen is Despite significant advances in laparoscopic technique and technologies, laparoscopic Urologic surgery remains technically demanding regarding various surgical steps including the challenge of specimen retrieval and extraction, whether to install a drainage system and the best option for wound closure. Laparoscopic specimen entrapment and extraction occurs at what is falsely considered the "end of the procedure". During open surgery, after the specimen has been mobilized, the specimen is simply lifted out of the larger incision which has been made to achieve the surgical objectives. In contrast, significant laparoscopic skill is required to entrap and safely extract laparoscopic specimens. Indeed, the Urologist and surgical team which are transitioning from open surgery may disregard this important part of the procedure which may lead to significant morbidity. As such, it is imperative that during laparoscopic procedures, the "end of the procedure" be strictly defined as the termination of skin closure and dressing placement. Taking a few minutes to focus on safe specimen entrapment and extraction will substantially reduce major morbidity. The following review focus on the technology and technique of specimen entrapment and extraction, on the matter of whether to install a drainage system of the abdominal cavity and the options for adequate closure of trocar site wounds. This article's primary objectives are to focus on how to minimize morbidity while maintain the advantages of a minimally invasive surgical approach.

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“…During laparoscopy, excellent visualization of the dorsal venous complex and a tamponade effect from the 15-mm Hg pressure of the carbon dioxide pneumoperitoneum minimizes blood loss. The necessity of transfusion varied from 1.6% to 31% among the analyzed series (Bove et al, 2009). …”

Section: Intraoperative Blood Loss Transfusion Ratesmentioning

confidence: 98%

“…The low conversion rates in all major series are a testimony to the careful introduction of LRP. With increasing experience, even challenging situations, such as cases following previous laparoscopic hernioplasty can be managed (Bove et al, 2009). Following the current literature we could ded u c e t h a t t h e r e i s a 4 % ( 1 -6 .…”

Section: Conversion To Open Surgery and Other Perioperative Complicatmentioning

confidence: 99%