Prolonged intraperitoneal versus extraperitoneal insufflation of carbon dioxide in patients undergoing totally endoscopic robot-assisted radical prostatectomy

Meininger, Dirk; Byhahn, Christian; Wolfram, M.; Mierdl, S.; Kessler, Paul D.; Westphal, K.

doi:10.1007/s00464-003-9086-9

Cited by 37 publications

(22 citation statements)

References 13 publications

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“…Though CO 2 absorption is slightly higher in the extraperitoneal approach, no clinically significant adverse hemodynamic or respiratory effects have been found, when compared with the transperitoneal approach (16).…”

Section: Commentsmentioning

confidence: 83%

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Tobias-Machado¹,

Lasmar²,

Medina³

et al. 2005

Int. braz j urol.

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Objective: To describe surgical and functional results with extraperitoneal laparoscopic radical prostatectomy with duplication of the open technique, from the experience obtained in the treatment of 28 initial cases.Materials and Methods: In a 36-month period, we prospectively analyzed 28 patients diagnosed with localized prostate cancer undergoing extraperitoneal laparoscopic radical prostatectomy.Results: Mean surgical time was 280 min, with mean blood loss of 320 mL. As intraoperative complications, there were 2 rectal lesions repaired with laparoscopic suture in 2 planes. There was no conversion to open surgery. Median hospital stay was 3 days, with return to oral diet in the first postoperative day in patients. As post-operative complications, there were 3 cases of extraperitoneal urinary fistula. Two of these cases were resolved by maintaining a Foley catheter for 21 days, and the other one by late endoscopic reintervention for repositioning the catheter. Five out of 18 previously potent patients evolved with erectile dysfunction. The diagnosis of prostate cancer was confirmed in all patients, with focal positive margin occurring in 3 cases. During a mean follow-up of 18 months, 2 patients presented increased PSA, with no clinical evidence of disease.Conclusion: Laparoscopic radical prostatectomy is a laborious and difficult procedure, with a long learning curve. Extraperitoneal access is feasible, and it is possible to practically duplicate the principles of open surgery. The present technique can possibly offer advantages in terms of decreased blood loss, preservation of erectile function and prevention of positive margins.

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Section: Commentsmentioning

confidence: 83%

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Tobias-Machado¹,

Lasmar²,

Medina³

et al. 2005

Int. braz j urol.

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“…Between They studied the effect of pneumoperitoneum specifically related to robotic prostatectomy [47][48][49][50]. In 2002, their initial team experience included a mean operating time of 10 hours as a result of the surgeon's steep learning curve associated with this procedure.…”

Section: Pneumoperitoneummentioning

confidence: 99%

Anesthetic considerations for robotic prostatectomy: a review of the literature

Awad

Walker

Shaikh

et al. 2012

Journal of Clinical Anesthesia

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“…Bei extraperitonealer CO 2 -Applikation z. B. im Rahmen einer laparoskopischen radikalen Prostatektomie wird wesentlich mehr CO 2 resorbiert als bei intraperitonealer Applikation [10]. Das zusätzlich aufgenommene CO 2 wird über die Lunge vermehrt abgegeben.…”

Section: Kohlendioxidresorptionunclassified

Anästhesie bei laparoskopischen Eingriffen

Hömme

2011

Anaesthesist

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Laparoscopic techniques are used in many surgical disciplines and have partially become a standard procedure. Cholecystectomy is performed laparoscopically in 90% of cases. During a pneumoperitoneum changes occur which have a large influence on physiological homeostasis. Furthermore there are specific complications of laparoscopy which can have severe consequences. For adequate management the anesthetist has to be aware of both in order to react in the correct way.

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Prolonged intraperitoneal versus extraperitoneal insufflation of carbon dioxide in patients undergoing totally endoscopic robot-assisted radical prostatectomy

Abstract: Prolonged intra- and extraperitoneal CO2 insufflation for TERP resulted in significant, but mostly clinically unimportant, hemodynamic alterations. Carbon dioxide absorption was more pronounced with extraperitoneal insufflation.

Cited by 37 publications

References 13 publications

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Preliminary experience with extraperitoneal endoscopic radical prostatectomy through duplication of the open technique

Anesthetic considerations for robotic prostatectomy: a review of the literature

Anästhesie bei laparoskopischen Eingriffen

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