Radical retropubic prostatectomy through a minimal incision with portless endoscopy: Our initial experience

Kiyokawa, Hideo; Kato, Hiroyuki

doi:10.1111/j.1442-2042.2006.01216.x

Cited by 7 publications

(11 citation statements)

References 9 publications

(12 reference statements)

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“…Although the anterior approach to LRP seem to be quicker, 7 a positive margin rate of 36.8% 8 is somewhat high compared with contemporary series. A minimally invasive approach while leading to more rapid convalescence, 9,10 may yield higher PSM rates than ORP 11 although this is dependent on the surgeons' experience 12 …”

Section: Oncologic Outcomesmentioning

confidence: 99%

Outcomes of robotic assisted radical prostatectomy

Dasgupta

Kirby

2009

Int J of Urology

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Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. However, cynics point to the increasing role of market forces in the robotic revolution. As yet, Europe has not taken up RARP in large numbers and this may in part relate to the high level of expertise in laparoscopy previously gained. Furthermore, setting up a robotic program is a major undertaking for many surgical units. This article reviews the current literature on RARP with regard to oncologic, continence and potency outcomes -the so called 'trifecta'. Preliminary data appears to show an advantage of RARP over open prostatectomy with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most intra-institutional studies demonstrate good postoperative continence and potency with RARP; however this needs to be viewed in the context of a paucity of randomized data available in the literature. There is no definitive data to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging.

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Section: Oncologic Outcomesmentioning

confidence: 99%

Outcomes of robotic assisted radical prostatectomy

Dasgupta

Kirby

2009

Int J of Urology

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“…In the recent decades an overwhelming medical interest and a social demand to minimally‐invasive surgery has been acknowledged in every field of surgery 1 and it is also the case in urology 2–8 . Genitourinary cancers comprise more than one fourth of all malignancy in US where prostate cancer is the second most prevalent cancer in men 9 .…”

Section: Introductionmentioning

confidence: 99%

Surgical practices for urological tumors: A nation‐wide survey in Japan in 2005

Kawakami

Kihara

2009

Int J of Urology

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Objective: To clarify how popularly the minimally invasive surgeries for urological tumors are currently conducted in Japan and to predict future trends. Methods: A nation-wide survey was performed by the Japanese Association for Minimum-Incision Endoscopic Surgery under the support of the Japanese Urological Association (JUA). A questionnaire was sent to 1186 JUA-certified educational institutions asking about surgical practices for representative urological tumors performed in 2005 and those to be performed in the near future. Surgical modalities were categorized into open, laparoscopic and minimized-incision surgeries, defined as that the operator considers the incision to be minimal and including minimumincision endoscopic surgery but not limited. Results: 506 of the 1186 institutions (43%) responded and 20 193 surgical procedures were reported with radical prostatectomy being most frequently performed. Overall 20% and 6% of the procedures were performed with laparoscopic and minimized-incision surgeries, respectively. More than 20% of the respondents performed open surgery with reduced incision size than before. Surgical procedures without inserting fingers or hand were reported in 5-11% of the open surgeries and 33-45% of the minimized-incision surgeries. Endoscopy was utilized in 4-14% of the open surgeries and 24-59% of the minimized-incision surgeries. There was no difference in the incidence of complications among the surgical modalities. 40% and 27% of the respondents are aiming at laparoscopic surgery and at minimized-incision surgery, respectively. Conclusions:The results of this nation-wide survey indicate that minimally invasive surgeries, currently performed in 26% of urological tumor surgeries, are aimed at by the majority of the survey respondents.

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“…In Japan, Kihara and colleagues developed minimum incision endoscopic urological surgery (MEUS) 11 . Their technique has also been applied to RRP 12–14 . We introduced the endoscope‐assisted mini‐lap RRP in November 2003.…”

Section: Introductionmentioning

confidence: 99%

Frequency of postoperative inguinal hernia after endoscope‐assisted mini‐laparotomy and conventional retropubic radical prostatectomies

et al. 2008

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Objective:The objective of the present study was to compare the incidence of postoperative inguinal hernia between endoscope-assisted mini-laparotomy retropubic radical prostatectomy (mini-lap RRP) with conventional techniques to identify possible risk factors. Methods: From April 1998 to December 2006, 347 consecutive cases with localized prostate cancer were treated with conventional RRP (75 cases) and mini-lap RRP (272 cases) with pelvic lymphadenectomy. Mini-lap RRP was carried out with a 6-cm median incision. The charts were retrospectively reviewed , and the incidence of and risk factors for postoperative inguinal hernia were assessed. Results: There were no significant differences in age, initial prostate-specific antigen concentrations, clinical stage, Gleason score, body mass index, incidence of previous major abdominal surgery (cholecystectomy, gastrectomy, and colectomy), previous appendectomy, and previous inguinal hernia repair between the two groups. Postoperative inguinal hernia was observed in 29 cases (38.7%) in the conventional RRP group and in eight cases (2.9%) in the mini-RRP group during the mean follow-up period of 26.1 months (range: 3-105 months). The patients treated with mini-lap RRP had significantly higher hernia-free survival than those treated with conventional RRP (log rank test, P < 0.001). Multivariate analysis showed that surgical technique (conventional RRP) and previous major abdominal surgery were risk factors for inguinal hernia (P < 0.001 and P = 0.007, respectively). Conclusions: Inguinal hernia was less frequent after mini-lap RRP than after conventional RRP. A history of a major abdominal surgery was an independent risk factor for this event.

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Radical retropubic prostatectomy through a minimal incision with portless endoscopy: Our initial experience

Cited by 7 publications

References 9 publications

Outcomes of robotic assisted radical prostatectomy

Outcomes of robotic assisted radical prostatectomy

Surgical practices for urological tumors: A nation‐wide survey in Japan in 2005

Frequency of postoperative inguinal hernia after endoscope‐assisted mini‐laparotomy and conventional retropubic radical prostatectomies

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