Retroperitoneoscopy: A laparoscopic approach for adrenal and renal surgery

Gasman, D.; Saint, F.; Barthélémy, Yvan; Antiphon, Patrick; Chopin, Dominique; Abbou, Claude-Clément

doi:10.1016/s0090-4295(96)00064-7

Cited by 68 publications

(21 citation statements)

References 16 publications

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“…Guillonneau and Vallancien [19]considered that radical prostatectomy could become a routine laparoscopic procedure and should help to improve functional outcome. In our center, the laparoscopic procedure is performed by the retroperitoneal approach for diseases of the upper urinary tract, and by the transperitoneal approach for the lower urinary tract [8, 9, 10]. We perform radical prostatectomy by a retropubic or perineal approach [7].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Radical Prostatectomy: Preliminary Results

Jacob¹,

Salomon²,

Hoznek³

et al. 2000

European Urology

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Background: Retropubic and perineal radical prostatectomy are used for curative treatment of localized prostate cancer. More complex urological procedures are now being done with laparoscopy. We present our initial results of transperitoneal laparoscopic radical prostatectomy.Materials and Methods: Twenty laparoscopic radical prostatectomies were performed between May 1998 and May 1999. The mean age at the time of surgery was 64.2 years. There were 14 stage T1c, 5 stage T2a and 1 stage T2b tumors. The preoperative PSA was 9.3 ng/ml (normal <4 ng/ml). The Gleason score for positive specimens in 6 random echo–guided endorectal biopsies was 5.7. Four trocars were used. Insufflation pressure was 15 mmHg. The seminal vesicles were first dissected. The prostate was dissected free from the anterior face of the rectum to the prostate apex. Then the peritoneum was incised to find the apex of the prostate. The puboprostatic ligaments were isolated and cut, and the dorsal vein complex was ligated and cut to expose the urethra. The bladder neck was opened and dissected free from the prostate. The lateral pedicles were coagulated before sectioning the urethra. The radical prostatectomy specimen was left along the sigmoid colon, the bladder neck was reconstructed, and a urethrovesical anastomosis was performed with 6 interrupted sutures. The prostatectomy specimen was removed intact in a sack by enlarging the umbilical trocar port. All the prostatectomy specimens were processed according to the Standford protocol. Prostate weight, tumor weight, the Gleason score, and the tumor status of the capsule, seminal vesicles, lymph nodes and surgical margins were studied.Results: The operating time was 385 min. Two patients were transfused. The mean hospital stay was 7.8 days. The Foley catheter was removed 10.7 days after the operation. Specimen weight was 61 (28–126) g, the Gleason score was 5.9, and tumor volume was 1.4 ml. There were 18 stage pT2, 1 stage pTa (capsular effraction) and 1 stage pT3b (seminal vesicle invasion) tumors. There were four positive surgical margins (2 at the apex and 2 at the bladder neck). All the patients had a postoperative PSA level <0.1 ng/ml at 1 month. The first patient had urethrovesical anastomotic leakage, and required Foley catheterization for 21 days. There was 1 colostomy for rectal injury and 1 urinoma because of urethrovesical anastomotic leakage that required an open surgical procedure. One month after surgery, 15 (75%) patients were fully continent. Six patients had erections, and 5 stated having sexual intercourse.Conclusion: These preliminary results show that radical prostatectomy can be performed laparoscopically. Laparoscopy offered excellent vision of all the anatomical structures of the pelvis, permitting precise dissection. Long–term follow–up and further studies are required to confirm and improve these results.

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Section: Discussionmentioning

confidence: 99%

“…We used to perform radical prostatectomy for localized prostate cancer by the retropubic and perineal approaches [7]. Starting in 1994, we began to develop laparoscopic procedures for upper and lower urinary tract disease [8, 9, 10]. We first performed successful laparoscopic radical prostatectomy in 1998.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Radical Prostatectomy: Preliminary Results

Jacob¹,

Salomon²,

Hoznek³

et al. 2000

European Urology

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“…The absorption of a gas from a closed cavity depends on its diffusibility and the perfusion of the walls of that cavity and not on the rate of insufflation of the gas into the cavity [7, 8]. Laparoscopic adrenalectomy has been performed by the retroperitoneal lateral flank approach [9, 10].…”

Section: Discussionmentioning

confidence: 99%

Influence of Carbon Dioxide on Respiratory Function during Posterior Retroperitoneoscopic Adrenalectomy in Prone Position

Sasagawa

Suzuki²,

Izumi³

et al. 1999

European Urology

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“…They were successively improved with experience melting together both the experiences: a finger dissection was used to create the initial space instead of a balloon [10] and the fluoroscopy was abandoned also by ourselves [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. By the end of the 20th century the laparoscopic and retroperitoneoscopy adrenalectomy had gained the benchmark for the adrenal surgery: "After the comparative experience of multicentric studies [25,26] it is assessed that laparoscopic adrenalectomy is feasible and safe with a low ratio of cost/benefit regardless the pathology.…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneoscopic Adrenalectomy 20 Years, and More, After. A Review

Mandressi¹

2016

UNOAJ

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Adrenalectomy has been a challenging surgery mainly due to the deep position of the adrenal gland in the retro-peritoneum under the diaphragm. Laparoscopy and the laparoscopic retroperitoneal approach offered a newer, easier, faster way to remove adrenals. The development of these techniques are described, up to nowadays, at what time a wide choice of tailored approaches to remove adrenal gland, according to its size, disease's status and position, are available.

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Retroperitoneoscopy: A laparoscopic approach for adrenal and renal surgery

Cited by 68 publications

References 16 publications

Laparoscopic Radical Prostatectomy: Preliminary Results

Laparoscopic Radical Prostatectomy: Preliminary Results

Influence of Carbon Dioxide on Respiratory Function during Posterior Retroperitoneoscopic Adrenalectomy in Prone Position

Retroperitoneoscopic Adrenalectomy 20 Years, and More, After. A Review

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