Transperitoneal Endosurgical Lymphadenectomy in Patients with Localized Prostate Cancer

Abstract

The main appeal of radiotherapy for carcinoma of the prostate lies in the low morbidity and good subsequent quality of life. The handicap of this approach is the absence of adequate staging through pelvic lymphadenectomy. A new operation with minimal morbidity for the patient is presented and described in detail: endosurgical (laparoscopic) pelvic lymphadenectomy. This operation can be performed on an outpatient basis and is extremely well tolerated by the patient. The results of the first 12 consecutive cases indicate that, with experience, the procedure can be performed within a reasonable time limit (90 to 205 minutes) and that the number of lymph nodes removed (right and left obturator fossae mean 7.6 and 7.1, respectively) is adequate. Endosurgical lymphadenectomy adds only minimal morbidity to the radiotherapeutic treatment of prostatic cancer but permits more accurate staging and, therefore, counseling of the patients.

Laparoscopic Transperitoneal Ureterolithotomy- An Alternative to Open Surgery

“…During the last decade laparoscopic surgery has added a further endoscopic minimally invasive option in urology. Since the description of laparoscopic lymphadenectomy [2] and laparoscopic nephrectomy [3] , the role of laparoscopy in urology has expanded enormously. A numer of different uretric procedures have been performed including nephro-ureterectomy [4] ureterolysis [5] , ureteric resection and repair [6] .…”

Kars Devlet Hastanesi’nde laparoskopik üroloji deneyimlerimiz

“…Laparoskopik cerrahi ürolojide ilk defa prostat kanserli bir hastada pelvik lenf nodu diseksiyonunda kullanılmıştır (2). Bunu takiben 1990 yılında laparoskopik nefrektomi, 1991'de radikal prostatektomi, 1992'de laparoskopik adrenalektomi, 1993'de laparoskopik üreterolitotomi ve piyeloplasti ameliyatları tanımlanmıştır (3)(4)(5)(6)(7)(8).…”

Laparoscopy in Urology: An Overview

“…In these early days, laparoscopy was still far away from being standard of care in the field of urology. In 1989, the first cases of laparoscopic pelvic lymphadenectomy in prostate cancer patients have been performed and published be Schuessler et al (Schuessler et al, 1991). In the early 1990s, some centres advocated laparoscopic pelvic lymphadenectomy prior to radical prostatectomy or radiotherapy for prostate cancer, since treatment with curative intent was indicated only in cases with histologically negative nodes.…”