Laparoscopic radical prostatectomy: Initial short-term experience

TLDR

The study reports three complications (cholecystitis, thrombophlebitis with pulmonary embolism, and small bowel hernia) and concludes that laparoscopic radical prostatectomy offers no advantage over open surgery in oncologic control, continence, potency, length of stay, convalescence, or cosmetic outcome. The authors aimed to assess the feasibility and efficacy of a laparoscopic approach to radical retropubic prostatectomy. They performed a transperitoneal laparoscopic RRP using five 10‑mm trocars, creating a transvesical urethrovesical anastomosis and removing the prostate through an extended umbilical incision in nine patients between 1991 and 1995. Operative time averaged 9.4 h; only one of nine patients had a positive surgical margin, six of.

Abstract

To determine the feasibility and efficacy of a laparoscopic approach to the radical retropubic prostatectomy (RRP).A transperitoneal laparoscopic technique was developed to perform an RRP. Intra-abdominal access was obtained through five 10-mm trocars. After dissection of the prostate, the urethrovesical anastomosis was created via a transvesical approach. The prostate was removed by extending the umbilical incision.Between September 1991 and May 1995, nine laparoscopic RRPs were performed. The operative time averaged 9.4 hours. Only 1 of 9 patients had a positive surgical margin that involved the urethra. Six of 9 patients were completely continent postoperatively. Of the 4 patients who were potent preoperatively, 2 continued to have erections. There were three complications: cholecystitis, thrombophlebitis associated with a pulmonary embolism, and a small bowel hernia into a trocar site.Laparoscopic radical prostatectomy is feasible but currently offers no advantage over open surgery with regard to tumor removal, continence, potency, length of stay, convalescence, and cosmetic result.