Category: Laparoscopy: Lower Tract - Malignant

VS11-5 - 3D Ultra-minilaparoscopic radical prostatectomy: new approach and initial experience.

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

The ML has been considered as an experimental technique, recommended only for laparoscopic experts. With the advent of a new generation of instrumentation this technique has grown in interest and initial limitations has been improved. We present the first experience of Ultra-Minilaparoscopic radical prostatectomy. To our knowledge there are no previous reports of this technique published in the bibliography.
Our objective was to study the reliability and safety of Ultra-Minilaparoscopy (U-MiniLap) technique in prostatic surgery.

Methods :

An U-MiniLap radical prostatectomy was performed on 3 patients. In all patients two 3-mm trocars were placed in both iliac fossae two centimeters above the superior iliac spine, respectively. For the optic, a 3-mm trocar was used on the umbilicus and finally a 5-mm trocar four fingerbreadths infraumbilical in the middle line. The surgical technique was completed transperitoneally under general anesthesia. One-single surgeon performance was assessed by a five-category numerical scale1. Postoperative pain was evaluated by the EVA scale and cosmesis outcomes by PSAQ score one week after the surgery.

Results :

A total of four patients were operated on according to this technique. One of the surgeries could not be completed due to the finding of an inflammatory bowel process. The mean surgeon's total evaluation for the surgeries was 24.3+/-1.1. All surgeries were completed without complications in 115+/-8.7 minutes on average. The mean postoperative pain was 2+/-1 in the EVA score respectively and the hospital stay 2.3+/-0.6 days in both cases. The Cosmetic results were equally good, with a mean 40+/-8.5 total PSAQ score at discharge.

Conclusions :

The U-MiniLap was a safe and reproducible technique. The surgeon's perception of the U-MiniLap was favorable with regards to surgical field vision, bimanual dexterity, efficiency, tissue handling and autonomy.

1Autorino R, Kim FJ, Rassweiler J, et al. Mini-laparoscopy, laparoendoscopic single-site surgery and natural orifice transluminal endoscopic surgery-assisted laparoscopy: No- vice surgeons’ performance and perception in a porcine nephrectomy model. BJU Int 2012;110(11 Pt C):E991–E996.

Alberto Pérez-Lanzac

Professor Alfonso X el Sabio University (Madrid)
Ruber Internacional Hospital
Madrid, Madrid, Spain

Dr. Alberto Pérez-Lanzac.
Professor Alfonso X el Sabio University.
Head of Lithiasis and Endourology.
Urology department.
Ruber Internacional Hospital. Madrid (Spain).

Doctor in Medicine (Cum Laude). Two specialization fellows in the USA (Columbia University, NY / California University, CA). Specialized in Minimally Invasive and Robotic Surgery. Member of the Ethics Committee of Cádiz and member of the Board of the European Association of Urology (until 2018). Involved in international and national research groups. Editor and reviewer of international scientific journals.

Jose Luis Álvarez-Ossorio

Cadiz, Andalucia, Spain

Federico Rodriguez-Rubio

cadiz, Andalucia, Spain

Antonio Allona

Head of the Department
Ruber Internacional Hospital
Madrid, Madrid, Spain