Category: Laparoscopy: Lower Tract - Malignant

VS13-9 - Total extraperitoneal endoscopic radical prostatectomy: combined ascending/descending technique

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : In 1999, J. Rassweiler et colleagues are presented a laparoscopic technique similar to the classic retropubic radical prostatectomy. A combined ascending/descending method was used to access the prostate and seminal vesicles. In this report, we present our experience with the performance of extraperitoneal combined endoscopic radical prostatectomy.

Methods :

From March 1999 to December 2000 we have performed 180 procedures.

A extraperitoneal approach is used with access to Retzius' space. After the dorsal vein complex is endoscopically sutured, the urethra is incised and distal pedicles of the prostate with or without the neurovascular bundle transected. The apex is then pulled ventrally followed with incision at the bladder neck, and transvesical access to vas deferens and seminal vesicle. After accomplishing the posterior wall of the urethrovesical anastomosis with six interrupted sutures, the urethral catheter is placed into the bladder and the bladder neck is closed.

Results :

The mean operating time was 278 (180-500) min. there was no need for blood transfusion or conversion. median catheter time was 8 (6-30) days.

Median followup was 18 months (range 4 to 24). Positive lymph nodes were detected in 5 patients. Positive margins were documented in 22 patients. PSA recurrence was diagnosed in 55 patients (11.0%) at a mean of 20.8 months (range 6 to 36). No port site metastasis was observed.

Conclusions : Morbidity is low, oncological control is similar to results of open surgery, functional results are promising

Vasily Zipunnikov

assistant Professor
Volgograd State Medical University
Volgograd, Volgograd, Russia

I Studied urology at Volgograd state medical University. Residency in the Volgograd regional uronephrological centre by Professor Perlin D. the Main activities associated with the treatment of kidney cancer, prostate cancer and endourology.

Dmitry Pelin

Volgograd, Volgograd, Russia

Ilya Aleksandrov

Volgograd, Volgograd, Russia

Ivan Dymkov

Volgograd, Volgograd, Russia