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Laparoscopic radical prostatectomy. Technical aspects and experience with 125 cases.

I Türk1, S Deger, B Winkelmann

  • 1Department of Urology, Charité Hospital, Medical School of the Humboldt University, Schumannstrasse 20/21, D-10177 Berlin, Germany. ingolf.tuerk@charite.de

European Urology
|August 31, 2001
PubMed
Summary

Laparoscopic radical prostatectomy offers a minimally invasive alternative to open surgery, demonstrating excellent oncological and functional outcomes. This technique reduces morbidity and hospital stays, becoming a promising future standard for prostate cancer treatment.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Radical prostatectomy is a standard treatment for localized prostate cancer.
  • Laparoscopic surgery offers potential benefits over open procedures, including reduced morbidity.
  • Evaluating the feasibility and outcomes of establishing laparoscopic radical prostatectomy as a routine procedure is crucial.

Purpose of the Study:

  • To assess the feasibility and outcomes of 125 laparoscopic radical prostatectomies.
  • To evaluate the oncological and functional results of the laparoscopic approach.
  • To determine if the laparoscopic approach can be routinely implemented.

Main Methods:

  • 125 laparoscopic radical prostatectomies were performed on patients with T1/T2 cancer stages.

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  • The descending technique with free-hand laparoscopic suturing for urethrovesical anastomosis was employed.
  • Specimens were removed using an endobag via a muscle-splitting incision.

    • Main Results:

    • All 125 procedures were completed successfully without conversion to open surgery.
    • Average operating time decreased with experience, and mean blood loss was 185 ml.
    • Postoperative outcomes included an average catheter time of 5.5 days, 8-day hospital stay, 4% intraoperative and 10.4% postoperative complications, with 86% continence at 6 months.

    Conclusions:

    • Laparoscopic radical prostatectomy is achievable with a steep learning curve, particularly in suturing.
    • The procedure offers reduced blood loss, faster recovery, and lower morbidity compared to open surgery.
    • Oncological and functional results are equivalent to open procedures, suggesting it as a future standard.