The endoscopic extraperitoneal radical prostatectomy (EERPE): technique and initial experience

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Traditional radical prostatectomy approaches carry risks of intra-abdominal complications.
• Laparoscopic radical prostatectomy has advanced minimally invasive options.
• Extraperitoneal techniques have been used for pelvic procedures.

Purpose of the Study:

• To describe the technique of totally extraperitoneal endoscopic radical prostatectomy (EERPE).
• To evaluate the short-term outcomes and safety of the EERPE procedure.
• To establish EERPE as a standardized minimally invasive surgical option.

Main Methods:

• Development of a totally extraperitoneal endoscopic radical prostatectomy (EERPE) technique.
• Utilizing balloon dissection to create a preperitoneal space in the hypogastrium.
• Replicating classical retropubic radical prostatectomy steps with modifications, including pelvic lymph node dissection.

Main Results:

• Twenty patients underwent EERPE with a mean operating time of 170 minutes and no conversions.
• No major complications were reported; only one patient required a blood transfusion.
• Pathologic evaluations showed negative surgical margins in 17 patients, with various pT stages.

Conclusions:

• Totally extraperitoneal endoscopic radical prostatectomy (EERPE) is a safe and effective minimally invasive approach.
• This technique avoids peritoneal entry, thus preventing intra-abdominal complications.
• EERPE combines the advantages of laparoscopy and open retropubic surgery for prostatectomy.