Technique of laparoscopic (endoscopic) radical prostatectomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Laparoscopy is now a standard urological technique, enabling complex oncological surgeries like radical prostatectomy.
• Laparoscopic radical prostatectomy (LRP) has evolved significantly since the 1990s.
• Transperitoneal LRP is a reproducible standard procedure with outcomes comparable to open surgery.

Purpose of the Study:

• To review the surgical techniques of transperitoneal laparoscopic radical prostatectomy (LRP) and totally extraperitoneal endoscopic radical prostatectomy (EERPE).
• To highlight the indications, contraindications, and outcomes of LRP and EERPE.
• To compare the safety and efficacy of transperitoneal versus extraperitoneal approaches for radical prostatectomy.

Main Methods:

• Review of surgical techniques for laparoscopic radical prostatectomy (LRP) via transperitoneal and totally extraperitoneal endoscopic radical prostatectomy (EERPE) approaches.
• Analysis of potential intraperitoneal complications associated with the transperitoneal route.
• Evaluation of the benefits of the extraperitoneal approach in obviating intra-abdominal complications.

Main Results:

• Transperitoneal LRP is a standard, reproducible procedure with outcomes similar to open retropubic prostatectomy.
• Transperitoneal laparoscopy carries a risk of intraperitoneal complications.
• Totally extraperitoneal endoscopic radical prostatectomy (EERPE) offers a safe, minimally invasive alternative that avoids intra-abdominal complications.

Conclusions:

• Both transperitoneal LRP and EERPE are viable minimally invasive options for radical prostatectomy.
• EERPE provides a significant advantage by eliminating the risk of intra-abdominal complications.
• The choice between LRP and EERPE depends on patient factors and surgeon expertise, aiming for optimal outcomes.