Transcapsular adenomectomy(Millin): a comparative study, extraperitoneal laparoscopy versus open surgery.

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Benign prostatic hyperplasia (BPH) is a common condition requiring surgical intervention.
• Traditional open prostatectomy carries risks of significant blood loss and prolonged recovery.
• Laparoscopic techniques offer potential advantages in reducing surgical morbidity.

Purpose of the Study:

• To evaluate the safety and efficacy of Millin extraperitoneal laparoscopic adenomectomy.
• To compare peri-operative and post-operative outcomes between laparoscopic and open adenomectomy.
• To assess the learning curve associated with extraperitoneal laparoscopic adenomectomy.

Main Methods:

• A prospective, non-randomized study included 40 patients undergoing prostatic adenomectomy.
• Patients were divided into two groups: 20 underwent extraperitoneal laparoscopic adenomectomy (Group A) and 20 underwent open surgery (Group B).
• Pre-operative, peri-operative, and post-operative parameters were meticulously evaluated. Group A was further analyzed to determine the learning curve.

Main Results:

• Both groups were comparable in pre-operative parameters (p>0.3).
• Group A demonstrated significantly lower mean blood loss (411.6 ml) compared to Group B (687.5 ml) (p=0.004).
• No significant differences were observed in operative time, adenoma weight, hemoglobin levels, analgesic consumption, catheterization time, or hospital stay (p>0.4). One patient in Group A required re-operation for bleeding.

Conclusions:

• Extraperitoneal laparoscopic adenomectomy is a safe surgical technique for BPH.
• It achieves comparable results to open surgery.
• The primary advantage is significantly reduced peri-operative blood loss, enhancing patient recovery.