'LESS' radical prostatectomy: a pilot feasibility study with a personal original technique.

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Radical prostatectomy is a standard treatment for prostate cancer.
• Single-port laparoscopic surgery aims to minimize invasiveness.
• Achieving optimal working angles in laparoscopic prostatectomy can be challenging.

Purpose of the Study:

• To evaluate the feasibility and benefits of a modified two-port laparoscopic radical prostatectomy.
• To assess a technique using a periumbilical multichannel port and a left iliac fossa port.
• To determine if this approach provides an adequate working angle for critical surgical steps.

Main Methods:

• Five patients with early-stage prostate cancer (T1c) and normal BMI underwent the procedure.
• A multichannel trocar (two 5 mm, one 10 mm) and a 5 mm left iliac fossa port were used.
• Nerve-sparing radical prostatectomy was performed in the first two patients.

Main Results:

• All five procedures were completed successfully with a mean operative time of 225 minutes and minimal blood loss (<100 ml).
• No intraoperative complications occurred; patients were discharged on postoperative day 3.
• Pathological staging confirmed pT2bNo prostate cancer without positive margins in all cases.
• At a mean follow-up of 4 months, all patients had undetectable PSA levels.
• Functional outcomes showed varying degrees of urinary continence and erectile function recovery.

Conclusions:

• Two-port laparoscopic radical prostatectomy is feasible in carefully selected patients.
• This pilot study is a technical report, and further investigation is needed.
• Larger studies are required to define the technique's limitations and broader applicability.