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Transperineal laparoscopy: a new approach
Eduardo Sanchez-de-Badajoz1, Adolfo Jimenez-Garrido, Montserrat Salvi
1Teaching Unit of Urology, Department of Surgery, School of Medicine, University of Malaga, Malaga, Spain. edusaba@telefonica.net
Purpose:
We describe and evaluate a new transperineal laparoscopic approach for male patients, designed to facilitate laparoscopic prostatectomy and cystectomy.
Patients And Methods:
We operated on 12 patients. We did three laparoscopic prostatectomies and nine laparoscopic cystectomies. On five, an ileal conduit was made, and on the other four, an orthotopic bladder was constructed. An incision was made in the perineum. A space was bluntly created between the rectum and the prostate. A cannula was then introduced up to the Douglas pouch, which was opened to enter the peritoneal cavity.
Results:
One patient of the three prostatectomies needed incontinence pads. None of the four orthotopic bladder cases presented daytime incontinence. The urethra of one of the patients who had an ileal conduit was injured. No other significant complications occurred.
Conclusion:
Transperineal laparoscopy in male patients is a feasible technique that may be an alternative for natural orifice translumenal endoscopic surgery in women, but further assessment is required.
