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Single-port laparoscopic radical prostatectomy: initial experience and technical points to reduce its difficulties.

Xing-Qiao Wen¹, Wen-Tao Huang, Jie Situ

¹Department of Urology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510630, China.

Chinese Medical Journal

|February 21, 2012

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Laparoendoscopic single-site radical prostatectomy (LESS-RP) is a feasible and effective approach for selected early-stage prostate cancer patients. This minimally invasive technique utilizes specialized instruments and surgical tricks to overcome challenges, leading to successful outcomes.

Area of Science:

Urology
Minimally Invasive Surgery
Surgical Oncology

Background:

Laparoendoscopic single-site surgery (LESS) is increasingly used for pelvic procedures.
Previous studies indicate LESS is feasible and effective in select patients.
Radical prostatectomy (RP) is a standard treatment for prostate cancer.

Purpose of the Study:

To evaluate the initial experience and efficacy of LESS radical prostatectomy (LESS-RP).
To assess the feasibility of performing RP through a single umbilical incision using a multichannel port.

Main Methods:

Six patients with early-stage prostate cancer underwent LESS-RP between July 2010 and April 2011.
A multichannel port was inserted via a 2-cm umbilical incision.
Flexible-articulating laparoscopic instruments and specific surgical techniques were employed, including double Lapro-Clips for urethrovesical anastomosis.

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Main Results:

All six cases were completed successfully without conversion to open surgery or additional ports.
Mean operative time was 265 ± 43 minutes, with mean blood loss of 230 ± 65 ml.
No intraoperative complications or blood transfusions were required; all patients achieved undetectable PSA levels by 12 weeks, with good continence reported.

Conclusions:

LESS-RP is a feasible and effective surgical option for selected patients with early-stage prostate cancer.
The use of flexible-articulating instruments and specific technical modifications aids in overcoming surgical challenges.
This approach offers a minimally invasive alternative for radical prostatectomy.