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Laparoendoscopic single-site radical prostatectomy: technique and initial outcomes.

Gang Zhu1, Ya-Qun Zhang, Philippe Grange

  • 1Department of Urology, Beijing Hospital of the Ministry of Health, Beijing 100730, China.

Chinese Medical Journal
|October 31, 2012
PubMed
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This study shows laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a safe and feasible technique. Early results indicate acceptable outcomes for patients undergoing this minimally invasive procedure.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a complex urological procedure requiring further evaluation.
  • This study aimed to assess the safety and initial outcomes of pure LESS-RP using standard laparoscopic instruments.

Purpose of the Study:

  • To evaluate the feasibility and initial results of pure laparoendoscopic single-site surgery radical prostatectomy (LESS-RP).
  • To demonstrate the safety and efficacy of LESS-RP using conventional laparoscopic instruments.

Main Methods:

  • A prospective clinical database was used to collect data from six LESS-RP procedures performed between September 2010 and June 2012.
  • Procedures utilized an extra-peritoneal approach with a single port, a flexible tip video-laparoscope, and conventional instruments.

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  • Key parameters assessed included operative time, blood loss, complications, drainage duration, postoperative pain, and pathological and PSA results.

    • Main Results:

    • All six LESS-RP procedures were successfully completed without conversion to standard laparoscopy or open surgery.
    • Mean operative time was 252.5 minutes, with an estimated blood loss of 300 ml. No intraoperative complications occurred.
    • Postoperative outcomes included a mean drainage time of 5.2 days, a low VAPS score of 0.8 on postoperative day one, negative surgical margins, undetectable PSA levels at one month, and full continence at one year.

    Conclusions:

    • Pure laparoendoscopic single-site surgery radical prostatectomy (LESS-RP) is a feasible surgical technique.
    • The initial outcomes of LESS-RP are acceptable, suggesting its potential as a viable option for radical prostatectomy.