The transrectal single port laparoscopic radical prostatectomy in a cadaver model

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Urology

Background:

• Radical prostatectomy is a standard treatment for localized prostate cancer.
• Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers a minimally invasive approach by utilizing internal body routes.
• Transrectal access for NOTES radical prostatectomy has not been extensively explored.

Purpose of the Study:

• To assess the feasibility of laparoscopic trans-rectal NOTES radical prostatectomy.
• To identify key anatomical landmarks for this surgical approach.
• To evaluate the safety and efficacy of the trans-rectal route in a cadaveric model.

Main Methods:

• The study utilized a cadaveric model in an exaggerated lithotomy position.
• A transanal single-port device was inserted following an anterior rectal wall incision.
• Laparoscopic instruments were introduced for dissection and visualization of prostatic anatomy.

Main Results:

• The posterior surface of the prostate and seminal vesicles were readily exposed.
• The integrity of the surgical specimen was maintained during extraction.
• No unintended rectal wall perforations occurred during the procedure.

Conclusions:

• Transrectal NOTES radical prostatectomy is technically feasible in a cadaver model.
• The trans-rectal route provides adequate visualization and access to the prostate.
• Further research should focus on reproducibility and lymph node dissection feasibility.