Laparo-endoscopic single-site radical prostatectomy: Feasibility and technique

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Laparoscopy is a standard urological approach.
• Ongoing research aims to reduce invasiveness in minimally invasive surgery.
• Development of new equipment and techniques is crucial for advancing surgical procedures.

Purpose of the Study:

• To develop and apply a novel technique for laparo-endoscopic single site radical prostatectomy (LESS-RP).
• To utilize recent innovations in surgical equipment and approaches for LESS-RP.

Main Methods:

• LESS-RP technique combines standard laparoscopic radical prostatectomy (RP) with urological LESS techniques.
• Utilized low-profile trocars, flexible instruments, and a flexible-tip laparoscope.
• Procedure performed through a single 3-cm infra-umbilical incision without auxiliary needles or trocars.

Main Results:

• Successful completion of LESS-RP via a single operative site.
• Operative time was 424 minutes; hospital stay was 10 days due to vesicourethral leak and ileus.
• Final pathology revealed negative margins and Gleason 3+4 pT2c prostatic adenocarcinoma; anastomotic leak resolved within 4 weeks.

Conclusions:

• Laparo-endoscopic single site radical prostatectomy (LESS-RP) is feasible with current flexible instrumentation and techniques.
• Overcoming the learning curve is essential for successful implementation.
• Prospective studies are required to compare oncological and functional outcomes with laparoscopic and robotic-assisted RP.