Laparoscopically assisted transperineal interstitial brachytherapy with omental flap for locally recurrent...

In most cases, Syed-Neblett template placement is blind with respect to intraperitoneal structures. We evaluated the feasibility of laparoscopic assistance to add a potentially useful dimension to this technique. Two patients successfully underwent laparoscopic lysis of pelvic adhesions, assisted needle placement and creation of an omental pelvic carpet to protect the small intestine. The procedure resulted in avoidance of direct vascular and bowel injury and more appropriate depth of needle placement at 24 and 26 month follow-up, there is no evidence of radiation induced complications. The technique of laparoscopically assisted Syed-Neblett placement as described is feasible and may decrease operative and radiation associated morbidity.