A Novel Practical Trocar Placement Technique for Extraperitoneal Laparoscopic and Robotic-Assisted Laparoscopic Radical Prostatectomy in Patients with Lower Midline Abdominal Incisions

Gözen, Ali Serdar; Akın, Yiğit; Akgül, Murat; Yazıcı, Cenk Murat; Klein, Jan; Rassweiler, Jens

doi:10.1089/lap.2013.0569

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…To overcome limitations, including the extended OT and financial burden of RARP, a narrow operating space with an increased risk of complications of single-port LRP, and a loss of triangulation without efficient cooperation by 3 unfamiliar surgeons of the conventional 4- to 5-port LRP, our team modified the conventional LRP technique and now performs 3-port LRP as our first-line treatment for PCa.Gozen et al [13] have proposed that trocar placement is an important step at the beginning of LRP. Thus, it may affect the continuum of the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Learning Curve of an Innovative “3-Port” Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019

Xu¹,

Ma²,

Peng³

et al. 2021

Urol Int

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Background: “Three-port” laparoscopic radical prostatectomy (LRP) has been applied as a substitution for the conventional 4- to 5-port LRP to treat prostate cancer (PCa) patients in our institution. Objective: To evaluate the learning curve of an innovative “3-port” LRP for PCa patients. Methods: 206 patients who received “3-port” LRP were retrospectively reviewed between January 2016 and December 2019 at our institution. According to the different years of operations performed, all of the patients were divided into group A (No. 1–50), group B (No. 51–107), group C (No. 108–160), and group D (No. 161–206). A learning curve was depicted by analyzing the parameters of operative time (OT), estimated blood loss (EBL), hospitalization, and drainage indwelling days. Results: All groups were comparable with regard to the preoperative characteristics (p > 0.05). The sloping learning curve for the surgeon showed that OT and EBL were strongly correlated with an accumulated experience when compared between group A and the other groups (p < 0.05), denoting that the surgical skill of the “3-port” LRP can be fully mastered after around 50 cases. Although no significant correlation with additional experience was observed in the hospitalization and drainage indwelling days among groups, a tendency towards less hospitalization and drainage indwelling days was still reflected. Conclusions: Our 4-year analysis based on a single-center experience exhibits that the innovative “3-port” LRP appears to be favorable with decreasing tendency in OT and EBL with experience accumulation. In view of its advantage of perioperative parameters with an evidently improved learning curve, it should be recommended in the clinical practice!

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Section: Discussionmentioning

confidence: 99%

Learning Curve of an Innovative “3-Port” Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019

Xu¹,

Ma²,

Peng³

et al. 2021

Urol Int

View full text Add to dashboard Cite

show abstract

“…To overcome limitations, including the extended OT and nancial burden of RARP, a narrow operating space with an increased risk of complications of single-port LRP, and a loss of triangulation without e cient cooperation by three unfamiliar surgeons of the conventional port LRP, our team modi ed the conventional LRP technique and now performs three-port LRP as our rst-line treatment for PCa. Ali SG et al [22] has proposed that trocar placement is an important step at the beginning of LRP. Thus, it may affect the continuum of the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

A Novel “Three-port” Trocar Placement Technique for Laparoscopic Radical Prostatectomy

Song

Luo

et al. 2020

Preprint

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Background: To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients.Methods: We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A: three-port LRP, group B: conventional four-five port LRP, group C: open RP (ORP) and group D: robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages.Results: All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0d, the mean hospitalization was 5.1 d, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization and transfusion in group A were statistically significant among the majority of the other groups (p<0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased.Conclusions: Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice!

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“…Minimally invasive treatment options, such as laparoscopic RP (LRP) and specifically RALP, are the contemporary surgical methods for treatment of organ-confined PCa [16]. However, most of the surgical methods in RALP have been adapted from open and LRP [17].…”

Section: Discussionmentioning

confidence: 99%

Detailed Surgical Anatomy of Prostate: Relationship between Urethra and Dorsal Vein Complex with Apex

Tunç¹,

Akın

Gümüstas³

et al. 2016

Urol Int

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Aim: To describe our surgical technique for dissecting the apex of prostate during robotic-assisted laparoscopic radical prostatectomy (RALP) and detailed surgical anatomy of prostate including relationship between urethra and dorsal vein complex with apex. Materials and Methods: In retrospective view of prospective collected data, 73 patients underwent RALP between December 2012 and September 2014. Surgical anatomy of prostate was revealed in all procedures. Quality of life (QoL) scores were assessed before, immediately after catheter removal, and 1 month after surgery. We divided urinary continence into 3 groups, as very early continence; continence at time of urethral catheter removal, early continent; and continence 1 month after surgery. The rest of the patients were accepted as continence. Results: The mean follow-up was 10.2 ± 5.4 months and mean age was 61.5 ± 6.6. Maximum protection of urethra could be provided in all. Mean catheter removal was 8.9 ± 1.7 days, and all patients were continent at the time of catheter removal. QoL scores before RALP could be protected after surgery (p = 0.2). Neither conversion to open/conventional laparoscopic surgery nor complications related with bladder neck were detected. Conclusions: Our surgical technique can be a strong candidate for being a surgical technique for preserving urethra and very early continence could be provided after surgery.

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A Novel Practical Trocar Placement Technique for Extraperitoneal Laparoscopic and Robotic-Assisted Laparoscopic Radical Prostatectomy in Patients with Lower Midline Abdominal Incisions

Abstract: Our technique seems safe and practical for trocar placements for eLRP and eRALP in patients with lower abdominal incision scars.

Cited by 7 publications

References 23 publications

Learning Curve of an Innovative “3-Port” Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019

Learning Curve of an Innovative “3-Port” Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019

A Novel “Three-port” Trocar Placement Technique for Laparoscopic Radical Prostatectomy

Detailed Surgical Anatomy of Prostate: Relationship between Urethra and Dorsal Vein Complex with Apex

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