Extraperitoneal laparoscopic adenomectomy for benign prostatic hyperplasia

Abstract

In our experience, laparoscopic extraperitoneal adenomectomy (Millin's procedure) is feasible with minimal invasion and is a simple straightforward technique.

The Surgical Treatment of a Large Prostatic Adenoma: The Laparoscopic Approach—A Systematic Review

“…Twelve articles described the extraperitoneal approach, 9,10,12,14-22 one described the transperitoneal approach, 11 and one author used both the extra-and transperitoneal approaches. 13 Transverse capsulotomy (Millin) and a pure transvesical (Freyer) approach were performed in nine [10][11][12]16,17,[19][20][21][22] and two studies, 9,13 respectively; two other articles 14,18 described a mixed transvesicalprostatic approach (longitudinal capsulotomy extending from the anterior aspect of the prostate to the anterior part of the bladder wall), while a single study described both the transcapsular and the transvesical-prostatic approaches. 15 Finger assistance was routinely used by McCullough, 16 Chlosta,19 and Hoepffner, 21 as well as when separation of the hyperplastic tissue was difficult.…”

“…Figure 1 provides a four-phase diagram on the flow of information through the different phases of this systematic review, which followed the PRISMA guidelines. 23 Eleven studies were case-series, [9][10][11][12][13][14][17][18][19][21][22] and three were comparative retrospective nonrandomized studies. 15,16,20 Both transperitoneal and extraperitoneal approaches, as well as transvesical (Freyer) and transcapsular (Millin) routes, with or without finger assistance, have been described.…”

Extraperitoneoscopic Transcapsular Adenomectomy: Complications and Functional Results After at Least 1 Year of Followup

“…The only reported drawback was longer operative time. 10,11,12 These studies focused on the perioperative results of the procedure. 8 -12,21-23 However to our knowledge no group has addressed its functional results and complications at longer followup.…”

Single-Port Extraperitoneal Transvesical Adenomectomy: Initial Operative Experience

“…When prostate volume is higher than 80 ml, open surgery, HoLEP or KTP using PVP are the treatments of choice. As the use of laparoscopic surgery continues to expand there have been centers performing laparoscopic simple prostatectomy [6][7][8][9][10][11][12][13] . Laparoscopic simple prostatectomy has the potential to combine the advantages of a minimally invasive technique with the favorable results of open surgery [15] .…”

“…Transvesical or transcapsular simple open prostatectomy, holmium laser enucleation of the prostate (HoLEP) and potassium titanyl phosphate (KTP) using photoselective vaporization of the prostate (PVP) are traditionally the treatment of choice for large adenomas weighing more than 80-100 g [1][2][3][4][5] . Laparoscopic extraperitoneal adenomectomy is a reliable option in centers which are experienced in laparoscopic surgery and offers the same results as traditional methods with less morbidity and postoperative pain [6][7][8][9][10][11][12][13] . The introduction of single-port laparoscopy and natural orifice surgery represents the latest evolution in laparoscopy, characterized by a focus on esthetics and decreased postoperative pain [14] .…”