Laparoscopic Versus Open Simple Prostatectomy: A Comparative Study

Baumert, H.; Ballaro, A.; Dugardin, F.; Kaisary, Amir V.

doi:10.1016/s0022-5347(05)00986-9

Cited by 123 publications

(87 citation statements)

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“…Firstly, many authors report a reduction in the operative duration as the number of procedures performed increases, showing an inverse relationship between operative duration and surgeon experience, probably refl ecting an improvement in laparoscopic skills ( Table 4 ) [ 9, 18,19,25,28,29,33 ] .…”

Section: © 2 0 1 2 T H E a U T H O R S B J U I N T E R N A T I O N A mentioning

confidence: 99%

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Matei¹,

Brescia²,

Mazzoleni

et al. 2012

BJU International

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What ' s known on the subject? and What does the study add?The open simple prostatectomy (OSP) is the ' gold standard ' for high-volume prostate adenomas. It shows very good functional results despite its invasiveness. Minimally invasive approaches, e.g. laparoscopy or holmium laser enucleation of the prostate, have been ' tested ' but none have proved a substitute for the OSP.The robot-assisted approach provides optimal functional results and is easy to perform for experienced robotic surgeons. Extending the indication of robotics to low-incidence pathologies can take advantage of the opportunity to ' see the procedure ' using available information technology, e.g. Youtube TM that presents as an unexpectedly useful tool. OBJECTIVE• To evaluate the outcome, feasibility and reproducibility of a robot-assisted (RA) approach for simple prostatectomy (SP) in cases of high-volume symptomatic benign prostatic hyperplasia (HVS-BPH). PATIENTS AND METHODS• In all, 35 consecutive patients underwent RASP for HVS-BPH using a previously described technique.• The mean prostate volume on preoperative transrectal ultrasonography was 106.6 mL.• All but two patients (with bladder calculi) had an adenoma volume of > 65 mL and 27 (77.1%) > 80 mL. Nine patients (25.7%) had an indwelling catheter.• The mean International Prostate Symptom Score (IPSS) was 28. RESULTS• The median operative duration was 180 min and the mean hospital stay was 3.17 days.• The mean catheter duration was 7.4 days and discontinuous or continuous catheter irrigation was required in two and seven patients, respectively (25.1%).• In all, 10 patients (28.6%) had practically no blood loss. No patients had a transfusion.• The mean postoperative peak urinary fl ow was 18.9 mL/s ( P < 0.001), while the mean IPSS was 7 ( P < 0.001).• For costs, while superfi cially RASP appeared more expensive than open SP (OSP), when considering the higher costs of hospitalisation for OSP, RASP was cheaper. Also, bipolar-TURP costs in patients with large-volume prostates had rather similar costs to RASP. CONCLUSIONS• RASP is a feasible and reproducible procedure with outcome advantages when compared with the open or with other minimally invasive techniques (laser or laparoscopy). As a result, a RA approach is worth considering in cases of high-volume prostate adenomas.• Extending the indication of the RA approach, to the SP, requires fi rstly that the surgeon be profi cient in RA surgery and secondly that as the incidence rate of HVS-BPH is low, the surgeon has had the opportunity to ' see the procedure ' . calculi, diverticula, etc.) were present. In fact, for these patients, OSP seems to be more effective and safer than TURP [ 7 ] .Nevertheless, looking at historical and more recent series [ 1 -7 ] one notices that, while

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Section: © 2 0 1 2 T H E a U T H O R S B J U I N T E R N A T I O N A mentioning

confidence: 99%

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Matei¹,

Brescia²,

Mazzoleni

et al. 2012

BJU International

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“…Vasküler kontrol için dorsal ven kompleksi ve/veya lateral pedikülün ligasyonunun ortalama kanama miktarına anlamlı derecede etkisinin olmadığı da raporlanmıştır. Literatürde laparoskopik transkapsüler (millin) ile transvezikal yaklaşımın sonuçlarının karşılaştırıldığı tek çalışmada her iki cerrahi teknik arasında İPSS ve Qmax değerlerindeki düzelme, operasyon süresi, kanama miktarı, irrigasyon süresi, kateterizasyon süresi ve hastanede kalış süresi bakımından anlamlı fark olmadığı belirtilmiştir (23). Bununla birlikte büyük prostatik median lob varlığında transkapsüler insizyondan …”

Section: Literatür Eşliğinde Laparoskopik Basit Prostatektomi Sonuçlaunclassified

“…Ayrıca, literatürde laparoskopik transperitoneal yaklaşım ile ekstraperitoneal yaklaşımın komplikasyon oranlarının karşılaştıran bir çalışma bulunmamakla birlikte çoğu yazarın ektraperitoneal tekniği tercih ettiği görülmektedir. Literatürde laparoskopik basit prostatektomi ve açık prostatektominin karşılaştırıldığı çalışmalar incelendiğinde laparoskopik basit prostatektominin daha az kan kaybı (23,24,25), daha kısa hastanede kalış süresi (23,24,26) ve daha kısa kateterizasyon süresine (23,24,26) sahip olduğu görülmektedir (Tablo 2). McCullough ve ark.…”

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“…Analjezik kullanım miktarı laparoskopi grubunda daha az olmakla birlikte bu da istatistiksel anlamlı düzeye ulaşmamıştır. Karşılaştırmalı çalışmaların çoğunda laparoskopik basit prostatektominin daha uzun ameliyat süresine sahip olduğu belirtilmektedir (23,24,26). Laparoskopik basit prostatektomi operasyonunun öğrenilmesinin zaman aldığı ve artan tecrübe ile birlikte operasyon süresinin azaldığı, laparoskopik deneyimli cerrahlar için bile bu rakamın 10 civarında olduğu belirtilmektedir (25,21).…”

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Laparoscopic Simple Prostatectomy

Gunseren¹,

Kordan²,

Vuruşkan³

2014

uob

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Büyük hacimli benign prostat hiperplazisi (BPH) cerrahi tedavisinde altın standart tedavi halen açık prostatektomi ameliyatıdır. Teknolojik ilerlemelere paralel olarak holmium lazer prostat enükleasyonu ve laparoskopik basit prostatektomi gibi minimal invazif yöntemler her geçen gün daha fazla kullanılmaya başlanmıştır. Bu derlemede büyük hacimli prostatların cerrahi tedavisinde laparoskopik basit prostatektomi ameliyatı ve sonuçlarının güncel veriler eşliğinde gözden geçirilmesi planlanmıştır. Literatürde laparoskopik basit prostatektomi ile açık prostatektominin karşılaştırıldığı yayınlar sınırlı olmakla birlikte mevcut çalışmaların sonuçları laparoskopik basit prostatektomi ameliyatının açık prostatektomi ameliyatının yakaladığı başarıya benzer sonuçlara ve kabul edilebilir komplikasyon oranlarına sahip olduğunu göstermektedir. Laparoskopik basit prostatektomi büyük hacimli BPH'ların cerrahi tedavisinde kullanılabilecek minimal invazif yöntemlerden biri olarak görünmektedir. Anah tar Ke li me ler: Açık prostatektomi, basit prostatektomi, benign prostat hiperplazisi, laparoskopiOpen prostatectomy is still considered as the gold standard in the surgical treatment of benign prostatic hyperplasia (BPH) with large volume prostates. In conjunction with technological advancements minimal invasive methods such as holmium laser prostate enucleation and laparoscopic simple prostatectomy began to be utilized more often day by day. In this paper, we aimed to review the laparoscopic simple prostatectomy procedure and its outcomes in the treatment of large volume prostates by reviewing the current literature. In the current literature, studies comparing the outcomes of laparoscopic simple prostatectomy with open prostatectomy are limited. Furthermore these studies revealed similar results for both procedures in regards to success and revealed acceptable complication rates for both procedures. Laparoscopic simple prostatectomy seems to be one of the alternative minimal invasive procedures in the treatment of patients with large volume BPH.

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“…After vascular control was achieved, the prostatic capsule and bladder neck were opened in the midline, and adenoma was enucleated. [Baumert et al 2006].…”

Section: Simple Prostatectomymentioning

confidence: 99%

Recent advances in the surgical treatment of benign prostatic hyperplasia

Rocco¹,

Albo²,

Ferreira³

et al. 2011

Therapeutic Advances in Urology

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TURP for many years has been considered the gold standard for surgical treatment of BPH. Symptoms relief, improvement in Maximum flow rate and reduction of post void residual urine have been reported in several experiences. Notwithstanding a satisfactory efficacy, concerns have been reported in terms of safety outcomes:intracapsular perforation, TUR syndrome, bleeding with a higher risk of transfusion particularly in larger prostates have been extensivelyreported in the literature.In the recent years the use of new forms of energy and devices suchas bipolar resector, Ho: YAG and potassium-titanyl-phosphate laserare challenging the role of traditional TURP for BPH surgical treatment.In 1999 TURP represented the 81% of surgical treatment for BPHversus 39% of 2005. Is this a marketing driven change or is there areal advantage in new technologies?We analyzed guidelines and higher evidence studies to evaluate therole of the most relevant new surgical approaches compared to TURPfor the treatment of BPH.In case of prostates of very large size the challenge is ongoing, withminimally invasive laparoscopic approach and most recently roboticapproach. We will evaluate the most recent literature on thisemerging field.

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Laparoscopic Versus Open Simple Prostatectomy: A Comparative Study

Abstract: Laparoscopic simple prostatectomy has inherent advantages over the open technique. Further studies are indicated to determine whether this technique should be considered the treatment of choice for prostatic adenomas too large for safe endoscopic resection.

Cited by 123 publications

References 9 publications

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Robot‐assisted simple prostatectomy (RASP): does it make sense?

Laparoscopic Simple Prostatectomy

Recent advances in the surgical treatment of benign prostatic hyperplasia

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