MP-06.16: Trans vesico-prostatic approach of laparoscopic simple prostatectomy (LSP): novel technique avoiding post operative bladder irrigation

Massoud, W.; Rebai, N.; Ballaro, A.; Saheb, N.; Schlosser, Joseph V.; Dumonceau, O.; Baumert, H.

doi:10.1016/j.urology.2007.06.282

Cited by 2 publications

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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%

“…Considering the surgeons viewpoint, the laparoscopic approach allows better vision due to image magnifi cation and an almost [ 25 ] 125 → 55 ' 0 ' Sotelo et al [ 9 ] 380 → 85 25.2% (intermittent) Baumert et al [ 18 ] 0.33 + 0.7 Porpiglia et al [ 28 ] 128 → 86.5 385 vs 430 mg Mariano et al [ 29 ] 1.5 days Massoud et al [ 33 ] 0 McCullough et al [ 19 ] 2.4 + 1.6 OSP median 4.0 bloodless fi eld due to the pneumoperitoneum. However, the fl at (two-dimensional) vision, with only three-degrees of freedom for instrument movement and prolonged standing and uncomfortable operating position are important disadvantages determining long learning curves and afterwards, slow refi nement of laparoscopic skills.…”

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%

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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%

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

View full text Add to dashboard Cite

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Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma

Uffort

Jensen

2010

J Robotic Surg

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To substantiate robotic-assisted laparoscopic simple prostatectomy (RLSP) as an alternative minimal invasive approach for the treatment of prostatic adenoma. Retrospective chart review performed with institutional review board (IRB) approval. Demographic and clinical data were collected on 15 men between May 2007 and October 2009 who underwent RLSP for urinary retention secondary to benign prostate hypertrophy (BPH) and complicated by significant median lobe hypertrophy, bladder diverticula and/or stones. International Prostate Symptoms Score (IPSS), postvoid residual (PVR), prostate-specific antigen (PSA) and cystoscopy, urodynamics evaluation, and operative reports were reviewed and analyzed. Average age, PSA, IPSS, and PVR in the series were 65.8 years, 5.17 ng/ml, 23.85, and 265.79 ml, respectively. Eleven men (73%) had urinary retention at presentation, 93.3% had significant intravesical lobe hypertrophy, 13.3% had bladder diverticula with/without stones, and mean prostate volume was 70.85 ml. All the men complained principally of persistent lower urinary tract symptoms (LUTS) despite maximal medical treatment. Mean operative time, estimated blood loss, and adenoma weight were 128.8 min, 139.3 ml, and 46.4 g, respectively. Mean hospital stay was 2.5 days with average postoperative Foley catheter time of 4.6 days. The only significant complication in the series was a postoperative incarcerated hernia in a patient with intraoperative repair of inguinal hernia. Postoperatively, symptom score improved significantly to an average of 8.13 (P = 0.0002), and urine residual also improved to an average of 44.19 ml (P ≤ 0.0001). Significant improvement from the sequelae of BPH can be successfully achieved with RLSP.

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MP-06.16: Trans vesico-prostatic approach of laparoscopic simple prostatectomy (LSP): novel technique avoiding post operative bladder irrigation

Cited by 2 publications

References 0 publications

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

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

Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma

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