MP62-10 LESS (LAPAROENDOSCOPIC SINGLE SITE SURGERY) RADICAL PROSTATECTOMY USING NEEDLE FORCEPS (ENDO RELIEF)

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2015MP62-10 LESS (LAPAROENDOSCOPIC SINGLE SITE SURGERY) RADICAL PROSTATECTOMY USING NEEDLE FORCEPS (ENDO RELIEF) Hidetoshi Akita, Akihiro Nakane, Takahiro Kobayashi, Kenji Yamada, Ryosuke Ando, Yutaro Tanaka, Takehiko Okamura, Takahiro Yasui, and Kenjiro Kohri Hidetoshi AkitaHidetoshi Akita More articles by this author , Akihiro NakaneAkihiro Nakane More articles by this author , Takahiro KobayashiTakahiro Kobayashi More articles by this author , Kenji YamadaKenji Yamada More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Yutaro TanakaYutaro Tanaka More articles by this author , Takehiko OkamuraTakehiko Okamura More articles by this author , Takahiro YasuiTakahiro Yasui More articles by this author , and Kenjiro KohriKenjiro Kohri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2384AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While 5-port laparoendoscopic radical prostatectomy(RP) is standard practice, efforts have been focused in developing a single port surgery, but this is still in the pioneering stage. We had therefore focused on reduced port surgery, using only 2-ports and reported. Endo Relief (Hope Denshi, Chiba, Japan), the new forceps, enabling to attach and remove the handle of needle forceps, has the same shape, size and sort as that of conventional 5-mm forceps and 2.4-mm diameter shaft. Using this forceps, we introduced LESS (laparoendoscopic single site surgery) radical prostatectomy for clinically localized prostate carcinoma and reported this surgical results in this study. METHODS From August 2012 to July 2014, A total 54 patients with clinically localized prostate cancer (cT1c, cT2, cT3aN0M0) were operated on and included in this analysis. A multichannel port (EZ ACCESS, Hakko, Nagano, Japan) with three 5-mm trocars, providing easier instrument handling, was inserted extraperitoneally through a 2.5-cm lower umbilical □gU□h incision. An additional needle forceps was inserted into the left fossa to allow an adequate working angle. RESULTS The operation was successfully completed in all patients. No patient required an additional port and open conversion. One patient (1.9%) had neurovascular bundle preservation surgery and 52 patients (96.3%) had Lymph Node dissection. The median operation time was 205.5(143-396) min, and the blood loss, including urine, was 402.5(2-1517) ml. The median Foley catheter indwelling period was 4 (3-55) days after surgery. Positive Surgical Margin rate was 18.5% (n=10). No intraoperative complications were occurred. CONCLUSIONS Judging from this initial trial, this procedure can be safely carried out, with cosmetic advantages and reduction in post surgical pain. Clinical characteristics and surgical results LESS-RP(n=54) Mean age (range) 69(49-75) BMI 23.4(16.8-30.2) Median PSA (ng/ml) 6.4(4.2-22.2) Clinical T stage cT1c 18(33.3%) cT2 33(61.1%) cT3a 3(5.6%) Biopsy Gleason score 6 or less 17(31.5%) 7 25(46.3%) 8 or more 12(22.2%) Pathological stage pT2 50(98.0%) pT3a 2(3.7%) pT3b 2(3.7%) Pathological Gleason score 6 or less 9(17.7%) 7 29(56.9%) 8 or more 13(25.5%) Extraprostatic extention 4(7.4%) Seminal vesicle invasion 2(3.7%) Positive Surgical margin 10(18.5%) operating time (min) 205.5(143-396) blood loss including urine (ml) 402.5(2-1517) Prostate volume (g) 41.5(21-80) Neuovascular preservation 1(1.9%) Lymph Node Dissection 52(96.3%) Indwelling catheter (day) 4(3-55) PAD Free Rate 1M (M:month) 15.8% 3M 44.7% 6M 78.9% © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e783-e784 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hidetoshi Akita More articles by this author Akihiro Nakane More articles by this author Takahiro Kobayashi More articles by this author Kenji Yamada More articles by this author Ryosuke Ando More articles by this author Yutaro Tanaka More articles by this author Takehiko Okamura More articles by this author Takahiro Yasui More articles by this author Kenjiro Kohri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...