V5-10 EXTRAPERITEONAL SIMPLE PROSTATECTOMY: A SURGERY FOR BEGINNERS?

Abstract

You have accessJournal of UrologyBPH and Voiding Dysfunction1 Apr 2017V5-10 EXTRAPERITEONAL SIMPLE PROSTATECTOMY: A SURGERY FOR BEGINNERS? Paulo Mota, Nuno Carvalho, Emanuel Carvalho-Dias, Agostinho Cordeiro, João Torres, Nuno Morais, Mário Cerqueira-Alves, Riccardo Autorino, and Estevão Lima Paulo MotaPaulo Mota More articles by this author , Nuno CarvalhoNuno Carvalho More articles by this author , Emanuel Carvalho-DiasEmanuel Carvalho-Dias More articles by this author , Agostinho CordeiroAgostinho Cordeiro More articles by this author , João TorresJoão Torres More articles by this author , Nuno MoraisNuno Morais More articles by this author , Mário Cerqueira-AlvesMário Cerqueira-Alves More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , and Estevão LimaEstevão Lima More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1415AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic simple prostatectomy has been introduced with the purpose of reducing the morbidity associated with classical and standard open surgery. The extraperitoneal (pré-peritoneal) approach adds no technical difficulty, and additionally, allows no surgical violation of the peritoneum. The purpose of this work (video), is to show step-by-step a video-endoscopic extraperitoneal simple prostatectomy technique and present a series of cases of patients treated with this approach, with residents as first surgeons. METHODS To create an educational video that shows in a didactic way the video-endoscopic extraperitoneal simple prostatectomy procedure. Eighteen consecutive cases performed with this technique were analysed. Demographic data and main perioperative outcomes were registed and analyzed. Pre and post-operative International Prostate Symptom Score and maximum flow rate were registered as indicators of relieving of bladder outlet obstruction (BOO). A questionnaire for surgery feasibility was applied to the surgeons. RESULTS An educational video that shows in a didactic way the simple video-endoscopic extraperitoneal simple prostatectomy is presented. The results of a series of 18 consecutive cases are presented: mean prostate volume was 98 ml; mean estimated blood loss was 150 ml (no transfusions required). No intraoperative complications or conversion were recorded. Mean length of hospital stay was 3,5 days. Post-operative complications occurred in a 5,6% rate (self-limiting prolonged haematuria). A significant improvement was observed of subjective and objective indicators of BOO (p<0.05). Retrospective study design, lack of a control arm, and limited follow-up represent major limitations of the present analysis. The surgeons assessment reveals that the technique was easy to perform. CONCLUSIONS This work proves that the video-endoscopic extraperitoneal simple prostatectomy is a safe and effective procedure and certainly a good option for the surgical treatment of high volume benign prostatic hyperplasia. Additionally, in our opinion this surgery appears to be a good procedure for iniciating laparoscopic training, due to the near absence of oncologic concern, and because of its feasibility. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e602 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Paulo Mota More articles by this author Nuno Carvalho More articles by this author Emanuel Carvalho-Dias More articles by this author Agostinho Cordeiro More articles by this author João Torres More articles by this author Nuno Morais More articles by this author Mário Cerqueira-Alves More articles by this author Riccardo Autorino More articles by this author Estevão Lima More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...