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