Extraperitoneal Robotic Assisted Laparoscopic Radical Prostatectomy: The New Approach for Early Prostate Cancer
Keywords:
radical prostatectomy, prostate cancer, robotic prostatectomy, impotencyAbstract
Introduction: Robotic Assisted Laparoscopic Radical Prostatectomy (RALRP) for treatment of localized prostate cancer has been shown to provide the best surgical outcomes in terms of potency and continence. Most RALRP has been done using transperitoneal approach at the expense of higher risk of small bowel injury, ileus and steep trendelenburg position during the procedure. With the use of extraperitoneal approach, those potential complications can be reduced. The program of Extraperitoneal Robotic Assisted Laparoscopic Radical Prostatectomy (EP-RALRP) was started at the Siriraj Hospital. Early result of the authorûs experience was evaluated.
Objective: To evaluate the feasibility of Extraperitoneal Robotic Assisted Laparoscopic Radical Prostatectomy (EP-RALRP) done at Siriraj Hospital.
Materials and methods: 6 patients with localized prostate cancer were undergone Extraperitoneal Robotic Assisted Laparoscopic Radical Prostatectomy (EP-RALRP). Perioperative data was evaluated and reported.
Results: Of 6 patients, 5 patients were undergone EP-RALRP with nerve sparing technique. There was no conversion to RALRP or Laparoscopic Radical Prostatectomy. Mean operative time was 135 minutes. The average blood loss was 450 mls. Mean catheterization time and hospital stay were 6.8 days and 5.4 days, respectively. There was no complication in all patients.
Conclusion: Our early experience has shown that EP-RALRP is feasible and safe. The operation should be encouraged among robotic surgeons as the patients can gain benefit from lower risk of intra- abdominal organ injury and lesser degree of trendelenburg position.
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