Laparoendoscopic Single-site Surgery Simple Prostatectomy: Initial Report
| Autor: | Alejandro Velasquez, Juan C Astigueta, Otto Moreira, Mihir M. Desai, Inderbir S. Gill, David Canes, Roy Lopez, Oswaldo Carmona, Rene Sotelo, Robert De Andrade |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Prostatic Hyperplasia Port (medical) Biopsy Humans Medicine Aged Prostatectomy medicine.diagnostic_test business.industry Urinary retention Ultrasound Equipment Design Hyperplasia medicine.disease Laparoscopes Surgery Dissection Catheter Laparoscopy medicine.symptom business |
| Zdroj: | Urology. 74:626-630 |
| ISSN: | 0090-4295 |
| Popis: | Objectives To report the first case and detailed technique of laparoendoscopic single-site (LESS) surgery simple prostatectomy for benign hypertrophy. Methods A 67-year-old man presented with acute urinary retention requiring catheterization. Serum prostate-specific antigen level was 5 ng/mL, and a biopsy revealed benign hypertrophy with a transrectal ultrasound volume estimation of 110 mL. LESS simple prostatectomy was performed using a single multilumen port inserted through a solitary 2.5-cm intraumbilical incision. Standard laparoscopic ultrasonic shears and needle drivers, articulating scissors, and specifically designed bent grasping instruments facilitated dissection and suturing. Results An R-port was placed intraperitoneally through a 2.5-cm intraumbilical incision. No extraumbilical skin incisions were made. Total operative time was 120 minutes and estimated blood loss was 200 mL. A closed suction drain was externalized through the umbilical incision. No intraoperative or postoperative complications occurred. Hospital stay was 2 days, the retropubic drain was removed at 3 days, and the catheter removed at 1 week. Specimen weight was 95 g and final pathology revealed benign prostatic hyperplasia. At 3 months follow-up, the patient was completely continent and voiding spontaneously with a Q max. of 85 mL/s. Conclusions We demonstrate technical feasibility and describe the detailed surgical technique of LESS simple prostatectomy. Our initial experience suggests that this technique may be an alternative for large-volume benign prostatic hyperplasia in lieu of open surgery. Comparative studies with other surgical techniques will determine its place in the surgical armamentarium of benign prostatic hyperplasia. |
| Databáze: | OpenAIRE |
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