LAPAROSCOPIC RADICAL PROSTATECTOMY: TECHNIQUE - 03/09/11
Resumen |
The goals in radical prostatectomy are curative removal of the organ-confined prostate cancer, return of urinary continence, and preservation of potency if nerve-sparing procedures are performed. With the recent evolution in laparoscopic technology and dexterity, laparoscopic removal of the prostate is now feasible, and several large series have been reported, most notably, those of Guillonneau and Vallancien2 and Abbou and colleagues.1 Although these pioneering reports show tumor control and continence rates comparable with open radical prostatectomy, the technique still is evolving. This update on the laparoscopic technique of radical prostatectomy summarizes the early Cleveland Clinic experience. Although the authors initially focused on the non–nerve-sparing approach, they have since expanded the indications to patients seeking nerve-sparing procedures. This article details the authors' technique of performing non-nerve-sparing and nerve-sparing laparoscopic radical prostatectomy. In developing this technique, which is based on the procedures performed by the two Parisian groups,1, 2 The authors have attempted to integrate the same concerns and technical considerations that routinely are employed in performing open radical prostatectomy (Table 1). It is the authors' hope that this detailed update on surgical technique will provide the advanced laparoscopic surgeon a foundation in initiating and developing an effective laparoscopic prostate cancer program.
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| Address reprint requests to Inderbir S. Gill, MD, MCh, Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute, A-100, The Cleveland Clinic Foundation 9500 Euclid Avenue, Cleveland, Ohio 44195 |
Vol 28 - N° 2
P. 423-436 - mai 2001 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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