Laparoscopic prostatic adenomectomy

Extraperitoneal laparoscopic prostatectomy results in a significant decrease in operative time and intraoperative blood loss. This is the case of a 56-year-old man who was found to have prostate cancer because PSA had risen to 4.3. The prostatic biopsy showed a bilateral Gleason 3+4 carcinoma. On clinical exam, he had a small benign prostate. He was a suitable candidate for radical prostatectomy. The surgeon performed this procedure using an extraperitoneal laparoscopic approach and have done this in over 800 cases.

With advances in medical technology, improved optics, and the widespread use of new laparoscopic instrumentation such as ultrasonic cutting and coagulating devices, laparoscopic radical prostatectomy has begun to gain acceptance and was performed increasingly in several high-volume centers worldwide. This video shows a laparoscopic radical prostatectomy using a preperitoneal antegrade approach.

The objective of this film is to demonstrate our operative technique of robotic-assisted laparoscopic radical prostatectomy by Richard Gaston from the Saint Augustin Clinic in Bordeaux. Robotic radical prostatectomy has been performed in our clinic since December 2005. We currently use the Intuitive 4 arm DaVinci system.

The first successful laparoscopic radical prostatectomies were performed by Schuessler in 1992 and 1997. Over the years, the laparoscopic approach has underwent some technical modifications and gained more popularity. In this lecture, Doctor Touijer details the surgical technique.

In this key lecture, Dr. Mandron describes laparoscopic prostatectomy.