PURPOSE: To describe the surgical technique and to report the midterm outcomes of laparoendoscopic single-site radical prostatectomy (LESS-RP) with a homemade single-port device. METHODS: Between August 2009 and October 2011, 20 LESS-RP procedures were performed in a single center by a high-volume surgeon. The surgical methods are outlined in the paper. Preoperative, perioperative, pathologic, midterm oncological, and functional outcomes data were analyzed. RESULTS: On average, patients were 66.1 years old, had a mean body mass index of 24.4 kg/m(2), and a mean prostate-specific antigen (PSA) value of 12.2 ng/ml. No conversion was required; however, a single additional 5-mm port was required in one case. The mean operative time was 248 min; mean estimated blood loss was 94 ml. The mean visual analog pain score at day 3 was 1.5 out of 10, and the mean hospital stay was 15.4 day. Pathology showed one focal positive margin (5 %) in a T3a patient, and mean Gleason score was 6.7. There were a total of four Clavien grade 2 complications. The median follow-up was 22.8 month (range 12-36 month). No PSA recurrence was detected during follow-up period; the potency rate after bilateral neurovascular bundle preservation was 60 % (3/5). Complete continence recovery (no pad) was observed in 85 % of the patients at 1 year, in 90 % at 2 years, and in all three patients at 3 years. CONCLUSIONS: LESS-RP is technically feasible and safe, with excellent cosmesis, low postoperative pain levels, and acceptable midterm oncological, and functional outcomes. Comparative investigation to conventional LRP is needed.
PURPOSE: To describe the surgical technique and to report the midterm outcomes of laparoendoscopic single-site radical prostatectomy (LESS-RP) with a homemade single-port device. METHODS: Between August 2009 and October 2011, 20 LESS-RP procedures were performed in a single center by a high-volume surgeon. The surgical methods are outlined in the paper. Preoperative, perioperative, pathologic, midterm oncological, and functional outcomes data were analyzed. RESULTS: On average, patients were 66.1 years old, had a mean body mass index of 24.4 kg/m(2), and a mean prostate-specific antigen (PSA) value of 12.2 ng/ml. No conversion was required; however, a single additional 5-mm port was required in one case. The mean operative time was 248 min; mean estimated blood loss was 94 ml. The mean visual analog pain score at day 3 was 1.5 out of 10, and the mean hospital stay was 15.4 day. Pathology showed one focal positive margin (5 %) in a T3a patient, and mean Gleason score was 6.7. There were a total of four Clavien grade 2 complications. The median follow-up was 22.8 month (range 12-36 month). No PSA recurrence was detected during follow-up period; the potency rate after bilateral neurovascular bundle preservation was 60 % (3/5). Complete continence recovery (no pad) was observed in 85 % of the patients at 1 year, in 90 % at 2 years, and in all three patients at 3 years. CONCLUSIONS: LESS-RP is technically feasible and safe, with excellent cosmesis, low postoperative pain levels, and acceptable midterm oncological, and functional outcomes. Comparative investigation to conventional LRP is needed.
Authors: Mihir M Desai; Andre K Berger; Ricardo Brandina; Monish Aron; Brian H Irwin; David Canes; Mahesh R Desai; Pradeep P Rao; Rene Sotelo; Robert Stein; Inderbir S Gill Journal: Urology Date: 2009-07-30 Impact factor: 2.649
Authors: Robert J Stein; Wesley M White; Raj K Goel; Brian H Irwin; George Pascal Haber; Jihad H Kaouk Journal: Eur Urol Date: 2009-03-31 Impact factor: 20.096
Authors: Monish Aron; David Canes; Mihir M Desai; Georges-Pascal Haber; Jihad H Kaouk; Inderbir S Gill Journal: BJU Int Date: 2008-09-03 Impact factor: 5.588
Authors: Oscar Darío Martín; Raed A Azhar; Rafael Clavijo; Camilo Gidelman; Luis Medina; Nelson Ramirez Troche; Leonardo Brunacci; René Sotelo Journal: J Robot Surg Date: 2016-04-12