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Laparoscopic adenomectomy in BPH-Does it have a role today? |
Manickam Ramalingam,Nachimuthu Sivasankaran,Kallappan Senthil,G.Pai Mizar
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Uro-Nephro Centre, Ganga Medical Centre & Hospitals, Ramnagar, Coimbatore, India |
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Abstract Symptomatic benign prostatic hyperplasia (BPH) is managed medically worldwide, but transurethral resection of prostate (TURP) is the gold standard in refractory cases. Holmium laser enucleation of prostate (HoLEP), laser vaporization are other options which are widely practiced. However in larger glands which are more than 80 g, open adenomectomy is still practiced. Laparoscopic adenomectomy is a minimally invasive option in such circumstances. This article explains about different techniques in minimally invasive adenomectomy and the role for this procedure today. Laparoscopic simple prostatectomy (LSP) has a place in symptomatic, larger prostatic adenoma in the hands of experienced laparoscopic surgeons when open simple prostatectomy is needed.
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Received: 11 October 2017
Published: 07 March 2018
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(A) Ports position for laparoscopic millins; (B) Transverse capsulotomy and enucleation of adenoma; (C) Capusulotomy closure with 2-0 polyglactin; (D) Entrapped specimen retrieved.
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(A) Transverse incision was made below the base of prostate; (B) Bilateral lobes of adenoma; (C) Urethra demonstrated after adenoma removal; (D) Last stage of the procedure showing capsule.
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Author | Patients number | Mean operative time (min) | Blood loss (mL) | Post-operative retention | Postoperative IPSS | Al-Aown et al. [18] | 11 | 99.5 | 205 | NA | 15.27 | Autorino et al. [16] (multi institutional) | 843 | 95 | 280 | 16 | 5 | Martín Garzón et al. [15] | 82 | 161 | 331 | 2 | 7.4 | Lucca et al. [19] (meta analysis) | 163 | 141 | 284 | 21 | 5.9 | Author series | 5 | 150 | 240 | NA | 8 |
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Outcomes of laparoscopic simple prostatectomy.
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