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Laparoscopic Radical prostatectomy

Laparoscopic Radical prostatectomy in patients with ca prostate with large prostate >100gms

Manohar T , Nandkishore S K , Joshi UB.

Centre for advanced urology and minimal invasive surgery

Columbia Asia Hospitals, Bengaluru.

Centre for advanced urology and minimally invasive surgery, Bengaluru

Introduction and objective:

LRP has been the standard of care worldwide with lap assisted robotic prostatectomy becoming the gold standard. However there are scanty literature regarding the problems faced in tackling ca prostate in large prostate size. The objective of this video is to show the intraoperative problems associated with large prostate

Material and methods:

72 year old gentleman having localized ca prostate with prostate size measuring 103 gms with Gleason score of 3+3 and PSA of 8.9 ng/dl was subjected to laparoscopic radical prostatectomy by trans peritoneal approach.

Results:

Overall operative time was 4hours 28 minutes. Blood loss was 112cc. Posterior dissection was difficult and bladder neck was very wide with ureteric orifices near the bladder neck margin. Urethrovesical anastomoses required anterior tennis rocket incision closure. Drain was removed on 2nd POD. Catheter removed 3 weeks post op.

Conclusion:

Laparoscopic radical prostatectomy can be done effectively for large prostates with favorable outcome , however posterior dissection seems to be more difficult and caution should be exercised in preserving the ureteric orifices.