Laparoscopic radical prostatectomy

Laparoscopic radical prostatectomy is a new technique for treating localized prostate cancer

being first described and proven to be feasible in 1997. At our department laparoscopic

radical prostatectomy is proposed as a first-line surgical treatment for organ-confined prostate

cancer. This video shows our technique of laparoscopic radical retropubic prostatectomy step

by step and aims to demonstrate its feasibility and reproducibility.

The patient is placed in dorsal supine position. A Foley catheter is inserted to facilitate the

continuous decompression of the bladder. The first 12 mm trocar is placed through a

minilaparotomy in the umbilicus. An 0o- optical system is inserted to view the abdominal

cavity. The secondary trocars are placed under visual control, a 5 mm trocar in the left iliac

fossa and a 5 mm trocars in the right iliac fossa, a 5 mm trocar between the umbilicus and the

trocar in the right iliac fossa on the lateral margin of the rectus abdominis and a 12 mm trocar

in the midline beween the umbilicus and the pubis for removing the lymph nodal packages,

for introduction the needles and the endobag finally.

The surgeon stands to the left of the patient with an assistant opposite.

The procedure starts with incision of the peritoneum along the vasa deferentia down to the

posterior aspect of the prostate. The vasa deferentia were identified and dissected toward the

prostate.

The accompanying artery of the vas deferens can easily be identified, coagulated and cut. The

seminal duct is cauterised with the bipolar forceps and divided or cut using the ultracision

shear, likewise.