Laparoscopic Extraperitoneal Radical Prostatectomy

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dc.authoridTaskiran, Arda Taskin/0000-0003-4556-3475
dc.contributor.authorTekin, Ali
dc.contributor.authorYuksel, Alpaslan
dc.contributor.authorTaskiran, Arda Taskin
dc.contributor.authorSenoglu, Yusuf
dc.contributor.authorKayikci, Muhammet Ali
dc.date.accessioned2021-12-01T18:48:38Z
dc.date.available2021-12-01T18:48:38Z
dc.date.issued2020
dc.department[Belirlenecek]en_US
dc.description.abstractRadical prostatectomy (RP) involves removing the entire prostate with its capsule intact and the seminal vesicles (SV). In this video article, we summarized the extraperitoneal laparoscopic RP with pelvic lymph node dissection procedure along with a video presentation of a case. The patient is placed in a Trendelenburg position. Through a small transverse infraumblical incision, the anterior rectus aponeurosis is identified and incised. The extraperitoneal surgical field is developed bluntly by a balloon dilator, and a 10 mm trocar is placed for the camera. CO2 insufflation at a 12-15 mmHg pressure is established, and the remaining trocars are placed. The fatty tissue is swept laterally to create a wide operative field. The endopelvic fascia is incised on both sides. The levator ani muscle fibers are separated from the lateral surface of the prostate. Dorsal vascular complex (DVC) is ligated with 2 consecutive sutures. Identification of the bladder neck (BN) is critical for proper dissection between the prostate and the BN. BN is incised until the catheter is seen. The urethral catheter is removed and a Bougie dilator is inserted through the urethra to elevate the prostate. With posterior oblique dissection, the vasa deferentia are exposed and clip-ligated, and SVs are identified and freed. Then, lateral pedicles are ligated with hemoclips and divided. Lateral dissection proceeds with an anterolateral incision from the base to the prostatic apex. The neurovascular bundles lie posterolateral to the prostate. Apical dissection and division of the DVC and urethra is a critical step to ensure a safe surgical margin and good postoperative erectile function and continence. The urethra is divided with a small rim on the prostate. The gland is totally freed, put into an endobag, and extracted. The vesicourethral anastomosis is done using two 3-0 monocryl sutures in a running fashion, starting from the posterior in both direction and tied together at the 12 o'clock position, anteriorly.en_US
dc.identifier.doi10.4274/uob.galenos.2020.1837.video
dc.identifier.endpage166en_US
dc.identifier.issn2147-2270
dc.identifier.issue3en_US
dc.identifier.startpage165en_US
dc.identifier.urihttps://doi.org/10.4274/uob.galenos.2020.1837.video
dc.identifier.urihttps://hdl.handle.net/20.500.12684/10574
dc.identifier.volume19en_US
dc.identifier.wosWOS:000562705900015en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherGalenos Yayinciliken_US
dc.relation.ispartofUroonkoloji Bulteni-Bulletin Of Urooncologyen_US
dc.relation.publicationcategoryDiÄŸeren_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectProstate canceren_US
dc.subjectradical prostatectomyen_US
dc.subjectextraperitonealen_US
dc.subjectlaparoscopyen_US
dc.titleLaparoscopic Extraperitoneal Radical Prostatectomyen_US
dc.typeEditorialen_US

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