| Journal: | International braz j urol |
| Database: | PERIÓDICA |
| System number: | 000296650 |
| ISSN: | 1677-5538 |
| Authors: | Tobias-Machado, M1 Forseto-Junior, Pedro Medina, Jimmy A Watanabe, Marcelo Juliano, Roberto V Wroclawski, Eric R |
| Institutions: | 1Faculdade de Medicina do ABC, Disciplina de Urologia, Sao Paulo. Brasil |
| Year: | 2004 |
| Season: | May-Jun |
| Volumen: | 30 |
| Number: | 3 |
| Pages: | 221-226 |
| Country: | Brasil |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Teórico, descriptivo |
| English abstract | INTRODUCTION: The laparoscopic radical prostatectomy is a continually developing technique. Transperitoneal access has been preferred by the majority of centers that employ this technique. Endoscopic extraperitoneal access is used by a few groups, nevertheless it is currently receiving a higher acceptance. In general, the antegrade technique is used, with dissection from the bladder neck to the prostate apex. The objective of the present paper is to describe the extraperitoneal technique with reproduction of the open surgery's surgical steps. SURGICAL TECHNIQUE: With this technique, the dissection of the prostate apex is performed and, following the section of the urethra while preserving the sphincteric apparatus, the Foley catheter is externally tied and internally recovered, which allows cranial traction, similarly to the way it is performed in conventional surgery. The retroprostatic space is posteriorly dissected and the seminal vesicles are identified by anterior and posterior approach, obtaining with this method an optimal exposure of the posterolateral pedicles and the prostate contour. The initial impression is that this technique does not present higher bleeding rate or difficulty level when compared with antegrade surgery. Potential advantages of this technique would be the greater familiarity with surgical steps, isolated extraperitoneal drainage of urine and secretions and a good definition of prostate limits and lateral pedicles, which are critical factors for preserving the neurovascular bundles and avoiding positive |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Neoplasias, Prostatectomía, Laparoscopia, Técnicas quirúrgicas |
| Keyword: | Medicine, Surgery, Neoplasms, Prostatectomy, Laparoscopy, Surgical techniques |
| Full text: | Texto completo (Ver HTML) |
